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Diphtheria

Nicole Dailey

H. C. Wilcox Regional Vocational Technical High School

Biology 2

December 8, 2021

Mr. Perez
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Introduction
Diphtheria is a very serious bacterial infection of the skin or throat that can cause serious

problems in the human body. It effects areas with poor hygiene and large population very

strongly and can be life threatening. Once the disease has progressed it can take a very long time

to recover and will cause huge health problems that will last for the rest of your life.

Etiology

The Diphtheria infection is caused by the bacterium

Corynebacterium diphtheriae, a rod-shaped, gram-positive

bacterium, which does not, in and of itself, cause the

effects of the disease. It instead produces a toxin which is

carried through the bloodstream distributing the toxin

throughout the body to where it will cause the most harm.

Dennis Kunkel Microscopy, Inc.

It is thereafter distributed to the throat or skin causing

lesions or severe throat issues depending on the area infection. It is highly contagious and

possibly life-threatening when not

treated immediately.

The History of Diphtheria

Diphtheria was first found

by Hippocrates in 4 B.C. who gave

the first clinical description of the

disease. It was found in ancient

Syria and Egypt around the same

Benjamin Cummings (Pearson Education, Inc.) (2004)
time as well. In the 17th century the

disease hit Europe gaining the name “El garatillo” (the strangler) in Spain and “the gullet
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disease” in Italy and Sicily. In the 18th century the disease spread to the American colonies

killing whole families in weeks. Diphtheria was first described by Klebs in 1883 to later be

cultivated by Leoffler in 1884 who applied Koch’s postulated to discover C. diphtheria as the

agent of the disease. In 1888 Roux and Yersin discovered the Diphtheria bacteria toxin could be

present in a cell-free environment. Two years later von Behring and Kitasato demonstrated that

the bacteria could be immunized with a heat-attenuated form. Later in 1909 Theobald Smith

showed that the disease could be

neutralized by an antitoxin and Schick

designed a skin test in 1913 to

determine the susceptibility and

immunity to diphtheria in humans. In

1929 Ramon discovered Diphtheria

could be treated with formaldehyde

Public Health Image Library (1941)

which provided the safest and surest

vaccine known to humans, the diphtheria toxoid. Though the vaccine was developed in 1929 it

was not widely distributed until the 1930s and was not combined with the pertussis vaccine and

the tetanus vaccine to make the DTP vaccine until the 1940s. In 1951 the research continued

with Freeman who discovered that the toxin is located on the DNA of the Beta phage and also

with Pappenheimer and his group in the 1960s who looked at the action of the diphtheria toxin.

The mechanism later became a classic model of an ADP-ribosylating bacterial exotoxin. They

discovered the toxin could be neutralized by prior treatment with the diphtheria antitoxin. Due to

the amount of research on diphtheria the etiology, mode of transmission, pathogenic mechanism,
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and molecular basis of exotoxin structure, function, and action have all been clearly established

for better treatment and prevention.

Epidemiology

Diphtheria is common in many underdeveloped countries such as Africa, South Africa,

South and Southeast Asia, the Middle East, Haiti, the Dominican Republic, Algeria, China, and

Ecuador due to poor hygiene and large crowded populations. Diphtheria was also found in the

former Soviet Union after the breakup of the society causing a distinct rise in diphtheria cases in

the 1990s. Though there have been about 0.001 cases per 100,000, or 1 per 1000 cases, in the

United States since 1980 the Soviet Union reported over 150,000 cases beginning in 1990 and

ending in 1998. From those cases about 5,000 of them died. Statistics have also shown that only

30% of the U. S. adults over the age 60 and under the age 69 are still under vaccinated immunity

against the disease.

Signs and Symptoms

Diphtheria can

develop in either respiratory

or cutaneous, or skin,

diphtheria though cutaneous

diphtheria is much rarer and

whose include scaling skin,

sores, blisters all of which Dr. Don McGavin

are painful and cause

swelling and redness.

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Respiratory diphtheria symptoms include sore throat, low-grade fever, headache, nausea muscle

weakness, loss of appetite, enlarged lymph nodes of the neck, grayish colored membrane that

attaches to the tonsils, pharynx, or nose, neck and throat swelling, barking cough, hoarseness

with extensive involvement of the throat, severe breathing problems, bluish coloration of the

skin, bloody watery drainage from the nose, rapid breathing, stirdor, chills, drooling, painful

swallowing, inflammation of the heart, neurologic problems, vision problems, bone infection,

lung infection, heart valve infection, heart rhythm disturbances, distinct and unpleasant breath

odor, polyneuritis, heart failure, blood disorders, paralysis, coma, suffocation, and death. There

can also be no symptoms at all resulting in a carrier having the disease in their DNA and

transmitting it to their children. If a person shows these symptoms seek immediate medical

attention.

Transmission

The Diphtheria

disease can be

transmitted from person

to person through

airborne respiratory

droplets, direct contact

with nasopharyngeal

secretions or skin lesions,

John R. Murphy

physical contact with a

diseased person, breathing in the coughed or sneezed breath of an infected person, or by fomites,

which is very rare. It is not easily transmitted from an object to person but more commonly from
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person to person within a tight area. There is no parasite or vector that specifically carries the

disease nor has it been found to be parasitic.

Treatment

Treatment for diphtheria includes immediate hospitalization in the ICU, isolation, fluids

by IV, antibiotics such as penicillin and erythromycin, oxygen, bed rest, heart monitoring,

insertion of a breathing tube, correction of airway blockages, breathing help from a respirator,

and in advanced and serious cases a tracheotomy. The diphtheria antitoxin should be

administered, by intravenous or intramuscular injection, even before confirmation of the disease.

People exposed to the disease should be kept under surveillance for a minimum of seven days,

have throat cultures taken, and be given the vaccine booster for added protection.

Issues of Resistance and Environmental Issues / Awareness

There is not much known about any issue of resistance in diphtheria though it is known to

attach its DNA or RNA to our DNA and be carried through generations. Though diphtheria does

not have a vector and cannot be easily transmitted from object to person hygiene and population

have a huge effect on the transmission of diphtheria. Vaccinations are a huge way of preventing

the transmission of diphtheria and getting the booster shots as well.

Future of Diphtheria

The future of diphtheria is not specifically clear. Keeping a high immunization level will

help to control the disease as much as possible. Helping countries to develop and increase good

hygiene skills will help to eradicate the disease as much as possible.

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Graphs / Charts / Data

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World Health Organization (2010 July)

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Power of 10 Received from: http://www.nfid.org/powerof10/section2/areyouprotected.html

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National Center for Immunization and Respiratory Diseases: Division of Bacterial Diseases

(2005, October 6) CDC: Diptheria

Retrieved from: http://www.cdc.gov/ncidod/dbmd/diseaseinfo/diptheria_t.htm

Dugdale, David C., III, MD & Zieve, David, MD, MHA (2009, November 9) MedlinePlus

Medical Encyclopedia: Diptheria

Retrieved from: http://www.nlm.nih.goc/medline plus/ency/article/001608.htm

Directors of Health Promotion and Education: Diphtheria Facts (n.d.)

Retrieved from: http://www.dhpe.org/infect/dip.html

Todar, Kenneth, PhD (2009) Diphtheria

Retrieved from: http://www.textbookof bacteriology.net/diphtheria.html

USA Today (n.d.) Health Encyclopedia- Disease and Conditions Diphtheria

Retrieved from: http://www.healthscout.com/ency/68/466/main.html

MedicineNet.com (2008, June 27) Diphtheria

Retrieved from: http://www.medicinenet.com/script/main/art.asp?articlekey=90657

New York State Health Department (2010, October) Diphtheria

Retrieved from:

http://www.health.state.ny.us/diseases/communicable/diphtheria/fact_sheet.htm

Department of Public Health (2007, February & 2008, June 6)

Retrieved from: http://www.ct.gov/dph/cwp/view.asp?a=3136&q=388276&pp=12&n=1

Branca, Barbara et al. (2003) Diseases. Bunch, Bryan (ed.) Diphtheria (vol. 3 pp. 48-49)

Danbury, CT: Grolier Educational

The Merck Manuals (2009, December) Diphtheria

Retrieved from: http://www.merckmanuals.com/professional/sec14/ch172/ch172c.html

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Red Book Online (2006) Diphtheria

Retrieved from: http://aapredbook.aappublications.org/cgi/content/extract/2006/1/3.36

Dennis Kunkel Microscopy, Inc.

Received from: http://www.historyofvaccines.org/content/diphtheria-bacteria-2
Benjamin Cummings (Pearson Education, Inc.) (2004)
Received from:
http://classes.midlandstech.edu/carterp/Courses/bio225/chap24/lecture2.htm
Public Health Image Library (1941)
Received from:
http://commons.wikimedia.org/wiki/File:A_diphtheria_skin_lesion_on_the_leg._PHIL_1
941_lores.jpg
Dr. Don McGavin
Received from:
http://uwadmnweb.uwyo.edu/vetsci/Courses/PATB_4110/2009_lectures/7_resp_cattle/H
TML/Class_Notes.htm
John R. Murphy
Received from: http://129.109.115.69/microbook/ch032.htm
Power of 10
Received from: http://www.nfid.org/powerof10/section2/areyouprotected.html
World Health Organization (2010 July)
Received from:
http://www.who.int/immunization_monitoring/diseases/diphteria/en/index.html