Diphtheria – Why Early Diagnosis Treatment and Prevention are Extremely Important?

Diphtheria – Why Early Diagnosis Treatment and Prevention are Extremely Important?

For the past 300 years, microbiologists have been conducting researches on microorganisms including their action and methodologies. These studies have enabled the experts to find cure and treatments of deadly diseases. Let’s discuss one such common condition which has been wreaking havoc on the human population since ages.


The condition refers to a severe bacterial infection that affects the mucous membranes of the nose and throat. This highly contagious infection causes fever, sore throat, weakness and swelling in glands. If left untreated, diphtheria can cause serious damage to nervous system, kidneys and heart. Death can occur in 5-10 percent of cases.

Causes – How do you catch diphtheria?

Diphtheria is caused by bacteria known as Corynebacterium diphtheria. The disease typically spreads via person to person contact or when contacting objects such as cup, towels or toys having bacteria on them. One can also get diphtheria through sneezing, coughing or blowing nose.

The condition is contagious in nature and even if the infected individual does not show any signs or symptoms, he can still transmit the infection for up to 6 weeks. Once a person is infected, the bacteria in throat and nose release toxic substances which spread through the bloodstream. It then causes a thick gray coating on the nose, throat, airway, and tongue.

In severe cases, the toxins can damage organs such as heart, kidneys, and brain. The damage can lead to fatal complications such as paralysis, myocarditis, and kidney failure.

Is diphtheria common in the present world?

Diphtheria is rare in developed countries due to widespread vaccination programmes. However, developing countries are still in the grip of this disease. There were 2,100 reported deaths worldwide in the year 2015. Though vaccination has reduced the mortality and morbidity rates of diphtheria in India, the resurgence of 3,380 cases and 177 fatalities in the year 2016 (WHO) has raised the eyeballs.

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Risk factors - Is diphtheria common in children?

As mentioned, diphtheria is still a common disease in developing nations due to lack of adequate immunization. The mortality rate of diphtheria is higher in children under the age of 15. Earlier in India, the condition was commonly found in the children aged under 5, but it is now affecting children and adults between 5-19 years of age. Diphtheria can also affect people aged over 60.

Other risk factors include:

  • People who are not properly vaccinated
  • People having a weak immune system such as in case of AIDS
  • Visiting a country that doesn’t provide immunization
  • Living in unhygienic and crowded environments

Signs and symptoms of diphtheria

After contacting the disease, the signs begin to appear within 2-5 days. Some people are asymptomatic, means they don’t experience any symptoms while some other feel mild symptoms. The most classic and visible symptom of diphtheria is thick grayish white membrane covering the tonsils and the throat.

Some other symptoms include:

  • Fever and chills
  • Nasal discharge
  • Swollen glands in the neck
  • Sore throat
  • Drooling

If the infection is left untreated or progresses further, following symptoms can occur.

  • Rapid breathing or difficulty in breathing
  • Fast heart rate
  • Changes in vision
  • Slurred speech

People who live in unhygienic or tropical areas might develop subcutaneous diphtheria, which causes redness, swelling and other skin infections such as ulcers.

How diphtheria is diagnosed?

The condition will be diagnosed based on the symptoms. The doctor would first be conducting the physical examination followed by medical history. If there is gray coating on your throat or tonsils, the diagnosis can be made straightforward. However, the doctor may like to confirm that by taking a sample of the tissue and send it for lab testing.

The doctor may also perform throat culture or sample tissue of the infected skin if he suspects subcutaneous diphtheria. Even if the doctor suspects diphtheria, he or she could start the treatment well before the test reports appear. This is to prevent the progress of the condition.

What treatment options are available for diphtheria?

As diphtheria is a serious condition, the treatment should be given as early as possible. Following treatment methods are used:

Antitoxin injection - The first step towards treating the condition is administering antitoxin or anti-diphtheritic serum injection. This will neutralize the toxin produced by the bacteria. For people allergic to antitoxin, they shall be given small doses first and then gradually increased it to higher amounts.

Antibiotics – The doctor will be prescribing antibiotics such as penicillin or erythromycin to wipe out the infection and prevent it from spreading.

During the treatment, you might be advised to stay in the hospital in order to prevent spread of the infection to others. The doctor may also give antibiotics to those people close to you.

Prevention - Diphtheria vaccination in India

The best way to prevent diphtheria is to get vaccinated against the disease. Diphtheria vaccination programme in India started in 1980s under the Universal Immunization Programme (UIP). Currently, under this programme, 3 doses of diphtheria, tetanus, and pertussis are given starting at the age of six. Following is the vaccination schedule of diphtheria in India:

  1. First dose – At 6 weeks
  2. Second dose – At 10 weeks
  3. Third dose – At 14 weeks
  4. Booster dose – At 16-18 months
  5. Second booster dose – At 4-6 years of age

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The reason behind the prevalence of diphtheria in India is due to inadequate coverage of the primary doses in about 80 percent region across the country. On the other hand, the coverage of booster doses is also irregular, showing a very poor rate of around 60 percent. Some countries like the USA recommend getting booster doses every 10 years in order to deal with decreasing immunity among the adult population.

Diphtheria is a preventable disease. Vaccination is the best answer to counter the disease. However, even if a person is not vaccinated, early diagnosis and prompt treatment can also work in favor. Talk to your doctor and get your child vaccinated today.