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Diphtheria is a highly infectious disease whose course depends on the place of infection. It is caused by the corynebacterium diphtheriae bacteria, which were previously attacked with an appropriate bacteriophage (virus that attacks bacteria) and have become lysogenic, i.e. they have changed their biological characteristics. This change resulted in obtaining by these bacteria a new gene (tox). Thanks to it, they can produce diphtheria venom, which is responsible for the symptoms of the disease.
Diphtheria(diphtheria) is a very dangerous contagious disease. You can become infected withdiphtheriain several ways. The corynebacterium diphtheriae ( Corynebacterium diphtheriae)bacteria can move both through direct contact, such as touch, and by droplets - when coughing or sneezing.
Each carrier or sick person infects two days before the onset of any symptoms of the disease, throughout its duration and up to three weeks after recovery. This is because the bacteria still remain in the secretions of the mucous membranes and on the skin. Infection is also possible due to contaminated items such as cutlery or dishes, food (e.g. milk).
In extreme cases, it is enough to stay in an endemic diphtheria area to become infected. Fortunately, systematic vaccination of children has eradicated diphtheria in Central and Western Europe.
The firstsymptoms of diphtheriausually occur 2 to 6 days after infection. The course depends on the clinical form. The most common are pharyngeal and laryngeal diphtheria. The disease usually begins with considerable weakness, sore throat and deterioration of well-being. Also quite characteristic are enlarged lymph nodes and a sweet and putrid, bland smell from the mouth.
In the case of diphtheria of the larynx there is also wheezing, coughing, shortness of breath, and in the next stage - silence. The patient has a temperature of up to 38 degrees Celsius, and there is a white coating on the tonsils, which leaves bloody traces after detachment. The whole thing resembles strep throat streptococcal.
If the disease is still untreated, diphtheria infection can lead to paralysis of the soft palate, heart disorders (toxins can cause myocarditis), paralysisnerves (peripheral and cranial), liver or kidney damage. The temperature can reach 40 degrees Celsius.
In the last stage, the submandibular and cervical lymph nodes (the so-called Nero's neck) may become enlarged and die by suffocation. In addition, the disease can also attack: nose, bronchi, eyes, genitals, navel, bronchi and skin in general.
Diphtheria vaccinations are mandatory in Poland. They are subject to children from 7 weeks of age up to 19 years of age inclusive, and people over 19 years of age, particularly vulnerable to infection (e.g. he alth care workers).
The vaccine is administered as a combination of DTP (or DTaP) against diphtheria (D), tetanus (T) and pertussis (P) or as a monovalent vaccine for children and adolescents (D) or adults (d) and a bivalent vaccine for children up to 7 years of age with contraindications to vaccinations with pertussis vaccine (DT), adolescents and adults (DT).
A Td / IPV combination vaccine against tetanus (T), diphtheria (D) and polio (IPV) is also available.
According to the vaccination schedule, children should receive 4 doses of DTP vaccine before starting school and one dose of TD vaccine at 14 and 19 years of age. Adults, on the other hand, should get vaccinated every 10 years.
If diphtheria has already been contracted and properly diagnosed, the person must be hospitalized immediately. He will be given antibiotics (mainly penicillin-based) and antitoxins.
In extreme cases, when the airway is blocked, a tracheotomy will be performed (incision of the larynx and insertion of a tube to allow breathing).
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