acute infectious disease Corynebacterium diphtheriae bacilli multiply in throat produce exotoxin caused form grayish yellowish membrane false membrane congestion ID: 916286
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خناقDiphtheria
Slide2acute infectious disease Corynebacterium diphtheriae bacilli multiply in throat produce exotoxin caused - form grayish / yellowish membrane- false membrane - congestion, oedema - enlarge lymph nodes
- toxaemia C/F fatal – 5 %
خناق
Diphtheria
Slide3DataRare in developed countries – routine immunizationSocio-economic / life style - changes patternEpidemic – decrease immunization / low immunity in adults / movement of groups / irregular supply of vaccineIn some countries – in older childrenIn developing countries – endemic – lack of vaccination2008 – 7008 cases reported
خناق
Diphtheria
Slide4In India – endemicData shows – decline - Because of vaccinationIn 1987 – 12952In 2009 3480 (113 deaths)Fatality rate – 3.25
خناق
Diphtheria
Slide5Agent – C. diphtheria - gram +ive , non-motile - 4 types gravis / mitis / belfanti / intermedius
خناق
Diphtheria
Slide6Source of infection1) cases – 5%2) carrier – 95 % ( benefit)Temp. – month / chronic - year / nasal / throat
خناق
Diphtheria
Slide7Infective materialNasopharyngeal sectretionsDischarge from skin lesionContaminated fomitesInfected dust
خناق
Diphtheria
Slide8Period of infectivity14 – 28 daysNon – communicable – 2 culture –ive frm nose / throat 24 hours apart
خناق
Diphtheria
Slide9Age – 1-5In immunization – preschool to schoolSEX – equalIMMUNITY – immune I immune mothers for weeks to monthIndia – 70 % - above 3 years age - 99 % - above 5 years
خناق
Diphtheria
Slide10Environmental factorsAll seasons – winter – moreKolkata – high in AugMumbai – high in winterDelhi – Aug – Oct.
خناق
Diphtheria
Slide11Mode of TransmissionDroplet infectionTransmitted to susceptible person from infected cutaneous lesionTransmission by objects – contaminated with nasopharyngeal secretion
Slide12Portal of EnteryRespiratory routesNon – respiratory routesSkin / eye / genitalia / middle ear
Slide13Incubation period2-6 days
Slide14Clinical featuresRespiratory tract – Pharyngeotonsillar / laryngeotracheal / nasal / combinedPharyngeotonsillar – sore throat / difficult swallowing / low feverThroat – erythema / exudate / psudomembraneMembrane – localized may cover tonsil, soft or hard plate, pharynx
Early stage – whitish , wipe off easily
Late stage – thick, blue- white, gray- black, bleed on wipingSevere – edema on submandibular
area, ant. Neck +
lymphadenopathy
-
bullneck
Slide15Clinical featuresLaryngeotracheal – preceded by above Fever / hoarseness / croupy coughSevere – spread to bronchial treeD/D epiglottisDyspnoea – suffocation if X tracheostomyToxin causes distant effects – parenchymatous degheneration, fatty infiltration, necrosis - heart muscles, liver kidney
Sometimes – gross
haemorrhageIrregular cardiac rhythm – damaged heartDifficulties in vision, speech, swallowing, movement limbs
Nerve damage, paralysis soft palate, eye muscle, extremities
Slide16Clinical featuresNasal – mildest, localized to septum – one side of noseMay extend to pharynxNon respirotory – conjunctiva , genitalsCutaneous diptheria – common in tropics , as secondary inf. An ulcer surrounded by erythema covered with membrane
Slide17ControlCAES AND CARRIERSA) early detectionB) Isolation C) treatment Cases – Carriers -
Slide18ControlCONTACTSVac. Received within 2 last year> 2 years Non immunized
Slide19ControlCOMMUNITYActive Immun.Booster dose
Slide20ImmunizationCombined Vac.DPT / DTPw / DTPa / Dt / dTSingleFt / APT / PTAP / PTAH / TAFAntiseraDip. antitoxin
Slide21The End with
Thanx