DIPHTHERIA

DIPHTHERIA. Diphtheria is an infectious disease caused by bacteria that usually produce exotoxins that damage human tissue. The initial symptoms of diphtheria are flu-like but worsen to include fever, swallowing problems, hoarseness, enlarged lymph nodes, coughing, and shortness of breath. Those prone to contract the disease, in addition to those not immunized were children with enlarged tonsils, adenoids or any other throat infection. (1) Some patients may have skin involvement, producing skin ulcers. The history of diphtheria dates back to Hippocrates; once the organisms were identified and found to produce exotoxins, the development of vaccines reduced diphtheria worldwide. (2)

The highest risk factor for developing diphtheria is not getting immunized against the disease; other factors include crowding, immunosuppression, and direct or indirect contact with an infected individual. (3)

The treatment of diphtheria involves early administration of antibiotics; the use of antitoxin, made in horses, is done to neutralize Corynebacterium exotoxin that has not bound to human tissue. (4)

Complications of diphtheria include heart-rhythm problems, sepsis, organ damage, and breathing problems that can be severe enough to cause death. If treated appropriately and early in the infection, the prognosis for diphtheria is usually good; however, if complications develop, the prognosis decreases, especially if sepsis and/or cardiac involvement occurs. It is possible to prevent diphtheria; the main way is to appropriately vaccinate individuals with one of the four major vaccine types available. (5)

Dubuque's experience with diphtheria included an outbreak in September 1896 in the "flats" area. (6) Following a conference between city officials and members of the Dubuque county Medical Society, the city council paid for advertisements to be placed in newspapers urging parents to have their children vaccinated. If families were unable to pay for the treatments, the "anti-toxin" wold be furnished free of charge. (7)

In May 1927 every resident six months of age or older could receive the toxin antitoxin immunization against the disease free of charge. This was made possible through an agreement worked out between the Dubuque County Medical Society and the city council. The immunization was administered in three stages each one week apart. (8)

---

Source:

1. "Health Officers Fight Diphtheria," Dubuque Telegraph-Herald, June 12, 1921, p. 15

2. "Diphtheria," MedicineNet.com. Online: http://www.medicinenet.com/diphtheria_facts/article.htm

3. Ibid.

4. Ibid.

5. Ibid.

6. "Antitoxin Drives Proves Fruitful," Telegraph-Herald, January 2, 1927, p. 2

7. "Caught on the Fly," Dubuque Daily Herald, September 10, 1896, p. 5

8. "Toxin Treatment is Free to All," Telegraph-Herald and Times-Journal, May 29, 1927, p 2