Diphtheria

Naresh Chand Sharma

doi:10.1038/s41572-019-0131-y

Diphtheria

2019-12-05

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Thandavarayan Ramamurthy *

DOI：10.1038/s41572-019-0131-y

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Diphtheria is a potentially fatal infection mostly caused by toxigenic Corynebacterium diphtheriae strains and occasionally by toxigenic C. ulcerans and C. pseudotuberculosis strains. Diphtheria is generally an acute respiratory infection, characterized by the formation of a pseudomembrane in the throat, but cutaneous infections are possible. Systemic effects, such as myocarditis and neuropathy, which are associated with increased fatality risk, are due to diphtheria toxin, an exotoxin produced by the pathogen that inhibits protein synthesis and causes cell death. Clinical diagnosis is confirmed by the isolation and identification of the causative Corynebacterium spp., usually by bacterial culture followed by enzymatic and toxin detection tests. Diphtheria can be treated with the timely administration of diphtheria antitoxin and antimicrobial therapy. Although effective vaccines are available, this disease has the potential to re-emerge in countries where the recommended vaccination programmes are not sustained, and increasing proportions of adults are becoming susceptible to diphtheria. Thousands of diphtheria cases are still reported annually from several countries in Asia and Africa, along with many outbreaks. Changes in the epidemiology of diphtheria have been reported worldwide. The prevalence of toxigenic Corynebacterium spp. highlights the need for proper clinical and epidemiological investigations to quickly identify and treat affected individuals, along with public health measures to prevent and contain the spread of this disease.

Keywords:

NONTOXIGENIC CORYNEBACTERIUM-DIPHTHERIAE

HUMAN MONOCLONAL-ANTIBODY

POLYMERASE-CHAIN-REACTION

MOLECULAR EPIDEMIOLOGY

AMINO-ACID

REGULATORY ELEMENT

EPITHELIAL-CELLS

ULCERANS STRAINS

TOXIN GENE

OUTBREAK

Diphtheria

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