A child may die from inability to breathe when the membrane obstructs the airway, unless he has a tracheostomy operation. However, the main reason for death is that the dipitheria germ produces a poison (toxin) which damages the heart muscles and results in cardiac failure. This happens within the first 2 weeks of the illness. When it does occur there may be very rare recoveries.
Another trouble caused by the action of this toxin is paralysis of the swallowing muscles, eye muscles, respiratory muscles, and lastly limb muscles, due to the action of the toxin on nerves. Fortunately, the damage is usually temporary, provided the children get good nursing, they can survive.
As it has these complications of obstruction of the larynx, cardiac damage, and paralysis, dipitheria is a very dangerous disease.
Before 1940 in England and many other European countries it caused many deaths among children, about 3000 a year in England alone.
Another form of the disease is nasal dipitheria characterized by crusts and bloody discharge from the nose, and the third kind is dipitheria of the skin, particularly dipitheria infection of slight cuts and sores, and producing small ulcers. Such sores are very difficult to clear up and often are not diagnosed as dipitheria; this is, in fact, the most common form of dipitheria in many tropical countries and the infection gives children an immunity.
Tonsillar dipitheria was common in Europe until immunization was begun. It is rarely reported in Africa and dipitheria antibodies can be found in the cord blood of nearly all babies born in the continent; the mothers must therefore have come into contact with the germ.
What probably happens is the most cases of it are due to infection with the mild form of the germ, and most of this is skin infection which goes unrecognized.
Cause of Dipitheria
A bacterium called Corynebacterium dipitheria. There are three distinct types of this germ, but only one produces a lot of dangerous toxin.Source. Other children who have the disease. There are also some who carry the germ itself.
Dipitheria Route
Spread by air, droplet infection. Moreover, the discharges from dipitheria ulcers or nasal discharge are very infectious, and can contaminate children's toys, books, or clothes; other children can pick up the infection from these.Susceptibles. Those who have never been infected or immunized before, especially children.
Treatment of Dipitheria
This disease must be treated in hospital as the complications can be fatal. It is treated with antitoxin and penicillin or erythromycin.Some of the complications occur late, for example a child who starts speaking in a strange way due to paralysis of the palate some time after a sore throat should be sent back to hospital.
- Most of dipitheria affects the skin and this needs treatment with penicillin.
Dipitheria Prevention
Immunization against dipitheria has been one of the great triumphs of medicine in this century. What was once a terrible disease which killed many children in Europe has now become very rare because of immunization.The vaccine is injected subcutaneously on three occasions, 4-8 weeks apart. The vaccine is usually now combined with the vaccines against whooping cough and tetanus (triple vaccine, or DPT).
It should be offered to children as early as possible after the age of 2 months. A booster dose is needed 1 - 2 years later, and again once within the third year.
