Diphtheria

Diphtheria

Diphtheria is no longer common in Canada, but it could easily make a comeback. In the 1990s, with the collapse of the Soviet Union came a breakdown in their routine immunization program. As a result, over 140,000 cases and 4,000 deaths occurred due to diphtheria.

Even today, with modern health care, between five to10% of people who are diagnosed with diphtheria die from the disease.

What is diphtheria?

Diphtheria is a serious, contagious bacterial infection, most often of the nose and throat. It can also infect the skin. The diphtheria bacterium releases a toxin—or poison—that can cause breathing problems and damage the heart and central nervous system.

How does it spread?

It can be spread through coughing, sneezing, or laughing—not to mention kissing, sharing toothbrushes and drinking glasses.

A person infected with diphtheria can spread the disease for up to four weeks, even if they don’t appear to be sick. It can take one to six days from the time of infection for symptoms to appear. So, even if infected people show no symptoms, they can still infect others.

Signs and Symptoms

In its early stages, diphtheria can be mistaken for a bad sore throat. Other symptoms include:

  • low-grade fever
  • swollen neck glands
  • thick, gray or black membrane may form in the nose or throat, leading to difficulty with breathing and swallowing

The infected person may also experience double vision, slurred speech and potentially go into shock.

If diphtheria is not diagnosed and treated immediately, it can spread through the bloodstream and eventually affect the heart and kidneys, and even cause nerve damage and paralysis. Up to 50% of people who don’t get treated die.

Treatment for diphtheria is an antitoxin given as a shot into a muscle or through an intravenous. The infection is then treated with antibiotics, such as penicillin and erythromycin.

How do I protect myself and people around me?

The best protection is immunization.

Diphtheria immunization is “inactivated.” This means that you need to complete the primary series and receive booster doses. If the series is not completed, your body’s immune system will not be able to protect itself from diphtheria. It’s very important that you receive all the shots and they need to be taken on time.

Diphtheria immunization is not given on its own. Throughout the world it is given together with protection against other diseases together in one immunization.

In Yukon, diphtheria is a part of the combination immunization DTaP-HB-IPV-Hib, which protects infants and children from: diphtheria, tetanus, pertusiss, Hepatitis B, polio and Haemophilus influenzae type B, all in one shot.

The Yukon immunization schedule calls for:

  • DTaP-HB-IPV-Hib  immunization at 2, 4 and 6 months of age
  • A dose (DTaP-IPV-Hib) at 18 months
    • After the dose at 18 months, the primary series is complete and children are protected against diphtheria. After this they need a booster dose when they start school, and just like adults, one dose every 10 years.
  • Booster dose (DTaP-IPV) at 4 to 6 years old
  • Booster dose (Tdap)  in Grade 9

As an adult you also need a tetanus-diphtheria booster shot every ten years to remain protected. These boosters keep the immunizations you received as a child working.

Contact your local health centre for drop-in and appointment times to get immunized.

Most children and adults have no reactions to immunization. Some people have minor reactions to the DTaP-IPV-Hib/DTaP-IPV/DTaP/Tdap-IPV/Tdap immunization. These reactions do not interfere with day-to-day activities and go away on their own in two to three days. The most common reaction is swelling and redness with or without tenderness around the injection site. A few people develop fever (one to 18 in 100 children immunized), headaches or muscle pain. If this is the case with you or your child, you many choose to give/take a fever medication such as acetaminophen if the fever is 38.5°C or higher.

Any fever medication, such as acetaminophen, before the immunization is not recommended.

Notes

  • DTaP (diphtheria, tetanus, acellular pertussis) is offered as a combined vaccine with Hepatitis B, Inactivated polio vaccine, and haemophilus influenza type B.
  • Tdap vaccine immunizes against tetanus, diphtheria, and pertussis.
  • The Tdap vaccine is similar to DTaP but with lower concentrations of diphtheria and pertussis. Tdap is used as a booster (to remind your immune system how to fight against diphtheria, tetanus, and pertussis) in children who have completed their primary series.

More About Diphtheria

There was a time in Canada when diphtheria was one of the most common causes of death in children. In 1924, there were 9,000 cases of diphtheria reported. Immunization against diphtheria became more common starting in 1930. As a result, by the mid-1950s, cases of the disease were significantly reduced.

Today, diphtheria is no longer common in many countries, including Canada, thanks to the success of immunization. Diphtheria is still very common in many underdeveloped countries, in people who are not immunized or people whose immunizations are not up to date. It is important to remember that, like all diseases, diphtheria doesn’t care what kind of house you live in, or car you drive, if you live in India or Whitehorse. If it is in your community, if you travel or are exposed to people who travel, and if you are unprotected, then you are at risk.