About 2 months ago, a child arrives at Pediatric Emergencies Pedro Emilio Carrillo Hospital, in the city of Valera Venezuela. With symptoms of a diphtheria, a disease that had been eradicated more than 3 decades ago in Venezuela and strangely this child suffered the symptoms of this disease. At the beginning of the 20th century, diphtheria was the tenth cause of death in the world. Thanks to the vaccine, safe and effective, its incidence has been significantly reduced, but it is still endemic in many countries.

Immediately my colleagues approached me because my face was astonished, during my university career, the teachers told us how this disease killed many children worldwide, it was like Yellow fever in its time, but it was completely eradicated. My colleagues asked me: "Joha is what we think" - and I reply: apparently, we have to analyze the patient well and diagnose and confirm if it really is diphtheria, although I was surprised I could not believe. Well after reviewing the child well, the diagnosis was expected, many specialists came to ask me, of course they all had their gloves and masks, because as few know this disease is spread through the person's saliva, then and they were all taking their forecasts. Immediately the hospital director ordered to close the pediatric emergency room and not allow access for any child, unless it is a very serious emergency, really this is very delicate.

To this day it is still closed, it is more when my daughter fractured her elbow and the father brought her on the way, I said: "PLEASE ENTER FOR EMERGENCIES OF ADULTS", and the very surprised asks me why? bring her here, in pediatrics to diphtheria, and even he is astonished: he replied: "is serious? diphtheria ?? holy god, but if that disease no longer exists !!! .. That happened already about a month.

The area of ​​pediatrics was totally sterilized, but there is still the fear that the virus is still found, the other areas of the hospital are constantly vigilant about what happened so that this virus does not spread.

The child died because the disease was very advanced and the vaccine did not arrive on time, as everyone knows Venezuela is experiencing a very serious hospital crisis, and unfortunately many people die because the necessary medicines to treat such diseases are not found.

In the city of Trujillo in the same state where Valera is located, about 20km away. A week later two more cases appeared in children and also died. The state was put on national alert and ministry of health began to move quickly to get the vaccines and send them to the entity.

But this is not over yet, because last week I was on call in adult emergencies, in the evening a patient arrived, immediately alerted all my colleagues, I was again surprised if I was a 65 year old man with symptoms of diphtheria, in this case the man could be diagnosed in time and be vaccinated to kill the virus, just as the hospital is on alert and adult emergencies were also closed, strictly emergencies. Unfortunate, very unfortunate this situation.

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Now I want to explain to you what this disease is about .. what is it? How do you get it? How is it treated

It is an infectious disease that mainly affects the tonsils, throat, nose, myocardium, nerve fibers or skin.

The bacterium usually colonizes the mucous membranes of the nose and throat, where it produces inflammation and the formation of grayish membranes that adhere strongly to the mucosa, making it difficult to breathe and even lead to suffocation.

Sometimes the toxin of the bacteria (called diphtheria toxin) can reach the bloodstream, spreading to the rest of the body and damaging organs such as the heart, nerves and kidneys.
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How do you contract?
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http://www.lavidalucida.com/difteria-cuales-son-sus-sintomas-y-como-tratarlo-naturalmente.html

 As they point out from Infosalus, it is highly contagious and contracts through the airways. Specifically through people who have passed the disease or who are healthy carriers. It attacks mainly children under five and people over 60.

The bacteria are mainly transmitted by the respiratory tract, so that when an infected person coughs, sneezes or talks, he releases small microscopic drops, which are spread through the air, and can be inhaled by people who are nearby, infecting them. Because of this, overcrowding and poor hygiene are risk factors that increase the likelihood of disease spreading.

A much less frequent route of transmission is through objects contaminated by secretions of infected persons (toothbrushes, glasses, etc.), since the microorganism can survive several hours in the environment. However, this route of transmission is much less relevant at the epidemiological level.
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Symptom.
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https://www.panamaparaninos.com/Ninos-enfermos-cuando-deben-ausentarse-de-la-escuela

In principle, diphtheria causes headache, high fever, difficulty swallowing, and swollen lymph nodes in the neck area. In addition, a membrane may form in the throat. Symptoms usually manifest 3 to 9 days after infection
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Diagnosis.
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The doctor should suspect this in children who are not immunized correctly, or in adults with compatible symptoms who have traveled or come from countries where diphtheria is endemic.

The physical examination then allows the physician to visualize the inside of the patient's mouth, where the presence of grayish membranes closely adhering to the mucous membranes of the tonsils and the back of the throat will be observed. However, the formation of similar exudates in many other pharyngeal infections, commonly known as plaques, makes it difficult to properly diagnose the disease

The presence of other symptoms such as those described above (fever, swallowing pain, cough, neck inflammation, lymphadenopathy ...) will help us think of C. diphtheriae as the cause of the condition.

The definitive diagnosis of diphtheria is achieved by the direct visualization of the bacterium under the microscope or its culture in the laboratory. To do this, it is necessary to extract a sample of the pharyngeal exudate from the throat of the patient.
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How is it treated?
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The treatment of diphtheria should be started as quickly as possible, so that if a patient is suspected to have the disease, it is essential to begin treatment before even having a definitive diagnosis. This reduces the mortality associated with diphtheria.

In order to treat infected persons, hospital admission is required, and isolation of the patient is necessary since it is a highly contagious disease. In this way the patient remains more vigilant and ensures a correct completion of the treatment. In the most severe cases it is even necessary to transfer the patient to the Intensive Care Units.

Apart from supportive measures (monitoring of vital signs, oxygen, intravenous fluids, bed rest), treatment against diphtheria is based on two fundamental pillars: the use of antitoxin and antibiotics:

Antitoxin: it is administered intravenously or intramuscularly and with it it is possible to neutralize the diphtheria toxin present in the blood circulation, which is the one that produces the main complications of the disease (heart, nerve, kidney).
In some people antitoxin can cause severe allergic reactions, so skin allergy tests are usually performed to ensure that the infected person is not allergic.

Antibiotics: they help to eliminate the bacteria present in the body, thus reducing the chances that the patient will infect other people. The most commonly used antibiotics are penicillin or erythromycin.
Asymptomatic people who are carriers of the bacteria should also receive antibiotic treatment.
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Prevention.
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The DTaP vaccine combines vaccines against diphtheria and two other serious diseases: tetanus and whooping cough. This vaccine consists of an inactivated toxoid or toxin, which causes no damage to the body, allows the development of an immune memory, and induces specific antibodies to neutralize the diphtheria toxin and prevent the onset of the disease.

To achieve optimum protection, children should be given five doses of the DTaP vaccine. The vaccination schedule varies depending on the country, and in Spain it is the following:

2 months (diphtheria, tetanus and whooping cough).
4 months (diphtheria, tetanus and whooping cough).
6 months (diphtheria, tetanus and whooping cough).
Between 15 and 18 months (diphtheria, tetanus and whooping cough).
Between 4 and 6 years (diphtheria, tetanus and whooping cough).
14 years (diphtheria and tetanus).
In addition, it is necessary for adults to be given booster doses every ten years. As this periodicity is not usually followed correctly, it is advisable that people who are going to travel to a region where there may be a risk of contracting the disease, or those who have been in contact with patients with diphtheria, dose of the vaccine, except in the case that they have been vaccinated in the last five years.

The DTaP vaccine is very safe and effective in preventing diphtheria (along with tetanus and whooping cough). It can have side effects, however, these are usually mild. The occurrence of serious adverse reactions to the vaccine in children is less than one in a million.
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Credits:
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http://www.20minutos.es/noticia/2481866/0/la-difteria/que-es-como-se-contrae/como-se-trata/
http://www.webconsultas.com/categoria/salud-al-dia/difteria
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By @joha09sohi
Doctor