Diphtheria
Medical Author: Steven E. Doerr, MD
Medical Editor: Melissa Conrad Stöppler, MD
What is diphtheria?
Diphtheria is an infectious disease caused by the bacterium Corynebacterium
diphtheriae. This disease primarily affects the mucous membranes of the
respiratory tract (respiratory diphtheria), although it may also affect the skin
(cutaneous diphtheria) and lining tissues in the ear, eye, and the genital
areas.
What is the history of diphtheria?
Throughout history, diphtheria was a leading cause of death among children,
and it was once referred to as the "strangling angel of children." Through the
ages, several epidemics struck Europe, and even the American colonies were
affected by an outbreak in the 18th century. Most recently, in the 1990s, large
outbreaks of diphtheria occurred in Russia and in the former independent states
of the Soviet Union.
The diphtheria bacterium was first identified in the 1880s. In the 1890s,
the antitoxin against diphtheria was developed, with the first vaccine being
developed in the 1920s. With the development and administration of the
diphtheria vaccine, the incidence of diphtheria has decreased significantly.
Though it is still endemic in many parts of the world, respiratory diphtheria
has now became a rare disease in the United States (with up to five cases per year).
Furthermore, whereas diphtheria primarily affected younger children in the prevaccination era, an increasing proportion of cases today occur in
unvaccinated or inadequately immunized adolescents and adults.
What causes diphtheria?
Diphtheria is caused by toxin-producing strains of the gram-positive bacillus
Corynebacterium diphtheriae. There are four biotypes of the bacterium (gravis,
mitis, intermedius, and belfanti), and each differs in the severity of disease
it produces. Nontoxigenic strains are usually responsible for less severe
cutaneous diphtheria.
The signs and symptoms of respiratory diphtheria are caused by the
bacterium's ability to cause a localized inflammatory reaction of the cells
lining the upper respiratory tract. In certain cases, the disease can become
more severe and widespread, and it can involve other organs of the body as well.
Next: How is diphtheria transmitted? »
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