Diphtheria is an acute infectious disease. It is transmitted by airborne droplets. It is characterized by local inflammation (mainly of the mucous membranes of the oropharynx) and the phenomena of general intoxication with a predominant lesion of the cardiovascular and nervous systems, kidneys.
1. Causes of diphtheria.
The causative agent is diphtheria bacillus, which produces a toxic substance resistant to various factors, can be stored in the environment for up to 15 days. The toxin released by the bacillus dies quickly when heated (+60 ° C), as well as due to direct sunlight. The incubation period of the disease (from the moment of penetration of the pathogen to the onset of symptoms) – from 3 to 10 days.
The source of infection is a sick person or a carrier of diphtheria. The infection is most often transmitted by airborne droplets, transmission factors can also be household items (utensils, toys).
2. Forms of the disease.
Nasal diphtheria: purulent discharge from the nose, a slight spread of fibrinous films (mainly the nasal membrane);
Pharyngeal diphtheria: bad breath, sore throat, difficulty swallowing, salivation, enlarged painful regional lymph nodes, and in severe cases, massive swelling of the soft tissues of the neck. Patients with airway obstruction involve the accessory respiratory muscles, sometimes cyanosis (cyanosis). Fibrinous films, first white, then gray-brown, appear within 2-3 days, cover the tonsils, the posterior wall of the pharynx, soft palate; the mucous membrane of the pharynx is slightly swollen.
Laryngeal and tracheal diphtheria: Swelling of the mucous membranes causes narrowing of the airway. Symptoms: hoarseness, loss of voice, loud “barking” cough, shortness of breath.
Diphtheria of the skin: wound infection; chronic ulcer that does not heal, covered with a dirty gray plaque or filled with necrotic masses, occasionally – symptoms of systemic toxin action.
General symptoms:
- sore throat;
- fever, chills;
- swelling of the mucous membrane of the oropharynx;
- gray plaque on the tonsils, hoarseness;
- swelling of the neck;
- enlargement of the cervical and submandibular lymph nodes.
3. Complications from diphtheria.
Diphtheria toxin can also enter the bloodstream. Almost all organs are sensitive to the toxin, but the most vulnerable are the heart, kidneys, adrenal glands, nervous system. Due to the action of the toxin, protein synthesis is disrupted by cells, which leads to cell death. Complications from diphtheria may include:
airway obstruction;
infectious-toxic shock;
heart muscle damage (myocarditis);
lesions of the nervous system;
nephrosis nephritis;
pulmonary infection (respiratory failure or pneumonia).
4. Treatment and prevention of diphtheria
All patients with diphtheria, regardless of severity, must be hospitalized in an infectious hospital. The main treatment for all forms of diphtheria (except bacteriocarriers) is the introduction of antitoxic diphtheria serum (PDS), which suppresses diphtheria toxin in the blood.
Vaccination of children can be prevented by vaccinating children, according to the Calendar of preventive vaccinations, and revaccination of adults every 10 years. Early detection, isolation and treatment, as well as detection and remediation of bacteria are required to prevent the spread of the disease.
The purpose of vaccination is to create antitoxic immunity against diphtheria (tetanus), the presence of which virtually eliminates the risk of severe diphtheria and helps reduce the incidence.
5. Vaccination of children
Vaccination with AKDP vaccine is carried out at 2 months (first vaccination), 4 months (second vaccination), 6 months (third vaccination). Revaccination is carried out at 18 months.
Revaccination against diphtheria and tetanus at 6 years is carried out with diphtheria-tetanus toxoid (hereinafter – ADP), the next at 16 years – diphtheria-tetanus toxoid with reduced antigen content (hereinafter – ADP-M).