Diphtheria

Diphtheria is an acute infectious disease characterized by a local inflammatory process, mainly mucous membranes, common intoxication and toxic damage to the cardiovascular and nervous systems.
Cause. The causative agent of diphtheria is a bacterium that is resistant to high and low temperatures. It can last for a long time on the objects used by the patient. Quickly dies when boiled and exposed to disinfectants. In the process of reproduction in tissues diphtheria bacillus produces a toxin, which plays a major role in the development of the disease.
The source of infection is a sick person and "healthy" carriers of diphtheria bacillus, which produces toxin. The greatest danger is represented by patients. At the same time, at least 90% of diphtheria diseases are associated with infection from "healthy" carriers of the diphtheria pathogen. The causative agent is localized in the nasopharynx and upper parts of the respiratory tract, discharging into the external environment with droplets of nasopharyngeal mucus. The airborne transmission route plays a decisive role in the spread of infection. Diphtheria microbes with droplets of saliva and nasopharyngeal mucus are released into the air by patients and carriers during conversation, sneezing, coughing.
The process of development of the disease. The causative agent is most often implanted in the mucous membranes of throat, less often there is another localization of the entrance gates (skin, eye, ear, wound, etc.). At the site of introduction into the body of diphtheria bacillus develops a local inflammatory process. The toxin of the pathogen extends to the surrounding tissues and causes swelling, fullness, hemorrhage, tissue death and the formation of a fibrinous film. In addition, the toxin, absorbed from the breeding site of the pathogen, enters the bloodstream and spreads through the body, causing common intoxication and damage to the cardiovascular and nervous systems. After the infection, there is persistent immunity.
Signs. The incubation period is 2-10 days. Depending on the localization of the primary process, diphtheria of throat, larynx, nose and rare forms (eyes, ear, skin, wounds, genitalia) are isolated. The most common diphtheria is throat, in which, according to the prevalence of the raids, the following forms are distinguished: localized (islanded, membranous) and widespread. Diphtheria of throat is characterized by fever, intoxication and local inflammatory changes of palatine tonsils.
The disease begins with weakness, malaise, and anorexia. The peculiarity of fever in diphtheria is its short-term and not pronounced character. Body temperature, often the entire period of the disease, can not exceed 38o C, and sometimes normal, or rise to 38oC in the first 2-4 days, then coming to normal. Toxic forms of diphtheria can be accompanied by high fever for 4-5 days, but then local and general changes develop against the background of normal body temperature.
Intoxication in diphtheria, unlike other infectious diseases, is manifested by lethargy, drowsiness, adynamy, pallor of the skin and is not accompanied by severe chills, severe headache, body aches.
Simultaneously with general toxic syndrome there are local changes. A peculiarity of this inflammatory process with diphtheria of the pharynx is a slight hyperemia with a bluish tinge, pronounced edema, the presence of a plaque on the surface of the affected tonsils with a slight expression of pain in the throat during swallowing and angular maxillary lymph nodes when they are probed.
Complications. Complications of diphtheria are caused by the action on the body of diphtheria toxin - myocarditis, paralysis of the heart muscle, paralysis of the respiratory muscles and diaphragm, neuritis.
Recognition of the disease. For laboratory confirmation of the diagnosis, a smear from the throat and nose is examined.
Urgent care. Patients with diphtheria, as well as patients with suspected diphtheria, should be immediately isolated and evacuated to the infectious disease department of the hospital, where serum protivodiphtheria is introduced and further treatment is performed.
Prevention of disease. The main measure for the prevention of diphtheria is properly organized and timely vaccinations with diphtheria toxoid. For this purpose, every 10 years, should be carried out a booster against diphtheria.
The apartment is disinfected.
For persons who have come into contact with a patient or a diphtheria bacillus carrier, medical supervision is established for 7 days and a bacteriological study for carriage.