 Hi, I'm Neha Mishra. I'll be talking about diphtheria today. Today I'm going to talk about a rare but severe disease which predominantly affects nose and throat. It is easily preventable by vaccine. And no, I'm not talking about COVID. It is diphtheria. Diphtheria is a bacterial disease caused by corneobacterium diphtheria. It is also known to elicit a toxin which is primarily responsible for all the signs and symptoms that we see in the disease. The word diphtheria is derived from Greek letter which means leather. It denotes the thick membrane that deposits in nose and throat of a patient, which is a hallmark clinical feature of diphtheria disease. If we talk about the pre-vaccination era, diphtheria was the reason of major complications and mortality among the children lesser than 15 years of age. As the vaccination got introduced, the number of diphtheria cases, the prevalence of it became less. If you talk about resource rich countries by 1930s and 1940s that is post-vaccination era, the prevalence was, the diphtheria disease was almost eliminated in these countries. While in resource limited countries where the vaccination is still a problem, so there are more number of people who are not vaccinated or there are more number of people who are partially vaccinated, they still remain the reason for resurgence of disease or outbreaks of disease every now and then. The way to know whether you have it or you don't have is the patient who is unvaccinated fitting into the classical symptoms and also supported by the correct adequate laboratory diagnostic test will confirm the diagnosis of diphtheria, the test being the toxin test and also the culture and sensitivity test. So, the usual symptoms of diphtheria includes malaise, fever, throat pain and lymph node enlargement in the neck. Such patients cannot be differentiated from other respiratory tract infections on the basis of symptoms itself or symptoms alone, so you have to back it by a laboratory diagnosis. Otherwise, when if the patient is left untreated at this stage and the disease progresses, they may develop other complications or other severe symptoms associated with diphtheria itself. When I say other symptoms, I mean there can be a membrane in the nose and throat which is whitish to grey in colour which is very much other into the underneath surface and it will bleed if you try to pull it out. This is one of the major classical sign of diphtheria and it is seen in up to one third of the cases associated with diphtheria. Also, there are other features like swelling of neck which gives a picture of bull's neck and that is also classical feature of diphtheria. Diphtheria is not limited to nose, throat and lungs alone. It can also lead to involvement of other symptoms like heart which happens in about 10-25% of cases of diphtheria or sometimes it can also involve central nervous system that is brain. It occurs in about 5% of cases associated with diphtheria. It also can involve kidney which is lesser known complication but direct involvement of kidney is also something that can happen in cases of diphtheria. Diphtheria spreads by airborne droplet. Another way through which diphtheria can spread is if somebody contacts the respiratory secretions which are infected. So, these are the two predominant ways of diphtheria spread. So, there are two major component of treating diphtheria. One is antitoxin which is administered to nullify the effect of toxin that is produced by the bacteria. Second part of the treatment is antibiotics to kill the bacteria per se so that there is no toxin production at all. The common antibiotics that are used are erythromycin, penicillin, clarithromycin, they can use glindamycin and the list goes on. I think the best way to treat diphtheria is to contact your doctor, they will help you and guide you further. So, vaccination for diphtheria is probably one of the most important way to prevent diphtheria disease. It is approved by international and national bodies, WHO promotes it. It is a very simply available, easily available vaccine with least amount of toxic side effects has been given to children from years together now. And we have seen the risk of this particular disease and the complications associated with disease declining tremendously. And we have seen the benefits associated with vaccine over the period of years. Hence, I think the best and the first way that we should utilize to prevent diphtheria is to get vaccinated. Every time there is a break in, you know, vaccination cycle or there is a reduction in herd immunity, that time we see the resurgence of this disease and outbreaks of diphtheria. So, vaccination is the cure here. People who are not vaccinated adequately will have lesser immunity to protect themselves from the disease. Or people who are not vaccinated at all are another group which will not be able to protect themselves from the disease. So, they will be at higher risk. The patient who started on treatment for diphtheria can become non-infectious as early as 34th day of treatment. So, they can stop spreading the disease and for them also the symptoms considerably improved.