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Diphtheria is caused by the release of toxins by the bacterium C. diphtheriae, which can cause life-threatening infections. Vaccination has largely eradicated the disease in developed countries, but it still affects thousands in poorer regions. Symptoms include sore throat, cough, and difficulty breathing, and treatment involves antitoxin injections and antibiotics. Prevention through vaccination is the best approach.
Diphtheria toxin is a chemical secreted by an infectious bacterium called Corynebacterium diphtheriae or C. diphtheriae. When a person inhales C. diphtheriae spores, they get stuck in the throat and respiratory tract and start releasing toxins. If the immune system isn’t strong enough to suppress the toxins, a potentially life-threatening infection occurs. Diphtheria has been largely eradicated in developed countries thanks to vaccination efforts, but the disease still affects thousands of people a year in poorer regions without access to quality health care.
Extensive medical research has been conducted on C. diphtheriae and diphtheria toxin. The bacterium is found worldwide and is most prevalent in temperate climates. Most infections occur when pathogens become airborne and are inhaled by a host. Once inside the body, C. diphtheriae spores attach themselves to the mucous membranes lining the lungs, airways, and throat. The bacterium is highly contagious and an individual can contract it after being in close contact with an infected person.
Diphtheria toxin is not always released by C. diphtheriae, and inactive infections generally do not cause health problems. However, some strains of bacteria can be activated by iron from the bloodstream, causing toxins to be excreted. Toxic effects are initially isolated to the original site of infection and can result in sore throat, cough, hoarseness and difficulty breathing.
Over the course of several hours or days, the diphtheria toxin begins to spread through the bloodstream to other parts of the body. A person may develop skin lesions, sinus congestion, and frequent bloody noses. If diphtheria toxin reaches the heart, it can cause severe inflammation and swelling that raises blood pressure and poses a risk of heart attack. Rarely, toxins in the nervous system can lead to partial or total muscle paralysis.
A person showing possible symptoms of diphtheria should be evaluated by a doctor as soon as possible. Blood and sputum tests can confirm the presence of C. diphtheriae and indicate whether or not the toxins have been released. A synthetic antitoxin can be injected directly into the bloodstream which nullifies the effects of the toxin. Additionally, penicillin and other antibiotics are given to help prevent secondary infections. Critically ill patients may need oxygen therapy and close cardiac monitoring to prevent serious complications.
When antitoxin solutions are readily available, most cases of diphtheria can be cured. The best treatment, however, is to prevent infection in the first place and minimize the risks of an outbreak. A diluted form of diphtheria toxin is used as part of a routine childhood vaccination program in most countries. Even adults who have never had diphtheria can be vaccinated.
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