What are symptoms for detecting diphtheria? Is there a vaccine for diphtheria in Vietnam?

Diphtheria is an extremely dangerous disease. If not treated promptly, it may lead to the risk of death. What is diphtheria? Is there currently a vaccine and treatment available for diphtheria in Vietnam? Let’s explore through the article below.

1. What is diphtheria?

Diphtheria is a toxic-infectious disease, transmitted via respiratory droplets and capable of causing epidemics. It is caused by the bacterium Corynebacterium diphtheriae (also known as Klebs-Loeffler bacillus). The disease usually affects children under 15 years old and individuals who are not immune to diphtheria due to incomplete vaccination. The bacteria usually reside and create damage in the upper respiratory tract (nose, throat, larynx), forming a tough, adherent membrane difficult to remove, producing toxins that affect the entire body (heart, kidney, nervous system), with a high risk of death due to airway obstruction and myocarditis.

The causative agent of diphtheria is the diphtheria bacterium. Diphtheria bacilli survive long in membranes and in the throat of patients. In dark conditions, the bacteria can survive up to 6 months and linger on toys of infected children, medical staff's gowns, and more. Diphtheria bacteria die at 58°C within 10 minutes, and under sunlight, they die within a few hours.

2. What are symptoms for detecting diphtheria?

People with diphtheria will have the following symptoms:

(1) Initial phase:

- The patient usually has a fever of 37.5° - 38°C, sore throat, discomfort, fatigue, poor appetite, slightly pale skin, and runny nose possibly with blood.

- Mouth examination: Slight throat redness, tonsils with a grayish membrane on one side. Small, mobile, and painless neck nodes are palpable.

(2) Full-blown phase: On the 2nd-3rd day of illness.

- Whole body: The patient has a fever of 38° - 38.5°C, painful swallowing, pale skin, severe fatigue, loss of appetite, rapid pulse, and slightly low blood pressure.

- Mouth examination: Widespread membrane on one or both tonsils; in severe cases, the membrane covers the uvula and soft palate. Initially, the membrane is ivory white, then turns to a slightly yellowish color, tightly adheres to the mucosa, removal causes bleeding, and if detached, it regenerates quickly. The membrane is tough, insoluble in water, and the surrounding mucosa is normal.

- Swollen, painful jaw nodes. The patient has copious nasal discharge, either clear or mixed with pus.

(3) Malignant diphtheria

It can appear early within 3-7 days of the illness. Severe toxic-infectious syndrome with high fever (39°-40°C), widespread membrane throughout the throat and lips, significantly swollen neck nodes leading to a thick neck, and many early complications like myocarditis, renal failure, and nerve damage.

(4) Laryngeal diphtheria

- Pure laryngeal diphtheria is rare, usually it’s pharyngo-laryngeal diphtheria.

- Clinical presentation includes: acute laryngitis (barking cough, hoarse voice, difficulty breathing on inhalation with stridor). At a later stage, it will lead to asphyxia.

3. Is there a vaccine for diphtheria in Vietnam?

Currently, in Vietnam, there is a vaccine and specific antibiotics for prevention and treatment of diphtheria. However, the diphtheria toxoid vaccine only creates immunity against the toxin, protecting the body from the disease but not preventing local bacterial colonization in the throat, thus, it does not reduce the state of carriers after vaccination.

4. What should be done to prevent diphtheria?

To prevent diphtheria, Vietnamese citizens need to take the following measures:

- Proper handwashing with soap or antiseptic solution.

- Disinfect and sanitize the patient's living area, utensils, personal items, and clothing.

- Vaccination against diphtheria: as part of the national expanded immunization program, use combination vaccines: diphtheria - pertussis - tetanus for children. Start vaccination from 2-3 months of age, two doses, each 1ml, one month apart. A booster is given one year later and then annually until the age of 5.

- For suspected diphtheria patients: Hospitalization is required to isolate until two consecutive negative bacterial test results. Each sample is taken 24 hours apart and no more than 24 hours after antibiotic treatment. If testing is not feasible, the patient should be isolated for 14 days after antibiotic treatment.

- For contacts: Bacterial testing and monitoring for 7 days are necessary.

+ Administer a single dose of benzathine penicillin (600,000 units for children ≤ 5 years; 1,200,000 units for children > 5 years).

+ Take Erythromycin (children 40mg/kg/day, 10mg/dose every 6 hours) for 7 days. Adults: 1g/day, 250mg/dose every 6 hours.

+ Take Azithromycin: children 10-12mg/kg once/day, maximum of 500mg/day. Treatment for 7 days. Adults: 500mg/day, for 7 days.

*Legal Basis:

Decision 2957/QD-BYT in 2020 on guidelines for diagnosis and treatment of diphtheria issued by the Minister of Health of Vietnam.

Decision 3593/QD-BYT in 2020 on "Guidelines for surveillance and prevention of diphtheria" issued by the Minister of Health of Vietnam.

Sincerely!

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