The extreme danger of diphtheria epidemic, more frightening than COVID-19, what are the signs?

People across the country are extremely bewildered by the information about the outbreak of diphtheria that occurs in some provinces. Worryingly, this disease has complications faster than the "nightmare" of Covid-19, even some people have not survived.

In recent days, information about a case of death due to diphtheria in Nghe An and a case in Bac Giang due to contact with this case has made many people worried. The Center for Disease Control of Nghe An province identified 119 people who had contact with the patient from the time of onset to the time of non-recovery. Similarly, Bac Giang also identified 15 people in contact with the case.

ASS. Dr. Tran Dac Phu, former Director of the Department of Preventive Medicine, Ministry of Health, said that diphtheria is a dangerous infectious disease even though it belongs to group B. The disease is transmitted through the respiratory tract in the form of droplets, which can be transmitted directly by contact with sick people when speaking, coughing, sneezing, etc. or indirect transmission through contact with secretions containing bacteria from the nasopharyngeal mucosa of patients or healthy people who carry the infection. Healthy carriers are people who carry diphtheria bacteria but have no symptoms of the disease, they are still capable of transmitting the disease to others.

"Thus, the source of infection can be sick people, healthy people carrying the infection, so many times we do not know from which source we are infected. Another danger point of the disease is the high mortality rate if not treated in time. Severe cases can lead to severe poisoning, especially myocarditis lesions, and the risk of loss is high," said Assoc. Prof. Phu.

According to Assoc. Prof. Phu, in the past, diphtheria was very common in both cities and rural areas, but thanks to the Expanded Immunization Program, the number of cases has decreased a lot. And after many years of no cases, many doctors did not know diphtheria patients, but recently the disease returned due to some problems related to vaccination.

So why does the disease often occur in mountainous areas? Assoc. Prof. Phu said that in mountainous areas, we still have so-called "low-lying areas" for vaccination, where the vaccination rate is low and sanitation is poor. People there live in isolation and have little interaction, so there is no natural immunity due to infection or immunity due to vaccination, so when there is an epidemic, it often breaks out in mountainous and remote areas.

There are many factors that lead to low vaccination rates in some regions such as due to the impact of the Covid-19 epidemic, so many cases do not get vaccinated or do not receive enough doses.

Diphtheria bacteria are usually localized and damage the upper respiratory tract (nose, throat, larynx) to create a sticky pseudomembrane, which is difficult to dissect and produces exotoxins that cause systemic toxicity (heart, kidney, neurotoxicity), which cannot survive due to airway obstruction and myocarditis. The rate of not passing is about 5-10%, which is higher in young children.

Diphtheria bacteria live for a long time in the pseudomembrane and throat of patients. In conditions of lack of light, bacteria live up to 6 months and survive for a long time on toys of children with diphtheria, gowns of medical staff... Common forms of diphtheria include pharyngeal diphtheria (70%), laryngeal diphtheria (20-30%), nasal diphtheria (4%), ocular diphtheria (3-8%), cutaneous diphtheria, etc.

People with diphtheria often have typical symptoms such as mild fever, red throat, painful swallowing, cough, hoarseness, tiredness, bluish skin, loss of appetite. After 2-3 days, the patient appears pseudomembranes on the back or sides of the throat, which are ivory white, gray or black. Pseudomembranes are tough, sticky, and easy to bleed. This is the most important sign for detecting the disease.

In addition, patients may have signs of shortness of breath, swollen lymph nodes under the jaw, causing swelling of the neck area. If detected early, treated promptly, the patient can recover normally.

The disease can cause complications such as respiratory obstruction due to pseudomembranes spreading down the pharynx, myocarditis, arrhythmias, heart failure, paralysis due to damage to motor nerves and can lead to death.

With diphtheria body, after an incubation period of 2-5 days, the patient begins to have symptoms such as a slight fever of 37.5-38 degrees Celsius, sore throat, malaise, and runny nose. When examining the throat, it can be seen that the throat is slightly red, the amydan has a faint white spot; palpable cervical lymph nodes are small, mobile, painless.

After about 3 days, the disease will enter the full-blown stage with the most typical symptoms: fever rising to 38-38.5 degrees Celsius, painful swallowing, pale skin, heavy fatigue, runny nose, white nasal discharge or pus. Throat examination reveals that the pseudomembrane is diffuse on one or both sides of the amydan, which can spread to both the tongue and the pharynx.

The disease is dangerous, but according to Assoc. Prof. Phu, those who have been in contact with the past case, we should not be too worried. Cases of close contact with the case will be given prophylactic antibiotics to immediately kill diphtheria bacteria, and will not develop the disease if unfortunately infected with the bacteria and will not become a source of infection to others.

In the long term, an effective preventive measure is still vaccination. Children need to be vaccinated on schedule, with sufficient doses, then booster shots every 10 years. In high-risk areas, the Ministry of Health can carry out vaccination campaigns, additional injections, etc.

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