DIPHTHERIA IN ENGLISH

                                             

                               DIPHTHERIA IN ENGLISH

                          watch my youtube video to understand this topic in easy way-

    https://www.youtube.com/watch?v=CKj3GPY9dvc

DIPHTHERIA-

u  Diphtheria is an acute childhood infectious disease caused by toxigenic strains of Corynebacterium diphtheriae. Diphtheria particularly affects children aged 1 to 5 and some time up to 15 years

CAUSATIVE AGENT-

u  Diphtheria is  caused by a bacteria Corynebacterium diphtheriae. itis a gram-positive bacteria. Four types of diphtheria bacilli are differentiated - gravis, mitis, belfantiand intermedius, all are pathogenic to man

HOW IT SPREADS-

u  The source of infection may be a case or carrier:

u  (i) CASE :patients may be clinical or subclinical . Mild cases having no more than a mere running nose or sore throat

u  (ii) CARRIER : Carriers are common sources of infection, their ratio is estimated to be 95 carriers for 5 clinical cases

u  Mode of transmission is –

u  Droplet infection.

u  Direct contact

u  Indirect contact

u   Unless treated, the period of infectivity may vary from 14 to 28 days from the onset of the disease, but carriers may remain infective for much longer periods

INCUBATION PERIOD-

u  The incubation period of diphtheria is 2 to 6 days. Some times it may be longer

CLINICAL MENIFESTATIONS-

u  Diphtheria may affect nasal, pharyngeal or laryngeal mucosa and  patient usually have

u   Sore throat,

u   Difficulty in swallowing, and

u   Low grade fever

u  Throat may show mild erythema, localized exudate, or a pseudo-membrane.

u  The pseudo membrane may be a patch on the posterior pharynx or tonsil. it may cover the entire tonsil, or, less frequently, may spread to cover the soft and hard palates and the posterior portion of the pharynx. In the early stage the pseudo-membrane may be whitish and may wipe off easily.

u  Later the membrane may become thick, blue-white to grey-black, and adherent. Attempts to remove the membrane result in bleeding.

u  Patients with severe disease may have marked oedema of the submandibular area and the anterior portion of the neck, along with lymphadenopathy

u  Distant toxic damage, it may damage heart muscle, liver, kidneys, and adrenals, sometimes accompanied by gross haemorrhage.

u  Irregularities of cardiac rhythm indicate damage to the heart.

u  Later, there may be difficulties with vision, speech, swallowing, or movement of the arms or legs.

u  The toxin also produces nerve damage, resulting often in paralysis of the soft palate, eye muscles, or extremities

u  Some times Non-respiratory diphtheria may affect mucus memberane of the conjunctiva and genitals and skin lesions.

u   The presenting skin lesion is often an ulcer that may be surrounded by erythema and covered with a membrane.

DIAGNOSTIC INVESTIGATIONS-

u  Presence of  sign and symptoms are suggestive of diphtheria.

u  Nasal/oral sab for bacteriological examination to confirm the diagnosis.

u  Open sore sample can also be tested in case of cutaneous diphtheria.

TREATMENT-

u  Antitoxin is helpful to counter the effects of toxin.

u  Antibiotics are also prescribed to kill bacteria present in tissues. Penicillin and erythromycin are drugs of choice

CONTROL AND PREVENTION-

u  The best control measures for diphtheria are notifications and isolation of patient for infective period.

u  There is effective vaccine against diphtheria that is available in combination vaccines as DPT or pentavalent vaccine

u  health education regarding routine immunization is important in prevention of diphtheria as vaccine against diphtheria is included in national immunization schedule in Inida.

u  Concurrent disinfection: Of all articles in contact with patient and all articles soiled by discharges of patient .

u  Terminal disinfection: Of all articles in contact with patient and unit should be disinfected after discharge of the patient.

u  Management of contacts: All close contacts should have cultures taken from nose and throat and be kept under surveillance for 7 days. a 7–10 day course of erythromycin (PO, 40 mg/kg/day for children and 1 gram/day for adults) is recommended for all persons with household exposure to diphtheria