Diphtheria is a very contagious and potentially life-threatening infection that usually attacks the throat and nose, particularly the area around the upper respiratory tract. In extreme cases, it can attack the nerves and heart as well. There are also milder forms of diphtheria that are limited to the skin. Widespread immunization practices have made diphtheria very rare in the United States. However, cases still occur especially among people who have not been adequately vaccinated.

The word diphtheria has Greek origins and is based on the Greek word for leather, dipthera. The first known reference to the disease was recorded by French physician Pierre Bretonneau in 1826 in reference to the leathery membrane that grows on the tonsils, throat and in the nose.

There was a time when diphtheria was the most dreaded disease in the world and the source of numerous outbreaks. One such epidemic occurred in 1735 to 1740 and reportedly killed as many as 80% of all children below the age of 10 in small towns under New England colonies. The last known diphtheria outbreak of comparative proportions occurred in the United States in the 1920s when 13,000 to 15,000 people were killed a year (from among an estimated 100,000 to 200,000 cases of diphtheria per year). Although it was once quite common, diphtheria has now largely been eradicated in developed nations. In fact, the United States has reported less than five cases a year since 1980.

There are two ways wherein diphtheria is spread – by breathing in an infected person’s secretions (respiratory) or direct physical contact (cutaneous). In its respiratory form, diphtheria takes two to five days to incubate and symptoms include fever and fatigue, a mild sore throat, listlessness, pallor, problems with swallowing and a fast heart rate caused by the toxin released by the bacterium, as well as additional symptoms in children such as nausea, vomiting, chills and a high fever. A chilling symptom is neck swelling, which is associated with a higher risk of death. In its cutaneous form, diphtheria appears as a secondary infection to an existing skin disease. It appears about a week after the primary skin disease.

Diphtheria is considered a medical emergency and delays in treatment can result in death or long-term heart disease. It is highly recommended that persons suffering from diphtheria should be hospitalized until fully recovered. Patients should be given regular doses of diphtheria antitoxin to fight the diphtheria poison and antibiotics to fight the diphtheria bacteria. In some cases, patients may need a respirator to help them breath.

In severe cases, when lymph nodes in the neck swell, doctors strongly recommend seeking immediate medical attention. An increased heart rate may lead to cardiac arrest as well as paralysis in the eye, neck, throat or respiratory muscles. In extreme cases, patients could end up in an intensive care unit (ICU) and administered with a diphtheria anti-toxin.

In addition, people who come into close contact with diphtheria patients should, first of all, already be immunized against the disease. They should also be closely observed for possible symptoms and should be given throat cultures and antibiotics. Even if you have been immunized before, a booster vaccine could still be helpful.

Despite the great strides made in the eradication of diphtheria, it remains a serious concern. Among adults, five to 10% of persons afflicted with diphtheria ultimately die compared to the much higher fatality rate of 20% among children under five years of age and adults over 40. Only recently, the Guinness Book of World records dubbed diphtheria as the “most resurgent disease,” citing its resurgence in 1998 where 5,000 people died and 200,000 others were afflicted with diphtheria in the Commonwealth of Independent States, according to Red Cross estimates.