text: Diphtheria is a serious bacterial infection that affects the nose, throat and sometimes, the skin of an individual. It is caused by a toxin from the bacteria, Corynebacterium diphtheria. The toxins begin to damage the body’s organs by spreading from the bloodstream to organs such as the heart and brain. If diphtheria spreads throughout the body, it can cause paralysis and heart failure. The disease also affects people of all age groups, especially unimmunised children.
  How is Diphtheria transmitted
  Diphtheria can be transmitted by direct contact or through respiratory droplets from coughing or sneezing of an infected person. It may also be spread by contaminated clothing and objects.
  A person is infectious for as long as the bacteria are present in respiratory secretions, usually two weeks without treatment, and seldom more than six weeks.
  According to the Center for disease control (CDC) in rare cases, chronic carriers may spread the bacteria for six months or more
  Symptoms of Diphtheria
  The first 2 – 5 days (could be as high as 10 days) after exposure:
  - runny nose,
  - sore throat,
  - cough, and
  - red eyes (conjunctivitis).
  – Thick grey or white patch (pseudo-membrane) on the tonsils and/or at the back of the throat
  – Colouration of the Skin.
  – Watery or bloody drainage from the nose.
  – Breathing Problem.
  – Swallowing Problems.
  The Following People are at High Risk
  – When you are not completely immunised.
  – Exposure to someone infected with diphtheria.
  – Living in an unclean and crowded environment.
  – PCR of swab material to detect the presence of the A and B subunits of the diphtheria toxin gene (tox)
  – Elek test
  – In other words, go to the hospital to be tested.
  – Administration of a diphtheria antitoxin (DAT), administered intravenously or through an intramuscular injection.
  – Antibiotics can also be given to eliminate the bacteria to prevent transmission and toxin production to others.
  – Close contacts of the patient are to be monitored for signs and symptoms for 10 days
  – Healthcare workers exposed to the case’s oral or respiratory secretions or exposed to their wounds should also be monitored.
  – Prophylactic antibiotics (penicillin or erythromycin) are indicated for close contact for seven days.
  – Child immunisation
  – Individuals with signs and symptoms should isolate, take precautionary measures, visit hospital for diagnosis, treatment
  – Healthcare workers should practise standard precautions
  Diphtheria is one of the priority diseases in Nigeria requiring immediate reporting and as such all suspected cases of diphtheria picked by healthcare workers in a health facility are required to be reported to the respective Local Government Area (LGA) Disease Surveillance and Notification Officer (DSNO) either directly or through the health facility surveillance focal person depending on what is obtainable within the health facility. Reports from the health facility are expected to reach the LGA DSNO within 24 hours. The LGA DSNO in turn reports the case to the state epidemiologist who then reports to NCDC.
  Written by: Zainab