Diphtheria

Diphtheria is a vaccine-preventable, bacterial communicable disease caused by toxin-producing strains of Corynebacterium diphtheriae. Transmission is person-to-person via respiratory droplets or by close contact with a skin lesion or discharge. The incubation period is usually 1 to 5 days, and the disease is characterized by the presence of a firmly adherent, tough pseudo-membrane over the mucous membrane of the upper respiratory tract or in skin ulcers. Symptoms and manifestations include sore throat of variable severity, difficulty in swallowing, and mild fever; life-threatening airway obstruction; and toxin-related systemic complications (including myocarditis and polyneuropathy of cranial and peripheral nerves). Early diagnosis and treatment with diphtheria antitoxin and antibiotics prevent complications and death. Fatality rate ranges between 5% and 10%, even if properly treated, and can exceed 50% among untreated patients. For prevention, a primary series of combined diphtheria–tetanus–pertussis vaccines are recommended for all infants, with booster vaccinations being administered to older children and adults.