The acute bacterial infection with symptoms of a sore throat, a fever, a rapid pulse, and swollen neck glands is called diphtheria. Mass immunization has made the disease extremely rare in developed countries. However, it is still a hazard to nonimmunized people in poor, developing countries. The Corynebacterium diphtheriae bacterium has an incubation period of two to five days and may be carried on the skin or in the nose of a person immune to the disease. Once it is passed on to a nonimmune person, the bacterium may multiply in the throat and create a membrane that spreads over the surrounding areas of the throat and cause breathing difficulties. When the infection is confined to the skin, it causes minor yellow spots or sores.
Life-threatening complications may arise when the bacterium releases a toxin into the bloodstream. Other rare complications are paralysis of the throat or limbs and heart failure.
Until the 1930s, diphtheria was one of the leading causes of death in children. The DPT vaccine (against diphtheria, pertussis, and tetanus) is routinely given to children in the first year of life, with additional boosters at 18 months, 4 to 6 years, and every 10 years thereafter. Antibiotics are used to treat the throat infection but are ineffective against the toxins in the bloodstream. Injections of diphtheria antitoxins derived from the blood of immunized horses are given in a hospital setting. If breathing difficulties persist, a tracheostomy (surgical placement of a breathing tube in the windpipe, or trachea) may be performed. Victims are isolated until no diphtheria bacilli are detected in the nose and throat.