Diphtheria is an acute, highly contagious, toxin-mediated infection that's preventable by vaccine. Diphtheria is rare in the UK but remains a serious problem in some other parts of the world. There have only been eight cases since 1986, and all of those have returned from abroad.
What causes it
Diphtheria is caused by an infection of Corynebacterium diphtheriae, a grampositive rod that usually infects the respiratory tract (primarily the tonsils, nasopharynx and larynx). It's more serious when it occurs in infants because they have smaller airways, which are more susceptible to obstruction because of their size.
How it happens
The infection is transmitted by:
contact with an infected patient's or carrier's nasal, pharyngeal, eye or skin lesion discharge
contact with articles contaminated with the bacteria
ingestion of unpasteurised milk.
Incubation and communicability
The diphtheria incubation period is 2 to 7 days. The period of communicability is 2 to 4 weeks after the onset of symptoms, or until 4 days after the initiation of antibiotic therapy.
What to look for
Symptoms of diphtheria include:
fever
malaise
purulent rhinitis
cough, hoarseness and stridor
cervical lymphadenopathy
pharyngitis.
Obstruction production
The infection, localised to the tonsils and posterior pharynx, is characterised by a thick, patchy, greyish green, membranous lesion that can lead to airway obstruction. Some children also exhibit infectious, ulcerated skin lesions as a manifestation of the disease.