Health Care and Diptheria

Diphtheria once was a major cause of illness and death among children, according to the Centers for Disease Control (CDC). The United States recorded 206,000 cases of diphtheria in 1921 and 15,520 deaths. Before there was treatment for diphtheria, up to half of the people who got the disease died from it.

Starting in the 1920s, diphtheria rates dropped quickly in the United States and other countries with the widespread use of vaccines. In the past decade, there were less than five cases of diphtheria in the United States reported to CDC. However, the disease continues to cause illness globally. In 2014, 7,321 cases of diphtheria were reported to the World Health Organization, but there are likely many more cases.

Diphtheria is an infection caused by the Corynebacterium diphtheriae bacterium, according to the CDC. Diphtheria is spread (transmitted) from person to person, usually through respiratory droplets, like from coughing or sneezing. Rarely, people can get sick from touching open sores (skin lesions) or clothes that touched open sores of someone sick with diphtheria.

A person also can get diphtheria by coming in contact with an object, like a toy, that has the bacteria that cause diphtheria on it. For more details, visit this website: https://www.cdc.gov/diphtheria/about/index.html.

Diphtheria typically causes a sore throat, fever, swollen glands and weakness, according to the Mayo Clinic. But the hallmark sign is a sheet of thick, gray material covering the back of your throat, which can block your airway, causing you to struggle for breath. Diphtheria is extremely rare in the United States and other developed countries, thanks to widespread vaccination against the disease.

Medications are available to treat diphtheria. However, in advanced stages, diphtheria can damage your heart, kidneys and nervous system. Even with treatment, diphtheria can be deadly � up to 3 percent of people who get diphtheria die of it. The rate is higher for children under 15. More information on this disease is also available at this site: http://www.mayoclinic.org/diseases-conditions/diphtheria/home/ovc-20300505.

According to HealthLine, in some cases, these toxins can also damage other organs, including the heart, brain and kidneys. This can lead to potentially life-threatening complications, such as myocarditis, paralysis or kidney failure. Children in the United States and Europe are routinely vaccinated against diphtheria, so the condition is rare in these countries. However, diphtheria is still fairly common in developing countries where immunization rates are low.

In these countries, children under age 5 and people over age 60 are particularly at risk of getting diphtheria. People are also at an increased risk of contracting diphtheria if they:

�         Aren�t up to date on their vaccinations.

�         Visit a country that doesn�t provide immunizations.

�         Have an immune system disorder, such as AIDS.

�         Live in unclean or crowded conditions.

You may also develop cutaneous diphtheria, or diphtheria of the skin, if you have poor hygiene or live in a tropical area. Diphtheria of the skin usually causes ulcers and redness in the affected area. More info on diptheria is located at this website: http://www.healthline.com/health/diphtheria#Overview1.

Preventing diphtheria, according to KidsHealth, depends almost completely on giving the diphtheria/tetanus/pertussis vaccine to children (DTaP) and non-immunized adolescents and adults (Tdap). After a single dose of Tdap, adolescents and adults should receive a booster shot with the diphtheria/tetanus vaccine (Td) every 10 years.

Most cases of diphtheria occur in people who haven't received the vaccine at all or haven't received the entire course.The Tdap vaccine is also recommended for all pregnant women during the second half of each pregnancy, regardless of whether or not they had the vaccine before, or when it was last given.

The immunization schedule calls for:

�         DTaP vaccines at 2, 4, and 6 months of age

�         Booster dose given at 12 to 18 months

�         Booster dose given again at 4 to 6 years

�         Tdap vaccine given at 11-12 years

�         Booster shots of Td given every 10 years after that to maintain protection

�         Tdap vaccine during the second half of each pregnant woman's pregnancy

Although most children tolerate it well, the vaccine sometimes causes mild side effects such as redness or tenderness at the injection site, a low-grade fever, or general fussiness or crankiness. Severe complications, such as an allergic reaction, are rare. Much more information on this subject is found at this site: http://kidshealth.org/en/parents/diphtheria.html.

Additional online sources are these sites: http://www.immunize.org/diphtheria/,  https://www.vaccines.gov/diseases/diphtheria/, and this website http://www.vaccineinformation.org/diphtheria/  .

Usually the matter is settled, one way or the other, in 7 to 10 days. Sometimes there are lasting complications such as arthritis, paralysis, or brain damage, according to this website: https://www.drgreene.com/articles/diphtheria/ . Cutaneous diphtheria is not as serious as other forms, but it usually takes up to 3 months to recover � and sometimes a year or more.

Antitoxin and diphtheria antibiotics should be given immediately. Skin lesions need to be thoroughly and carefully cleaned. Other treatment will depend on the clinical status of the victim. It may be minimal or critical care may be required. Most need tube feedings and frequent suctioning. Some need a tracheostomy, according to DrGreene.com. Strict bed rest is recommended for all those with diphtheria for at least 2 or 3 weeks, with heart monitoring at least several times a week for a month or more to detect any damage to the heart. Most people who recover from diphtheria do not develop immunity! They need to be immunized soon after recovery.

Diptheria is deadly, and can be spread easily in many situations. If you or your children have not been immunized against it, visit your doctor or a health care facility as soon as possible to be vaccinated. Preventive care is the first line of defense against this terrible disease.

Until next time.