Diphtheria is also called true croup. The disease is caused by a bacterium that forms a toxic substance, a so-called toxin. The bacterium grows in the throat of the infected person and is transmitted between people through direct contact, sneezing and coughing. The infection can also be spread via wounds during wound dressing if hygiene is deficient. In Sweden, vaccination is included in the childhood vaccination program and diphtheria is unusual. Older people may have poorer basic protection.
Diphtheria usually begins with a throat infection that is similar to sore throat, with symptoms such as fever and difficulty swallowing. In the throat you can see light coatings over the tonsils.
The disease can cause severe throat infections and complications with nerve and heart muscle effects. It also happens that kidney function is affected. Some may even develop paralysis symptoms. You can also bleed easily from the mucous membranes of the mouth and throat. The disease can also cause an infection in the skin, called skin diphtheria. Sometimes the neck swells up and you see a so-called “bull neck” in the patient, which is caused by swollen lymph nodes. Time from infection to illness varies between one to ten days. The mortality rate is 5-10% in areas with modern healthcare. If healthcare is primitive or non-existent, mortality from the disease increases. In the past, diphtheria was called “thrush” because of the respiratory problems that afflicted those who fell ill.
You can be a carrier for months even if you do not show symptoms of the disease yourself.
Basic vaccination is given in three doses when the children are 3, 5 and 12 months old. Thereafter, a refill dose is given at 5-6 years of age and again at 14-16 years of age. Then a new vaccination is recommended every 20 years with a combination vaccine which, in addition to diphtheria, also contains a vaccine against pertussis and tetanus.
Risk areas for diphtheria
Diphtheria is most common in Southeast Asia and Africa.
Treatment of diphtheria
Anyone who falls ill with diphtheria needs hospital care with antibiotic treatment. You can also give an “antitoxin” that counteracts the toxin formation from the bacterium. Sometimes the patient needs medical help due to breathing problems.