Diphtheria Facts (cont.)

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What are the symptoms and signs of diphtheria?

Initially the symptoms of diphtheria may be similar to a viral upper respiratory infection but symptoms worsen over about two to five days. The symptoms may include a sore throat, fever, difficulty swallowing, weakness, hoarseness, headache, enlarged lymph nodes producing a thick or "bull" neck (resembling mumps), cough, and difficulty breathing. As the disease progresses, an adherent membrane (pseudomembrane) may begin to cover the tonsils, pharynx, and/or nasal tissues. If untreated, the pseudomembrane can extend into the larynx and trachea and obstruct the airway; this can lead to death.

Cutaneous diphtheria symptoms include initial reddish lesions that are painful and that may develop into nonhealing ulcers. Some ulcers may be covered by a gray-colored membrane.

What is the history of diphtheria?

Diphtheria has been infecting humans for centuries. Hippocrates produced the first documented description of diphtheria in the fifth century BC. The disease has been a leader in causing death, especially in children, for many centuries. The bacteria were first identified in the 1880s by F. Loffler. In the 1890s, exotoxins were discovered. The first diphtheria toxoid vaccine was produced in the 1920s. Vaccination programs have decreased the incidence of diphtheria worldwide, however, when vaccination rates drop, infection rates of diphtheria rise and, occasionally, serious outbreaks of the disease occur. For example, in the 1990s, an epidemic in Russia caused about 5,000 deaths according to the World Health Organization's (WHO) statistics, and from about 1993-2003, Latvia reported 101 deaths from diphtheria.

Before the diphtheria vaccination program, there were 100,000 to 200,000 cases of diphtheria each year in the U.S., leading to approximately 15,000 to 20,000 deaths. According to the CDC, less than five cases have been reported in the U.S. in the last 10 years.

Medically Reviewed by a Doctor on 12/8/2014

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