I heard that diphtheria is making a comeback. I have vaguely heard about it, but am not sure what it is. It seems to be quite obscure, and yet – it is still out there. I heard my grandmother saying it was quite common in her day. What is it?
Diphtheria is a bacterial infection caused by a bacterium called Corynebacterium diphtheriae, which releases toxins.
The word diphtheria is derived from the Greek word "disphteria", which means "leather hide". Hippocrates, the father of medicine, observed it in the fifth century. There were many epidemics of it even back then.
The bacterium was first observed under a microscope in the 19th century.
What is the difference between a bacteria and a bacterium? Is bacterium the plural of bacteria?
Actually, the word bacteria is the plural of bacterium!
I have come across many types of bacteria when I was studying biology in Form 6. I remember the "coccus" and the rod-shaped "bacillus". But what is this corynebacterium, and why is it named so?
Many of us who studied biology or some version of it remember the coccus because they are spherical, and the bacillus because they are rod-shaped.
The corynebacterium are Gram +ve, which means they stain a certain color when you apply the Gram stain on them, and rod-shaped. In some phases of their lives, they become club-shaped.
This is more unusual than other rod-shaped bacteria, hence they inherited their name corynebacterium, because coryneform means club-shaped.
Some strains of Corynebacterium diphtheriae produce a toxin that is responsible for invading your cells and causing tissue destruction and inflammation. Other strains cause tissue damage directly.
Ah! Insightful! How does this particular corynebacterium spread?
It spreads by airborne droplets, when someone infected sneezes or coughs, especially in a crowded space, and people nearby inhale this.
Unfortunately, if you live with someone with diphtheria, the bacteria can also spread through contaminated personal and household items. For example, if you use someone else’s toothbrush or towel, you may also contract it.
That is why our grandmothers told us never to share toothbrushes, towels and personal things!
How will I know if I have diphteria?
After you contract the bacteria from an infected person or source, it takes anywhere from one to 10 days to incubate.
The bacteria then starts to attack the mucus membrane of several of your organs, namely your nose, throat, tonsils and voice box.
Your initial symptoms will depend on which of your tissues has been invaded. You may experience, for instance:
Nose: nasal discharge.
Throat: sore throat and/or hoarseness of voice. The doctor may see a thick, grey membrane covering your throat and tonsils.
Difficulty in breathing and rapid breathing can also happen because this grey membrane is very thick and can obstruct your nose and throat.
Neck: You may feel that the lymph nodes in your neck are swollen or have enlarged. This is related to the infection in your throat and tonsils.
Symptoms of infection: Fever, chills, tiredness and fatigue.
Some infected patients may not even show any symptoms, pretty much like Covid-19. They carry the bacteria around and infect other people without knowing they are doing it.
Diphtheria can also affect your skin, causing pain, redness and swelling, leading to ulcers covered by the same grey whitish membrane, which is the hallmark of diphtheria.
This skin type is especially common in people who do not have good hygiene and live in crowded conditions.
I heard that diphtheria, like Covid-19, can also affect multiple organs. Is this true?
Yes. This is true of many bacterial and viral infections.
Once they spread throughout our bloodstream to our other organs from where they entered, all hell can break loose.
If diphtheria is not treated in time, it can spread to our heart muscle, causing inflammation (myocarditis). This can lead to heart failure and sudden death.
The diphtheria toxin can also spread to our nerves, especially the ones in our throats. This can cause us to have swallowing difficulties. Later, it can spread to the nerves of our arms and legs, causing muscle weakness and inflammation.
It can even spread to our diaphragm, paralysing our breathing and causing death.
How is it treated?
Luckily, unlike Covid-19, there is a vaccine. The reason you don’t hear much of diphtheria these days is because it is part of our DPT (diphtheria, pertussis and tetanus) vaccine given at childhood in Malaysia.
Unfortunately, due to anti-vaxxers, it is making a comeback and threatening the community.
Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email firstname.lastname@example.org. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
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