Diphtheria is a bacterial infection that generally attacks
the mucous membranes in the nose and throat, and can sometimes affect the skin.
This disease is very contagious and includes serious infections that are
potentially life-threatening. Diphtheria is caused by the bacterium Corynebacterium diphtheriae. Diphtheria
is a terrible disease in which the past has caused thousands of deaths, and is
still endemic in undeveloped regions of the world. The survivors of this
disease suffer from paralysis of certain muscles and permanent damage to the
heart and kidneys. Children aged one to ten years are very sensitive to this
disease.
According to the World Health Organization (WHO), there were
7,097 cases of diphtheria reported worldwide in 2016. Among these numbers,
Indonesia also contributed 342 cases. Since 2011, extraordinary events for the
case of diphtheria have become a problem in Indonesia. 3,353 cases of
diphtheria were reported from 2011 to 2016 and this number ranked Indonesia
second after India with the highest number of diphtheria cases. Of the 3,353
people suffering from diphtheria, 110 of them died. Nearly 90% of infected
people do not have a complete history of diphtheria immunization. Overall, 5 to
10 percent of infected people will die. Some people are more vulnerable than
others, with a mortality rate of up to 20 percent in people who are infected
under 5 years or more than 40 years.
Diphtheria Causes
The condition of the disease will spread through direct contact
with objects containing bacteria, such as sharing a drink cup, or the same tissue
or handkerchief use. You can also be affected if there are diphtheria patients
around you who sneeze, cough or runny nose from the nose. Although an infected
person does not necessarily show signs and symptoms, the person is still able
to transmit up to 6 weeks after the initial infection.
Bacteria often infect the nose and throat. Once you are
infected, bacteria will release harmful substances called toxins. The toxin will
spread throughout the body through the bloodstream and often causes a thick
gray layer on the mucosa of the nose, throat, tongue, and airways.
In some cases, this toxin can also go to other organs and
damage other organs such as the heart, brain, and kidneys. This can cause
life-threatening complications such as myocarditis
(inflammation of the lining of the heart), paralysis (muscle weakness), and
kidney failure.
Diphtheria Symptoms
Diphtheria generally has an incubation period or time span
since the bacteria enter the body until the symptoms appear 2 to 5 days.
Symptoms of this disease include:
- The formation of a thin gray layer covering the throat and tonsils.
- Fever and chills.
- Sore throat and hoarseness.
- Difficulty breathing or rapid breathing.
- Swollen lymph nodes in the neck.
- Limp and tired.
- Cold. Initially liquid, but gradually becomes thick and sometimes mixed with blood.
Diphtheria can sometimes attack the skin and cause injuries
such as ulcers (ulcers). The ulcer will heal within a few months, but it will
usually leave marks on the skin.
Diagnosis and Treatment of Diphtheria
To make a diagnosis of diphtheria, the doctor will initially
ask a few questions about the symptoms experienced by the patient. Doctors can
also take samples from the mucus in the throat, nose, or ulcer on the skin for
examination in the laboratory.
If a person is suspected of being strongly infected with
diphtheria, the doctor will immediately start treatment, even before there are
laboratory results. The doctor will advise him to undergo treatment in the
isolation room at the hospital. Then the treatment step will be done with 2
types of drugs, namely antibiotics and antitoxins.
Antibiotics will be given to kill bacteria and cure
infections. The dose of antibiotic use depends on the severity of the symptoms
and the duration of the patient suffering from diphtheria.
Most patients can get out of the isolation room after taking
antibiotics for 2 days. But it is very important for them to continue
completing antibiotic consumption according to the doctor's advice, which is
for 2 weeks.
Patients will then undergo laboratory tests to see whether
there is a diphtheria bacterium in the bloodstream. If diphtheria bacteria are
still found in the patient's body, the doctor will continue to use antibiotics
for 10 days.
Meanwhile, the administration of antitoxin serves to
neutralize diphtheria toxins or toxins that spread in the body. Before giving
antitoxin, the doctor will check whether the patient has an allergy to the drug
or not. If an allergic reaction occurs, the doctor will give a low dose of
antitoxin and slowly increase it while looking at the patient's condition.
For patients who have difficulty breathing due to gray
membrane obstacles in the throat, doctors will recommend the process of
removing the membrane. While patients with diphtheria with ulcer symptoms on
the skin are recommended to thoroughly clean boils with soap and water.
In addition to sufferers, people who are nearby are also
advised to see a doctor because the disease is very contagious. Your doctor
will advise them to take a test and give antibiotics. Sometimes diphtheria
vaccine is also given again if needed. This is done to improve protection
against this disease.
Diphtheria Therapy
Diphtheria is a serious condition, so doctors will provide
therapy quickly and aggressively. The first step of therapy for diphtheria
treatment is antitoxin injection. This antitoxin injection will fight the
toxins produced by bacteria in the body. Be sure to tell the doctor if you have
allergies to certain drugs. If there is indeed an allergy, then the doctor will
be careful in giving antitoxin, starting from a small dose then increasing little
by little. Doctors can also prescribe antibiotics such as penicillin and
erythromycin, to help eradicate infections in the body.
