Diphtheria

Diphtheria is a vaccine-preventable disease that is caused by infection with the bacteria Corynebacterium diphtheria. It is transmitted person to person through respiratory droplets (usually from coughing and sneezing) and through close physical contact.

Diphtheria usually affects the mucous membrane of the upper respiratory tract (nose, tonsils, pharynx, and larynx), the skin, and rarely, other mucous membranes in the body. Even when properly treated, between 5 to 10 percent of diphtheria patients die. When the disease goes untreated, this rate is even higher. 

Diphtheria vaccination produces prolonged, but not lifelong immunity. Immunity wanes with increasing age. Recovering from the disease may induce lifelong immunity, but this is not always the case.

The general symptoms of respiratory diphtheria include sore throat, fever, malaise, difficulty breathing and/or swallowing, and a grey pseudomembrane forming over the tonsils and/or nasopharynx (which can extend into the larynx and trachea, causing obstruction of the airway and suffocation). Severe infection can cause swelling of the neck and enlarged neck lymph nodes, leading to a “bull-neck” appearance. Cutaneous (skin) diphtheria can cause a skin lesion covered by a grey-brown membrane.

Complications of diphtheria include: diphtheric myocarditis (inflammation of the heart muscle), heart rhythm disturbances, infection of the heart valves, congestive heart failure, neurological problems such as paralysis of the soft palate, vision problems, and muscle weakness, and infections (lung, blood or bone infections).

The standard treatment for diphtheria is the immediate administration of diphtheria antitoxin and antibiotics. Any delay in treatment is associated with increased risk for complications and death. After receiving antibiotic treatment, the patient usually becomes non-infectious within 24 hours. The diphtheria antitoxin is not recommended for diphtheria infections that do not show symptoms and is usually of no use in cutaneous (skin) diphtheria. Symptomatic treatment, such as intubation (inserting a breathing tube), may also be necessary.

La diphtérie peut se produire presque n'importe où dans le monde, mais les pays avec le plus de risque sont:

Afrique – Algérie, Angola, Egypte, Niger, Nigéria, Soudan et les pays subsahariens

Amériques – Bolivie, Brésil, Colombie, République dominicaine, Équateur

Asie/Pacifique du Sud – Afghanistan, Bangladesh, Bhoutan, Birmanie (Myanmar), Cambodge, Chine, Inde, Indonésie, Laos, Malaisie, Mongolie, Népal, Pakistan, Papouasie Nouvelle-Guinée, Philippines, Thaïlande et Vietnam

Moyen Orient - Iran, Irak, Arabie saoudite, Syrie, Turquie et Yémen

Europe – Albanie, Russie et les pays de l'ex-Union soviétique