Diphtheria

Diphtheria - the acute infectious disease characterised by the special inflammation of covers roto - and nasopharynxes, larynxes (with formation of dense scurfs in the form of Membranulas), and also the phenomena of the general intoxication (venenating) of an organism and a lesion of cardiovascular, excitatory and secretory systems. Damaging action on organs and tissues is caused by the toxin (poison) excreted with the infestant in a place of its introduction. Children at the age from 4 till 6 years most often are ill.

The infestant - a diphtheritic rod - well remains in environment. So, in water and milk it is teleorganic 7 days; on toys, linen, books, ware persists in flow of several weeks. All disinfectants (hydrogen peroxide, Chloraminum, etc.) in usual concentrations kill a diphtheritic rod; under the influence of direct solar beams it perishes in some hours.

Contagium source is the human at whom it shows in different clinical forms - from serious toxic to the erased, imperceptible forms and the bacteriocarrier i.e. when the child or the adult can not have visible signs of disease, but thus to excrete the diphtheritic rods dangerous to associates.

The diphtheritic rod is excreted with sick (bacillicarrier) at tussis, a sneezing, conversation with droplets of a saliva, phlegm, a sputum in environment last days incubation (latent initial) the season and further during all season of disease and even some time after clinical recover. The healthy human is infested at an aspiration of air containing a diphtheritic rod. For a diphtheria are characteristic periodicity (disease liftings become perceptible each 7-10 years) and osenne-winter seasonal prevalence. In 20-50th years agents of specific preventive maintenance began to be introduced into public health services practice against a diphtheria - engraftings that has led to sharp depression of a case rate activly. However recently cases of a diphtheria with a lethal outcome are registered. Among died the majority was compounded by children not inoculated against a diphtheria that presses for realisation of all complex of measures of the preventive maintenance provided for this disease - first of all mass bacterination of the population against a diphtheria.

The diphtheritic rod, amazing mucosas mainly nasopharynxes, fauces, a larynx and a trachea, excretes toxin which causes an inflammation of a mucosa with formation not it of dense scurf in the form of nitidous Membranula of the belovato-grey colour densely soldered to subject tissues owing to what to take out this scurf at a diphtheria inconveniently. Besides, diphtheritic toxin is carried by blood and a lymph on all organism, having the expressed toxic an effect on many organs and causing serious complications - lesions of nephroses, the excitatory system, heart, the pneumonia often educes.

Much less often the diphtheria originator gets on a mucosa of eyes, outside generative organs at girls, an umbilical wound at newborns, a damaged skin. Depending on a place of penetration and reproduction of diphtheritic rods excrete various forms of disease: the Diphtheria of a stomatopharynx, a nose, a larynx (true croup), an eye, outside generative organs, a skin, and also the combined diphtheria when some organs are simultaneously amazed. The incubation (latent) season of disease compounds from 2 till 10 days.

The stomatopharynx diphtheria happens localised, extended and toxic. At first two forms the disease beginning, as a rule, the acute. The body temperature raises to 38-390 in the first 2 days, then it is normalised or decreases. The general intoxication usually moderated also does not differ variety of implications: It is a headache, a malaise, appetite depression, pallor of a skin. Be rare unitary vomiting and a short-term abdominal pain at height of feverish reaction can.

Pharyngalgia at swallowing - an early symptom of a diphtheria of a stomatopharynx. In fauces soft reddening, puffiness of tonsils and palatal handles on which white or serovato-white dense membraneous scurfs with nacreous shine are formed is found. Than more extensively and widespreaded scurfs, the venenating of an organism is especially expressed and disease is more serious.

The toxic form of a diphtheria of a stomatopharynx differs massive formation of toxin in the inflammation locus. Diagnostics should be spent urgently and as more as possible precisely. Disease begins roughly with simultaneous appearance and advance of a body temperature, the general intoxication, painful sensations, inflammations of submandibular lymph nodes. The temperature quickly reaches 39-400, early implications of this form of a diphtheria are the headache, a fever, the general delicacy, abandoning of meal, pallor of a skin, repeated vomiting, an abdominal pain. One of precursory symptoms of a toxic diphtheria - a stomatopharynx edema. Membraneous scurf covers the sky and a nasopharynx, breath becomes noisy, rattling, the mouth is half-opened, later there are abundant abjections from a nose. Become perceptible a pharyngalgia at the swallowing, complicating reception not only firm, but also liquid nutrition, a pain in the field of a neck.

The larynx diphtheria (true croup) - in the isolated form is observed less often, than in combined, therefore its diagnostics is complicated, especially at accompanying an ARD. Gradual development of symptoms without sharp disturbance of the general condition and a heat at first does not cause fear in parents of the sick child. However characteristic symptoms of disease in process of a course of a disease become more and more appreciable: pallor of a skin, rasping "barking" tussis, hoarseness of a voice and the complicated breath is taped. Hoarseness strengthens up to full loss of a voice, breath disorder educes - it becomes audible on distance, there are dyspnea attacks, the child becomes blue, rushes about in a bed, quickly weakens. At untimely rendering of medical aid there can come mors.

The clinical picture of a diphtheria at adults differs now substantial growth of number of serious, toxic forms which are characterised by the same symptoms, as at children. Sometimes a unique symptom of a lesion of a larynx is the voice hoarseness. Complications at adults can educe at any form of a diphtheria. The most frequent complication is the myocarditis (a myocardium lesion - a cardiac muscle).

The main thing in treatment of all forms of a diphtheria is neutralisation of diphtheritic toxin by antidiphtherial Serum then additional treatment is required. In success of therapy terms of introduction of Serum are very essential - the earlier it is introduced, the its action is more effective. Serum introduction is effected in hospital. Any forms of a diphtheria demand strict isolation of the patient and treatment only in the conditions of hospital.

The basic method of preventive maintenance of a diphtheria is mass bacterination against this disease. It is necessary for children to do engraftings (in the absence of contraindications) since age of 3 months three times with an interval 1 months Repeated bacterination is carried out on the second year the life subsequent in 6 and 11 years.

Unitary bacterination is effected for rising of antidiphtherial immunodefence at adults each 10 years. To the preventive maintenance purposes also is served by early revealing, isolation and hospitalisation of patients with disinfection carrying out in the apartment of the diseased.

To children who had contact with sick diphtheria, forbid visitation of nurseries учереждений in flow of 10 days. The recovered child after an extract from hospital is supposed in children's collective after a double negative take of research on a diphtheritic rod.

At children visiting kindergartens, take smears for research on the bacteriocarrier. Bacillicarriers isolate and suppose anatropicly after an inspection negative take. The fast termination of the bacteriocarrier is promoted long stay on fresh air, by an aeration and cleaning of premises with use of disinfectants, application of vitamins and other medicines (under the reference of the doctor).