What if you get diphtheria

What is diphtheria?

In Germany, on the other hand, there have only been individual diseases, if at all, since the mid-1980s. Most of the people affected became infected during stays abroad. In other western countries, too, diphtheria almost no longer occurs because of the high vaccination rate among small children.

Most diseases occur in autumn and winter. The poison (toxin) of the bacterium, which triggers the typical diphtheria symptoms, is dangerous for humans.

How is diphtheria transmitted from person to person?

The infection occurs mainly via droplet infection. The bacteria get from person to person through close contact when coughing or sneezing. A smear infection on the skin and objects that the sick person has used is also possible, but this occurs less often than the droplet infection. With the skin type of diphtheria (skin diphtheria), the smear infection comes into play.

The time from infection to illness takes between two and five days, rarely up to eight days (incubation period).

What are the symptoms of diphtheria?

The most common form of diphtheria is so-called pharyngeal diphtheria. This is a localized form of the disease in which gray-white coatings (pseudo-membranes) appear on the tonsils and also in the rest of the nasopharynx, which adhere very firmly. Patients may have a sweetish halitosis. Other possible symptoms are bloody discharge from the nose, fever, severe sore throat, and difficulty swallowing. If the larynx is affected, the sick cough and are hoarse. If there is severe swelling in the neck area, those affected may find it difficult to breathe (croup).

Wound diphtheria rather rare

Skin and wound diphtheria can cause symptoms such as reddening of the skin with pain and swelling. In addition, superficial, poorly healing ulcers and suppurations are possible. Skin diphtheria usually arises on the basis of existing skin wounds or changes. This form of diphtheria occurs predominantly in the tropics; in the western world, certain risk groups are affected, such as the homeless, drug or alcohol addicts.

What complications are feared?

With diphtheria, there is a risk of serious complications. The life-threatening painful swelling of the soft tissues of the neck, including the lymph nodes and the larynx, is known as the neck of the caesar. A narrowing of the airways can lead to shortness of breath or attacks of suffocation.

Dangerous myocarditis

If the diphtheria takes a very severe course with a severe feeling of illness and high fever up to shock, this is referred to as toxic diphtheria. Heart muscle inflammation with palpitations and cardiac arrhythmias can occur. There is still a risk of sudden cardiac arrest weeks after the illness, but in many cases the heart recovers completely.

Damage to the nerves is also possible; the nerves of the head are particularly affected, which can lead to impaired vision and swallowing. Other rare complications include kidney failure, brain inflammation (encephalitis) or pulmonary embolism.

Diphtheria can be fatal in about five to ten percent of cases, often caused by a severe narrowing of the airways or an inflammation of the heart muscle. If diphtheria is untreated, mortality can increase to as much as 25 percent.

How is the disease diagnosed?

The typical gray-white deposits on the tonsils and the back of the throat, together with the other symptoms of the patient, make the examining doctor think of diphtheria. By analyzing the throat swab, the diphtheria bacterium can be detected after a few days. The dangerous diphtheria toxin can then also be detected in the isolated pathogens.

How do you treat diphtheria?

If diphtheria is suspected, therapy should begin immediately. For this purpose, the person affected receives an antidote (antitoxin) that binds and neutralizes the diphtheria toxin that has already formed. The antitoxin comes from the blood of horses and is injected into the muscle or a vein. Allergic reactions are possible because the antidote is a protein that is foreign to the human body. The doctor may therefore often perform allergy tests in the form of skin tests before injecting the antitoxin. In addition to the administration of the antidote, therapy with antibiotics is necessary to eliminate the bacteria and prevent the further production of the diphtheria toxin. The affected person is infectious for up to a week after starting antibiotic therapy.

According to the Infection Protection Act in Germany, suspected illness, illness and death from diphtheria must be reported by name to the responsible health department by the doctor.

It is not uncommon for diphtheria to be treated in hospital, possibly in an intensive care unit. The patient's breathing can be significantly impeded if the mucous membrane of the windpipe is inflamed. Then early mechanical ventilation is necessary, for which the affected person is put into an artificial coma.

If the course is uncomplicated, the chances of a complete cure without permanent damage are good.

How can you protect yourself from diphtheria?

The most important protection against diphtheria is vaccination. Since the diphtheria vaccination was introduced in 1955, the disease has become rare in Germany. After the basic vaccination, a booster vaccination is given every ten years in adulthood.

The vaccination against diphtheria is usually carried out in combination with that against tetanus. There is also a combination vaccination which, in addition to tetanus and diphtheria, also protects against whooping cough (pertussis). Adults who have not yet been vaccinated or who do not have a vaccination certificate will receive two vaccinations four to eight weeks apart and a third vaccination six months after the second.

Regular booster vaccinations are important

Booster vaccinations are necessary at least every ten years to avoid diphtheria. Despite a vaccination rate of over 97 percent for small children, unfortunately about half of adolescents or young adults and a third of all adults lack adequate vaccination protection.

Isolate the sick

In order to protect the environment from infection with diphtheria, a sick person should be isolated quickly. Contact persons who do not have adequate vaccination protection must immediately undergo a booster vaccination. They will also have a throat swab examined and therapy with an antibiotic will be carried out.