communicable bacterial disease

1. DIPHTHERIA

2. DISCRIPTION
 Diphtheria is an upper respiratory tract disease
characterized by mild fever, sore throat and the
formation of a pseudomembrane on the tonsil (s),
pharynx, and/or nose.
 A local lesion develops in the upper respiratory tract
and involves necrotic injury to epithelial cells.
 As a result of this injury, blood plasma leaks into the
area and a fibrin network forms which is interlaced
with rapidly-growing C. diphtheriae cells.

3. CAUSATIVE ORGANISM
 The disease is caused by
the exotoxin produced by
Corynebacterium
diphtheriae.
 It is Gram-positive, rod
shaped aerobic bacterium
which grows mainly on
throat, larynx and other
portion of URTI.

4. MODE OF SPREAD
 It is spread by droplet infection and through carriers
whether sick or healthy.
 Handling of fomites recently contaminated by nasal
or throat secretions also transmit the disease.
 The droplets containing the bacilli are expelled from
the mouth and nose by coughing, sneezing, spitting,
speaking and kissing.

5. INCUBATION PERIOD
 Incubation period varies from 2 to 5 days.

6. SIGNS AND SYMPTEMS
 The sick persons experience fatigue, fever, a
mild sore throat and problems in swallowing.
Infected children have symptoms that include
chills, nausea, vomiting and a high fever.
 There is difficulty in swallowing and patches
of grayish and yellow membrane appear over
tonsils and throat.

7. Thick Membrane

8. Pseudo membrane

9. ‘Bull Neck’

10. Skin Lesions

11. DIAGNOSIS
 The diagnosis of diphtheria is based on both clinical
symptoms and laboratory findings.
 Clinical criteria include upper respiratory tract
illness with sore throat, mild fever, and an adherent
membrane of the tonsil(s), pharynx, and/or nose.
 Laboratory criteria include isolation of
Corynebacterium diphtheriae from a clinical
specimen, or histopathologic diagnosis of diphtheria.

12. TREATMENT
 Advice complete bed rest to the patient to prevent
cardiac and other complications.
 Erythromycin (orally or by injection) for 14 days or
Procaine penicillin G given intramuscularly for 14
days. Patients with allergies to penicillin G or
erythromycin can use rifampin or clindamycin.

13. PREVENTIONAND CONTROL
 An effective DPT (Diphtheria-Tetanus-Pertussis) in
the form of a combination vaccine is available.
 DPT vaccine is given to all children. Boosters of the
vaccine are recommended for adults because the
benefits of the vaccine decrease with age;
 They are particularly recommended for those
travelling to areas where the disease has not been
eradicated yet.