Diphtheria – History & Facts

In the 1920’s the most common cause of death and illness in children was Diphtheria.  DIphtheria is a bacterial infection that causes a grey mucous membrane to form over the back of the throat and tonsils.  In 1921 there were 206,000 reported cases of diphtheria in the United States and 15,520 reported deaths. One of the most well known outbreaks of Diphtheria is the outbreak in Nome, Alaska.  That lead to a sled dog relay of the antitoxin to Nome. The sled dogs traveling over 674miles to carry the antitoxin back to the small town to save the confirmed 20 cases of diphtheria and about 50 others cases that were at risk.  If the town had not received the antitoxin the mortality rate could have grown to about 100% wiping out the entire population in that part of Alaska.

Diphtheria is easily spread by airborne droplets, or handling items from an infected person or being exposed to an infected person.  Thankfully there is a vaccine for diphtheria that now has brought down less than 20,000 cases per year worldwide. And brings the death percentage down to just 3% of people who end up with diphtheria die. 

Diphtheria is a bacterial infection.  Once you get the disease it can take from two to five days for you to become symptomatic.  The first sign of the disease is the grey mucous membrane that forms over the back of the throat and tonsils.  This can then cause you to have a sore throat, hoarseness, swollen glands, difficulty breathing, or rapid breathing, nasal drippage, fever, and chills.  Some people can have diphtheria and not be symptomatic. And the severity of how sick you get depends on the person as well. Some people will develop all of the symptoms where others may only have a sore throat.  You can be a carrier of the disease without showing any symptoms at all.     

Diphtheria affects children so greatly because of the mucousy build up that forms in the back of the throat.  This can cause difficulty breathing and can lead to death by suffocation in small children. Nowadays that medicine has advanced so greatly diphtheria can be treated with a full recovery if caught early enough.  The death rate has dropped significantly. A doctor usually catches diphtheria by looking in the throat and visibly seeing the grey membrane. If the doctor sees this they will take a throat culture to be sure. After the throat culture you doctor is likely to keep you in the hospital under isolation.  Since diphtheria is easily spread you will be kept under isolation until your symptoms have gone away. If you have not been given the vaccine to help prevent diphtheria, a way to treat the disease is an antitoxin.

Diphtheria is caused by a bacterial toxin, so the antitoxin given will stop the bacterial toxin from circulating in the body. The antitoxin will be administered in a vein or muscle.  It works like a neutralizer stopping the bacterial toxin.

Another option is antibiotics. Antibiotics kill bacteria in your body, so giving penicillin or erythromycin can help your body kill off the diphtheria bacteria in your body.

In some cases the build up of the grey matter in the back of the throat gets so thick it can cause difficulty breathing. If this happens your doctor may have to scrape away some of the matter to keep your airway open for you to be able to breathe.  After you have been treated you will need to stay on bed rest to allow your body to heal. Your doctor will tell you to avoid physical exertion as well. If you have diphtheria once it does not give you immunity to not catch it again. So after you have it your doctor will give you the vaccination for diphtheria to help your immune system be stronger towards getting it again.  

Thanks to the vaccine the number of cases per year have decreased exponentially.  As babies born in the United States you are given the first round of diphtheria shots at two months.  There is a series of five shots given to children for diphtheria, called the DTaP vaccine. The first one starting at two months, second at five months, third at six months, fourth given between fifteen to eighteen months, and the last one given between four and six years old.  The problem with vaccine immunity is that it fades over time. Meaning that though we were vaccinated as children the immunity does not carry into our adulthood. Your doctor will recommend getting a booster shot at age eleven or twelve, then another one following every ten years.  If you were not vaccinated with the DTaP vaccine as a child there is an adult vaccine called the TDaP. Same goes with that vaccine immunity though, it starts fading after ten years. 

Since vaccine immunity fades could diphtheria start to come back in full force like it was in the 1920’s?  As of right now there is not increase in cases. But that does not mean that if we do not stick with the booster shots our pack immunity will start to fade away.  Causing us to be more susceptible to this disease again. Thankfully in the United States the DTaP vaccine for children is a required series of shots. Hopefully keeping up with vaccines will help keep our pack immunity strong so that we don’t make ourselves more likely to bring the deadly disease back into normalcy.