France is experiencing a wave of diphtheria in 2023. This disease, which had disappeared in the country, is a very contagious angina which can be fatal in the event of complications. Should we fear it? What are the symptoms to watch out for?
Diphtheria is a disease bacterial believed to have disappeared in France in the early 1990s thanks to the mandatory vaccination (DTP vaccine) but cases are still detected. This disease is highly contagious. It is one of the notifiable diseases. How do you get diphtheria ? What are symptoms of this disease? Dangers for the body ? Can we die of it ? How to cure ? What vaccine?
What is diphtheria?
Diphtheria is an infectious disease caused by several species of bacteria (Corynebacterium) which can produce diphtheria toxin. She provokes a respiratory infection (whose symptoms resemble angina) which can affect the central nervous system, the throat and other organs. Without treatment, it can lead to death by asphyxiation.
What bacteria causes diphtheria?
Diphtheria is caused by several species of genus corynebacteria diphtheriae:
- Corynebacterium diphtheriae
- Corynebacterium ulcerans
- Corynebacterium pseudotuberculosis
Cases of diphtheria in France
Until the 1930s, diphtheria was responsible for several thousand deaths per year (45,000 cases of diphtheria and 3,000 deaths in 1945 according to the Montpellier University Hospital). Diphtheria then disappeared in metropolitan France in the early 1990s. But cases are still being reported. “At the beginning of 2022, several cases of diphtheria have been reported in 9 regions of France metropolitan as well as Mayotte and Reunion” has indicated Public Health France. In metropolitan France, the majority of cases were reported in migrants and travelers.
What are the symptoms of diphtheria? Angina ?
Diphtheria generally causes ENT impairment with so-called “diphtheria” angina whose characteristics are as follows:
- pharyngitis
- A fever
- a pallor
- Pain when swallowing (dysphagia)
- Lymphadenopathy under the jaws (or swelling of the neck)
- Headaches
- Tonsils covered with “whitish false membranes“, of cream or greyish color, which may bleed if the angina becomes complicated.
Transmission: how do you catch diphtheria?
The bacterium Corynebacteriumdiphtheriae spreads directly through nasopharyngeal secretions (droplets when sneezing, coughing, sputtering too) or some skin wounds And very rarely by indirect contact with soiled objects by patient secretions. The bacterium C. ulcerans is transmitted through milk and contact with cattle (contacts with cats or dogs have been described). Human-to-human transmission has not been documented. The bacterium C. pseudotuberculosis can also be transmitted to humans by goats.
What is the name of the diphtheria vaccine?
The diphtheria vaccine is the DTPolio. It is composed of purified and inactivated diphtheria toxin. Vaccination is mandatory for all children: primary vaccination is mandatory for children at 2 and 4 months. The first booster is done at the age of 11 months and the other boosters are done at 6 years, 11/13 years, 25 years, 45 years, 65 years and then every 10 years. Vaccination is also mandatory among health professionals (recalls carried out at the same fixed ages (25 years, 45 years and, depending on the pursuit of professional activities, 65 years), with a vaccine containing a reduced dose of diphtheria toxoid (dTPolio) and is particularly recommended in travelers in endemic areas.
What is the incubation period of the bacteria?
The incubation period of the bacterium is short: from 2 to 5 daysalways less than a week.
What are the dangers of diphtheria?
The most serious consequences come from the toxin that the bacteria can secrete. The main manifestation of the disease is angina which can be complicated by cardiac or neurological damage and train the death (by asphyxiation or croup), reports Public Health France.
What treatment to treat diphtheria?
The treatment of classic diphtheria is to administer as soon as possible anti-diphtheria serum by intramuscular injection and/or antibiotics (antibiotic therapy with amoxicillin is recommended, or with macrolides in case of allergy to beta-lactams). The management of a case of diphtheria carrying the gene encoding diphtheria toxin, in addition to specific treatment, also includes respiratory isolation in the event of ENT impairment and updating the vaccination status, explains Public Health France.
- Diphtheria sheet, Institut Pasteur
- Diphtheria sheet, Public Health France
- National reference center for Corynebacteria of the diphtheriae complex
- Document on what to do in the event of diphtheria published by the High Council for Public Health.