Diphtheria is an infectious disease that can cause shortness of breath and suffocation. Especially children used to be a risk group for infection. Thanks to the diphtheria vaccine, the disease is becoming less common – but it has not yet been eradicated!
In this article:
Diphtheria: what is it?
Diphtheria is an infectious disease caused by bacteria (Corynebacterium diphtheriae). The bacterium forms a toxin in the body called diphtheria toxin. It attacks the mucous membranes. Can even destroy body cells.
This is an acute bacterial infection. A distinction is often made between two types of diphtheria:
Pharyngeal diphtheria: The disease usually affects the mucous membranes in the throat and the upper respiratory tract. Because diphtheria used to affect mostly children, this type is also called the "choking angel of children".
Skin or wound diphtheria: If the bacteria get into an open wound, ulcers can also form on the skin. This type of disease is more common in tropical countries.
How to get infected with diphtheria?
Diphtheria is transmitted via droplet infection – i.e. from person to person. Bacteria can be spread by coughing, sneezing and talking. That's why it's also so important to teach your kids hygiene rules and how to sneeze and cough properly (into a cloth or their elbow).
As soon as the first symptoms appear, the infected person is contagious.
What are the symptoms of diphtheria? In most cases, the first symptoms appear a few days after infection. Here is a small selection:
– Swollen mucous membranes – Whitish coatings on the tonsils – Sore throat – Difficulty swallowing – Fever – Swollen lymph nodes – Cough – Hoarseness – Sweet and foul breath – In children, a bloody or purulent discharge from the nose may occur (bloody post-diphtheria)
The most important sign of diphtheria is the whitish coating on the tonsils (a so-called pseudo-membrane). The doctor will also look for this. The plaque can spread to the throat. If you notice it, you should not remove it – otherwise the mucous membrane may start bleeding.
In the beginning, diphtheria is often mistaken for tonsillitis or laryngitis – but since the disease can also become dangerous, a quick diagnosis is important.
You should take care that the disease does not spread too far in the body. If diphtheria spreads to the larynx, your child may experience a barking cough (croup cough) – if the swelling continues, your child may experience shortness of breath.
How dangerous is diphtheria for my child??
In addition to acute respiratory distress, suffocation can occur in the worst case.
If the bacterial toxin spreads and attacks the internal organs, symptoms such as cardiac arrhythmia, pneumonia or kidney failure can occur. If the nervous system is affected, paralysis of the head nerves can occur – nerve damage occurs according to the Professional Association of Pediatricians and Adolescents e.V. (BVKJ) usually occurs only a few weeks after infection.
A particularly serious complication occurs when the diphtheria bacteria attack the heart. If inflammation of the heart muscle occurs, this often ends in cardiac death.
What are the chances of survival?
So a diphtheria can have very bad consequences. The earlier it is noticed and treated, the better. According to the BVKJ, however, between five and 10 percent of those affected die despite timely therapy.
In young children and the elderly, the mortality rate, according to the Professional Association of German Internists e.V. at 40 percent, if treatment is started too late or treated incorrectly.
Diphtheria: When to vaccinate?
The most effective way to prevent infection is timely vaccination. For the diphtheria vaccination, the Standing Commission on Vaccination (STIKO) recommends early immunization of children. Basic immunization consists of four partial vaccinations:
1. Partial vaccination (from 2 months of age). month of life) 2. Partial vaccination (from the age of 3). Month of life) 3. Partial vaccination (from the age of 4 years) is recommended. month of life) 4. Partial vaccination (until the end of the first year of life – between the 11th month of life). and 14. month of life)
Children usually get the vaccination as part of the U-examinations – but you can also make extra vaccination appointments with your pediatrician. Important: If the child has an acute illness, the vaccination may have to be postponed.
The diphtheria vaccination is considered to be quite well tolerated. Side effects occur only in very rare cases. Since diphtheria can be fatal for your child in the worst case, you should consider vaccination in any case.
When does the diphtheria vaccination need to be refreshed??
After basic immunization, vaccination should be boostered at five to six years of age and then between nine and 16 years of age. After that, a booster vaccination is recommended every 10 years.
The situation in Germany: How common is diphtheria??
According to the Federal Center for Health Education (BZgA), due to the high vaccination rates (the vaccination rate is over 97 percent), very few children in Germany still contract diphtheria – there are isolated cases every few years. However, about half of the young people. About one-third of adults not adequately protected.
On the website vaccinate-info.The BZgA also points out the importance of vaccinations for children and adults:
[Vaccination is urgently recommended because diphtheria is still widespread in other countries and can therefore be brought back to Germany at any time. Only as long as a large enough proportion of the population is vaccinated will outbreaks be prevented.
Take a look at your family's vaccination records – even in adulthood, a catch-up vaccination is still possible and advisable.
Where else can you get diphtheria?
Diphtheria can occur anywhere in the world. In the past, according to the Professional Association of German Internists, mainly temperate climates, especially in the fall and winter. "However, in Western industrialized countries, fewer and fewer people have contracted the disease since the 1950s," explains Professor Thomas Loscher in an article. Diphtheria is currently still widespread in many parts of Africa and Asia, as well as in the South Pacific and Eastern Europe. Epidemic-like outbreaks occur here again and again.
The last major diphtheria epidemic in Germany occurred between 1942 and 1954.
Suspicion of diphtheria: What should I do??
Of course, there are also children who cannot be vaccinated due to illnesses or allergies. If you think your child might have diphtheria, you should call your pediatrician immediately. A quick diagnosis and a timely start of treatment are very important.
BUT: Don't just drive by the practice – your child might infect other children that way. Mention your suspicion on the phone, then special preparations can be made in the practice.
At the doctor's, your child will be examined extensively – but a definite diagnosis can only be made after a blood test has been performed. Your doctor can probably assess the risk of diphtheria well – he will tell you what else you should do.
My child has diphtheria: what happens now?
When the diagnosis is definitely made, the treatment begins. In most cases the treatment of diphtheria is similar – but there can be deviations. But here you can trust the doctors – they know their stuff!
By the way: Diphtheria (and even the mere suspicion of the disease) is notifiable in Germany!
If someone is infected with diphtheria, he gets an antidote (a so-called diphtheria toxin). It has the task to neutralize the toxins in the body. However, the antidote is only effective against toxins that move freely in the body. Toxins bound to cells are not neutralized with it.
The bacterium is also fought with an antibiotic – this also limits the production of new toxins. Most often children get the antibiotic for ten days.
#3 bed rest
For about one month it is also called: bed rest. With children it is usually a little more difficult to enforce. Especially, at the end of the treatment, when the child is already feeling better, of course, he wants to romp again. Books, children's series and kid-friendly apps can help keep the sick child in bed.
As diphtheria is highly contagious, infected persons are immediately isolated – i.e. quarantined. From this point on, only people who have been vaccinated may have contact with the sick person – otherwise there is a high risk of infection. Everyone who has had contact with your child is screened – often an antibiotic is also given as a precautionary measure.
Non-vaccinated contacts are also vaccinated immediately. So you don't have to leave your child alone in this case – just be vaccinated yourself.