What Is Throat Diphtheria? Australia’s NSW Detects 2 Cases First Time After 1990s. Know Symptoms, Causes, How To Prevent

Throat Diphtheria in Australia: NSW Health has both children who have contracted the potentially deadly bacterial infection are unvaccinated.

Diphtheria is a contagious bacterial infection. It can be fatal in 5-10% of the people infected. ( Image Source :Getty )

Throat Diphtheria in Australia: An Australian state has detected two rare cases of diphtheria of the throat, first time in this century. The two children who contracted the disease in the north coast of New South Wales (NSW) state are both unvaccinated, ABC News reported.

Quoting NSW Health, the report said an unvaccinated toddler was admitted to the intensive care unit of a Queensland hospital after contracting the potentially deadly infection. The child’s close family contact, a 6-year-old, is also in hospital after testing positive.

"The child was not immunised and had the classic features of what you would see with diphtheria," ABC quoted Dr Paul Douglas from the North Coast Public Health Unit as saying. 

NSW Health said the children are receiving antibiotics, and that the authorities are monitoring other close contacts and provided them with antibiotic therapy and anti-toxins.

NSW Health has said the throat diphtheria cases have been the first since the early 1990s. The Northern Rivers saw a case of toxigenic diphtheria in 2018, first time in 17 years, according to the ABC report.

What Is Throat Diphtheria?

Diphtheria is a contagious bacterial infection. In its most severe form, the infection affects the throat and tonsils, resulting in the formation of a greyish-white membrane that makes swallowing or breathing difficult.

There are largely four kinds of diphtheria: 

• Classical respiratory diphtheria (when the infects affects parts of the body involved in breathing)
• Laryngeal (throat) diphtheria
• Nasal diphtheria 
• Cutaneous diphtheria (skin lesions)

While diphtheria is treatable, advanced stages of it can damage the heart, kidneys and nervous system. Diphtheria can be deadly, especially in children, even with treatment, according to experts at Mayo Clinic.

What Causes Diphtheria? What Are The Complications?

According to the US Centers For Disease Control and Prevention (CDC), diphtheria is caused by bacteria strains called 'Corynebacterium diphtheriae', which creates a toxin (poison) that can make people very sick. Diphtheria bacteria spreads from human to human.

Complications from respiratory diphtheria may include:

• Airway blockage
• Damage to the heart muscle (myocarditis)
• Nerve damage (polyneuropathy)
• Loss of the ability to move (paralysis)
• Kidney failure

How Does Diphtheria Spread?

The infection is usually spread through respiratory droplets, like from coughing and sneezing. It can also spread by contact with contaminated surfaces. CDC said people can also get it if they touch infected open sores or ulcers.

What Are Diphtheria Symptoms?

Symptoms of diphtheria depend on the affected body part. The signs usually begin two to five days after a person contracts the infection. These are some of the signs and symptoms, according to Mayo Clinic:

• A thick, grey membrane that covers the throat and tonsils
• Sore throat, hoarseness
• Swollen glands in the neck
• Difficulty or rapid breathing
• Nasal discharge
• Fever,chills
• Tiredness

The CDC says the bacterial infection most commonly affects the respiratory system, which includes parts involved in breathing. It creates a toxin that kills healthy tissues in the system. And within 2-3 days, this dead tissue forms a thick, grey coating that builds up in the throat or nose. This coating, called “pseudomembrane” in medical parlance, can cover tissues in the nose, tonsils, voice box, and throat, which makes it very hard to breathe and swallow, according to the CDC. The condition can be fatal in 5-10% of the people infected. Without treatment, up to half of the patients can die.

Diphtheria Diagnosis And Treatment 

A person is diagnosed with diphtheria if the display the common signs and symptoms. Doctors usually prescribe swabbing the back of the throat or nose to test it for the bacteria that cause the infection, according to the US CDC. A sample can also be taken from an open sore or ulcer to see if the bacteria grow and make a toxin, which confirms the diagnosis of diphtheria.

The CDC says it takes time to grow the bacteria, and hence starting treatment quickly is important if a doctor thinks a patient has diphtheria.

The treatment involves using diphtheria antitoxin to stop the toxin made by the bacteria from damaging the body. This treatment, however, is rarely used for diphtheria skin infections, the CDC notes.

Antibiotics are prescribed to kill the bacteria in all types of diphtheria infections.

The CDC says diphtheria patients usually cannot infect others 48 hours after they begin taking antibiotics. Once the full course of antibiotics is over, tests are done to ensure the bacteria have left the patient’s body.

How To Prevent Diphtheria? What Are Diphtheria Vaccines?

Widespread vaccination is the best and only way to prevent diphtheria. In India, the vaccine is recommended under Universal Immunisation Programme (UIP).

The National Health Portal (NHP) of India says there is no single antigen vaccine for diphtheria, and it is normally given in combination with other vaccines — DPT (Diphtheria+ Pertussis + Tetanus Toxoid) vaccine or pentavalent vaccine (DPT+ Hep B+ Hib vaccine).

Under the UIP, five doses of DPT vaccine are recommended — three doses at 6th, 10th and 14th weeks after the child is born, and two booster doses at 16-24 months and at 5-6 years. The NHP says if any child has valid contraindication to pertussis component of DPT vaccine, they should be given paediatric DT vaccine. 

For adolescents and adults, the diphtheria toxoid is often combined with tetanus toxoid in lower concentration (Td vaccine).

The World Health Organization recommends that Td combination for unvaccinated children aged 7 years and older. They can be given two doses one to two months apart and a third dose after 6-12 months. For same long term protection, subsequent boosters are used at least 1 year apart for a total of 5 doses.

For adults who have completed a primary series, and if they get their last vaccination more than 10 years ago, a booster dose of tetanus and diphtheria toxoid containing the vaccine can be administered, according to the NHP.

For prevention of diphtheria, NSW Health lays down these measures for close contacts:

• Infected people should be kept in isolation until they are disease-free
• Their vaccination status should be checked and a booster given if needed 
• People in close physical contact should to be tested for the infection. They need to be prescribed a course of antibiotics, and their vaccination status should be checked 
• If unvaccinated or not completely vaccinated, the close contacts must complete a full course of diphtheria vaccination. Those vaccinated should get a booster dose if it has been more than five years since the last dose 
• Contacts involved in food handling or caring for children should be excluded from work until they are proven to be infection-free
• Children who are close contacts of a diphtheria patient should be excluded from child care or school until medically cleared