Most people recover from diphtheria with immediate admission and early management. Diphtheria patients will require bed rest for a period of time once the medicines and anti-toxin have taken action (4 to 6 weeks, or until full recovery). After this time, most people are able to return to their regular activities.
Those who develop complications during treatment should be monitored by health care professionals after discharge. In some cases, additional treatments may be needed.
People can get diphtheria again. Because there is no cure for diphtheria, everyone who has it must be vaccinated to prevent further outbreaks of the disease.
Diphtheria has an incubation period of 2 to 5 days, with a range of 1 to 10 days. Almost every mucosal membrane can be affected by disease. Organisms can be found in discharges and lesions of untreated persons for 2 to 6 weeks following infection. The throat is the most common site of involvement; however, any part of the respiratory system may be affected.
The virus that causes diphtheria infects cells that line your lungs, nose, mouth, and gut. It takes about 24 hours for the virus to show up in a sample of blood taken from someone with diphtheria. After that, the virus lies dormant in some parts of the body for an average of 10 days before it wakes up again and spreads more easily. This second phase of the illness is when people start feeling sick. There are two phases to this illness: a mild fever and sore throat, followed by a severe form without either fever or soreness. The severity of symptoms will depend on how many bacteria are present at the time of infection.
The best defense against diphtheria is a vaccine. A series of shots over several months protects you from the disease.
People who have not been immunized may still get sick from diphtheria, but their symptoms will be much worse if they catch the disease from someone who has not been vaccinated. That's why it's important to make sure children get vaccinated.
1. Hospitalized patients with confirmed pharyngeal diphtheria should be treated with droplet precautions until antimicrobial therapy has been completed and two cultures taken at least 24 hours apart, and at least 24 hours after antimicrobial therapy has been discontinued, fail to show diphtheria organisms. These precautions should be continued until at least 10 days after all signs of diphtheria have resolved.
2. Patients who cannot be hospitalized should be treated in a well-ventilated room with direct exposure to fresh air minimized. Droplets spread by coughing or sneezing may travel up to 6 feet from their source. Close contact with an infected person requires only routine hygiene practices such as washing hands frequently with soap and water or using hand sanitizer that contains at least 60% alcohol.
3. Treatment of pharyngeal diphtheria involves administration of antibiotics. Minimal inhibitory concentrations for common gram-positive and gram-negative bacteria that cause pharyngitis are shown in Table 1. Amoxicillin is the first-line treatment for children older than 2 years. For those younger than 2 years, amoxicillin should be administered no more often than once daily due to concerns about developing resistance. Children with penicillin allergies can be given azithromycin or erythromycin. Ceftriaxone is the drug of choice for adults.
Diphtheria therapy today is utilizing diphtheria antitoxin to prevent the toxin produced by the bacteria from causing harm to the body. This medication is critical for diphtheria respiratory infections, although it is rarely utilized for diphtheria skin infections. Antibiotics are used to destroy and eliminate germs. The primary antibiotic used to treat diphtheria is penicillin. Other antibiotics that have been used include tetracycline, erythromycin, and chloramphenicol.
Diphtheria vaccine has replaced diphtheria antitoxin as the standard treatment because it protects against the disease itself. However, if you have a severe case of diphtheria and require intensive care, then doctors may still give you diphtheria antitoxin. This medicine works by getting into your blood stream and killing any remaining bacteria or toxins that could be harming you.
As with all vaccines, there is a chance you might get sick from the diphtheria vaccine. Symptoms include fever, sore throat, cough, and muscle pain. If you do get sick within four days of receiving the vaccine, call your doctor immediately.
Diphtheria can be fatal if not treated properly. That's why doctors recommend that anyone who suspects they may have the disease seek medical attention immediately.
Diphtheria signs and symptoms often appear six to five days after infection and may include:
1. Place the patient in an isolation room (or area) as quickly as feasible and follow standard, droplet, and contact precautions when caring for the patient. Diphtheria antitoxin (DAT) should be given as soon as feasible.
2. The patient should remain in the isolation room until two consecutive blood cultures are negative.
3. Patients do not need to be isolated beyond this point unless they develop signs or symptoms of complications such as heart failure, paralysis, or hypothyroidism. Isolation may be continued if further doses of diphtheria toxin are administered.
Reporting to the CDC: Healthcare workers should report suspected diphtheria cases to their local health agency and then call the CDC Emergency Operations Center (770) 488-7100 to acquire diphtheria antitoxin for treating the patient. The healthcare worker should avoid contact with eyes, saliva, or urine while reporting a case.
To prevent spread of the disease: Cover coughs and sneezes with a tissue or elbow. Avoid touching your face. Clean and disinfect frequently touched objects such as keys, phones, desks, etc.
Contact your physician if you have any concerns about whether or not you have been exposed to diphtheria.