Materiały źródłowe

• #1 Diphtheria – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560911/

  Diphtheria is a toxin-mediated infection primarily caused by Corynebacterium diphtheriae, a member of the Corynebacterium species. […] The pathogenic impact of exotoxins extends to both localized and systemic manifestations of the disease. […] The pathogenesis of diphtheria involves various etiological factors, including: Incomplete or absent immunization, waning immunity over time, low herd immunity, travel to endemic areas, travel to regions experiencing current epidemics, immunocompromised states, low socioeconomic status, large-scale population movements, overcrowded conditions, and domestic animals. […] The organism’s pathogenicity hinges on the production of exotoxins, which can lead to severe complications, primarily affecting the heart muscle and nervous system. […] Three distinct strains of Corynebacterium diphtheriae, gravis, intermedius, and mitis have been isolated, and all 3 are capable of toxin production.

• #2 Diphtheria – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diphtheria/symptoms-causes/syc-20351897

  Diphtheria is caused by the bacterium Corynebacterium diphtheriae. The bacterium usually multiplies on or near the surface of the throat or skin. C. diphtheriae spreads through: […] People who have been infected by the diphtheria bacteria and who haven’t been treated can infect people who haven’t had the diphtheria vaccine even if they don’t show any symptoms.

• #3 Diphtheria: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/782051-overview

  C diphtheria is responsible for both endemic and epidemic diseases, and it was first described in the 5th century BC by Hippocrates. Diphtheria manifests as either an upper respiratory tract or cutaneous infection and is caused by the aerobic gram-positive bacteria, Corynebacterium diphtheria. […] People who are most susceptible to infection are those who are not completely immunized or have low antitoxin antibody levels and have been exposed to a carrier or diseased individual. A carrier is someone whose cultures are positive for the diphtheria species but does not exhibit signs and symptoms. […] Exotoxins are associated with both invasive localized and systemic forms of this disease; however, case reports of invasive disease in absence of the exotoxin release have been documented. […] The 3 isolated strains of C diphtheria include gravis, intermedius, and mitis. Intermedius is thought to be responsible for systemic elaboration of the disease, as it is most often associated with the exotoxin.

• #4 Factsheet about diphtheria

  https://www.ecdc.europa.eu/en/diphtheria/facts

  Diphtheria is an acute disease caused by toxin-producing strains of Corynebacterium diphtheriae (in some cases also by Corynebacterium ulcerans) bacteria, that is known to colonise mucous membranes. […] Diphtheria is a disease caused by bacteria Corynebacterium diphtheriae and Corynebacterium ulcerans. […] Diphtheria can cause toxins to be released into the circulatory system and tissues that can cause extensive organ damage. […] The most common cause of death is suffocation by aspiration of the membrane. […] Diphtheria is caught by coming into contact with droplets from the respiratory tract of an infected person particularly spread by coughing or sneezing. […] Diphtheria can be treated with antitoxin and antibiotics. […] An effective vaccine is available against diphtheria and mass immunisation has led to the reduction in the number of cases in Europe.

• #5 Epidemiology and pathophysiology of diphtheria – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-pathophysiology-of-diphtheria

  Diphtheria is an infectious disease caused by the gram-positive bacillus Corynebacterium diphtheriae. Infection may lead to respiratory disease, cutaneous disease, or an asymptomatic carrier state. […] There are at least four biotypes or biovars of C. diphtheriae: gravis, intermedius, mitis, and belfanti. All biotypes have been associated with both endemic and epidemic diphtheria. However, belfanti is rarely described as toxigenic, whereas the other biotypes are named for their association with disease severity: gravis (serious), intermedius (intermediate), and mitis (mild). […] C. ulcerans is a rare cause of respiratory illness that resembles diphtheria. It has been reported predominantly in industrialized countries, which may be due in part to detection bias. […] The primary modes of spread consist of close contact with infectious material from respiratory secretions (direct or via airborne droplet) or from skin lesions. Humans are believed to be the only known reservoir for C. diphtheriae, although rare cases of disease in animals have been reported.

• #6 Diphtheria – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-bacilli/diphtheria

  Diphtheria is an acute pharyngeal or cutaneous infection caused mainly by toxigenic strains of the gram-positive bacillus Corynebacterium diphtheriae and rarely by other, less common Corynebacterium species. […] Diphtheria strains infected by a beta-phage, which carries a toxin-encoding gene, produce a potent toxin. […] Nontoxigenic strains of C. diphtheriae can also cause nasopharyngeal infection and sometimes systemic disease (eg, endocarditis, septic arthritis). […] Humans are the only known reservoir for C. diphtheriae. […] A carrier state is common in endemic regions but not in high-income countries. […] Poor personal and community hygiene contributes to the spread of cutaneous diphtheria. […] The main complications of diphtheria are cardiac and neurologic. […] Myocarditis is usually evident by the 10th to 14th day but can appear any time during the 1st to the 6th week, even while local respiratory symptoms are subsiding; risk of cardiac toxicity is related to degree of local infection.

• #7 Diphtheria – MD Searchlight

  https://mdsearchlight.com/infectious-disease/diphtheria/?utm_source=pubmedlink&utm_campaign=MDS&utm_content=112524

  Diphtheria is an illness caused by a bacterium known as Corynebacterium diphtheriae. […] C. diphtheriae is a type of bacteria that does not form spores and is not able to move or encapsulate. […] The health-related impacts of exotoxins, which are toxins released by bacteria, can affect both localised and whole-body aspects of the disease. […] Many factors can contribute to the development of diphtheria, such as: Incomplete or lack of vaccinations, Weakening immunity over time, which makes older people without booster shots more likely to get infected, Low immunity in the community, Traveling to areas where the disease is common, Traveling to regions currently experiencing outbreaks, Having a weakened immune system, Low social economic status, Massive movements of people, Overcrowding, like in military barracks, prisons, and homeless shelters, Domestic animals. […] Diphtheria is still a challenge in developing countries and cases are still higher in specific areas like Southeast Asia and Africa. […] If a person doesnt get regular shots and booster doses, their immunity to diphtheria naturally goes down, raising their risk of getting the disease.

• #8 Diphtheria: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/782051-overview

  C diphtheria is responsible for both endemic and epidemic diseases, and it was first described in the 5th century BC by Hippocrates. Diphtheria manifests as either an upper respiratory tract or cutaneous infection and is caused by the aerobic gram-positive bacteria, Corynebacterium diphtheria. […] People who are most susceptible to infection are those who are not completely immunized or have low antitoxin antibody levels and have been exposed to a carrier or diseased individual. A carrier is someone whose cultures are positive for the diphtheria species but does not exhibit signs and symptoms. […] Exotoxins are associated with both invasive localized and systemic forms of this disease; however, case reports of invasive disease in absence of the exotoxin release have been documented. […] The 3 isolated strains of C diphtheria include gravis, intermedius, and mitis. Intermedius is thought to be responsible for systemic elaboration of the disease, as it is most often associated with the exotoxin.

• #9 Diphtheria – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560911/

  Diphtheria is a toxin-mediated infection primarily caused by Corynebacterium diphtheriae, a member of the Corynebacterium species. […] The pathogenic impact of exotoxins extends to both localized and systemic manifestations of the disease. […] The pathogenesis of diphtheria involves various etiological factors, including: Incomplete or absent immunization, waning immunity over time, low herd immunity, travel to endemic areas, travel to regions experiencing current epidemics, immunocompromised states, low socioeconomic status, large-scale population movements, overcrowded conditions, and domestic animals. […] The organism’s pathogenicity hinges on the production of exotoxins, which can lead to severe complications, primarily affecting the heart muscle and nervous system. […] Three distinct strains of Corynebacterium diphtheriae, gravis, intermedius, and mitis have been isolated, and all 3 are capable of toxin production.

• #10 Epidemiology and pathophysiology of diphtheria – UpToDate

  https://www.uptodate.com/contents/epidemiology-and-pathophysiology-of-diphtheria

  Diphtheria is an infectious disease caused by the gram-positive bacillus Corynebacterium diphtheriae. Infection may lead to respiratory disease, cutaneous disease, or an asymptomatic carrier state. […] There are at least four biotypes or biovars of C. diphtheriae: gravis, intermedius, mitis, and belfanti. All biotypes have been associated with both endemic and epidemic diphtheria. However, belfanti is rarely described as toxigenic, whereas the other biotypes are named for their association with disease severity: gravis (serious), intermedius (intermediate), and mitis (mild). […] C. ulcerans is a rare cause of respiratory illness that resembles diphtheria. It has been reported predominantly in industrialized countries, which may be due in part to detection bias. […] The primary modes of spread consist of close contact with infectious material from respiratory secretions (direct or via airborne droplet) or from skin lesions. Humans are believed to be the only known reservoir for C. diphtheriae, although rare cases of disease in animals have been reported.

• #11 Diphtheria: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/782051-overview

  C diphtheria is responsible for both endemic and epidemic diseases, and it was first described in the 5th century BC by Hippocrates. Diphtheria manifests as either an upper respiratory tract or cutaneous infection and is caused by the aerobic gram-positive bacteria, Corynebacterium diphtheria. […] People who are most susceptible to infection are those who are not completely immunized or have low antitoxin antibody levels and have been exposed to a carrier or diseased individual. A carrier is someone whose cultures are positive for the diphtheria species but does not exhibit signs and symptoms. […] Exotoxins are associated with both invasive localized and systemic forms of this disease; however, case reports of invasive disease in absence of the exotoxin release have been documented. […] The 3 isolated strains of C diphtheria include gravis, intermedius, and mitis. Intermedius is thought to be responsible for systemic elaboration of the disease, as it is most often associated with the exotoxin.

• #12 Diphtheria – Wikipedia

  https://en.wikipedia.org/wiki/Diphtheria

  Diphtheria is an infection caused by the bacterium Corynebacterium diphtheriae. […] Different strains of C. diphtheriae are the main cause in the variability of lethality, as the lethality and symptoms themselves are caused by the exotoxin produced by the bacteria. […] Diphtheria toxin (DT) is produced only by C. diphtheriae infected with a certain type of bacteriophage. […] Toxinogenicity is determined by phage conversion (also called lysogenic conversion); i.e., the ability of the bacterium to make DT changes as a consequence of infection by a particular phage. […] The chromosome of C. diphtheriae has two different but functionally equivalent bacterial attachment sites (attB) for integration of prophage into the chromosome. […] The diphtheria toxin precursor is a protein of molecular weight 60 kDa. […] Fragment A inhibits the synthesis of new proteins in the affected cell by catalyzing ADP-ribosylation of elongation factor EF-2a protein that is essential to the translation step of protein synthesis.

• #13 Chapter 7: Diphtheria | Pink Book | CDC

  https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-7-diphtheria.html

  Diphtheria is an acute, bacterial disease caused by toxin-producing strains of Corynebacterium diphtheriae. […] Toxin production (toxigenicity) occurs only when the bacillus is itself infected (lysogenized) by specific viruses (corynebacteriophages) carrying the genetic information for the toxin (tox gene). […] The toxin produced at the site of the membrane is absorbed into the bloodstream and then distributed to the tissues of the body. […] The toxin is responsible for major complications such as myocarditis, polyneuropathies, and nephritis, and can also cause thrombocytopenia. […] Most complications of diphtheria, including death, are caused by effects of the toxin. […] The severity of the disease and complications are generally related to the extent of local disease. […] The most frequent complications of diphtheria are myocarditis and neuritis.

• #14 Diphtheria – Wikipedia

  https://en.wikipedia.org/wiki/Diphtheria

  Diphtheria is an infection caused by the bacterium Corynebacterium diphtheriae. […] Different strains of C. diphtheriae are the main cause in the variability of lethality, as the lethality and symptoms themselves are caused by the exotoxin produced by the bacteria. […] Diphtheria toxin (DT) is produced only by C. diphtheriae infected with a certain type of bacteriophage. […] Toxinogenicity is determined by phage conversion (also called lysogenic conversion); i.e., the ability of the bacterium to make DT changes as a consequence of infection by a particular phage. […] The chromosome of C. diphtheriae has two different but functionally equivalent bacterial attachment sites (attB) for integration of prophage into the chromosome. […] The diphtheria toxin precursor is a protein of molecular weight 60 kDa. […] Fragment A inhibits the synthesis of new proteins in the affected cell by catalyzing ADP-ribosylation of elongation factor EF-2a protein that is essential to the translation step of protein synthesis.

• #15 Corynebacterium Diphtheriae – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK7971/

  Corynebacterium diphtheriae infects the nasopharynx or skin. Toxigenic strains secrete a potent exotoxin which may cause diphtheria. […] The pathogenesis of diphtheria is based upon two primary determinants: (1) the ability of a given strain of C diphtheriae to colonize in the nasopharyngeal cavity and/or on the skin, and (2) its ability to produce diphtheria toxin. […] The structural gene for diphtheria toxin, tox, is carried by a family of closely related corynebacteriophages of which the -phage is the most extensively studied. […] Diphtheria toxin is extraordinarily potent; in sensitive species (e.g., humans, monkeys, rabbits, guinea pigs) as little as 100 to 150 ng/kg of body weight is lethal. […] The intoxication of a single eukaryotic cell by diphtheria toxin involves at least four distinct steps: (1) the binding of the toxin to its cell surface receptor; (2) clustering of charged receptors into coated pits and internalization of the toxin by receptor-mediated endocytosis; following acidification of the endocytic vesicle by a membrane-associated, ATP-driven proton pump, (3) the insertion of the transmembrane domain into the membrane and the facilitated delivery of the catalytic domain to the cytosol, and (4) the ADP-ribosylation of EF-2, which results in the irreversible inhibition of protein synthesis. […] The control of diphtheria depends upon adequate immunization with diphtheria toxoid: formaldehyde-inactivated diphtheria toxin that remains antigenically intact.

• #16 Diphtheria – Wikipedia

  https://en.wikipedia.org/wiki/Diphtheria

  Diphtheria is an infection caused by the bacterium Corynebacterium diphtheriae. […] Different strains of C. diphtheriae are the main cause in the variability of lethality, as the lethality and symptoms themselves are caused by the exotoxin produced by the bacteria. […] Diphtheria toxin (DT) is produced only by C. diphtheriae infected with a certain type of bacteriophage. […] Toxinogenicity is determined by phage conversion (also called lysogenic conversion); i.e., the ability of the bacterium to make DT changes as a consequence of infection by a particular phage. […] The chromosome of C. diphtheriae has two different but functionally equivalent bacterial attachment sites (attB) for integration of prophage into the chromosome. […] The diphtheria toxin precursor is a protein of molecular weight 60 kDa. […] Fragment A inhibits the synthesis of new proteins in the affected cell by catalyzing ADP-ribosylation of elongation factor EF-2a protein that is essential to the translation step of protein synthesis.

• #17 Corynebacterium Diphtheriae – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK7971/

  Corynebacterium diphtheriae infects the nasopharynx or skin. Toxigenic strains secrete a potent exotoxin which may cause diphtheria. […] The pathogenesis of diphtheria is based upon two primary determinants: (1) the ability of a given strain of C diphtheriae to colonize in the nasopharyngeal cavity and/or on the skin, and (2) its ability to produce diphtheria toxin. […] The structural gene for diphtheria toxin, tox, is carried by a family of closely related corynebacteriophages of which the -phage is the most extensively studied. […] Diphtheria toxin is extraordinarily potent; in sensitive species (e.g., humans, monkeys, rabbits, guinea pigs) as little as 100 to 150 ng/kg of body weight is lethal. […] The intoxication of a single eukaryotic cell by diphtheria toxin involves at least four distinct steps: (1) the binding of the toxin to its cell surface receptor; (2) clustering of charged receptors into coated pits and internalization of the toxin by receptor-mediated endocytosis; following acidification of the endocytic vesicle by a membrane-associated, ATP-driven proton pump, (3) the insertion of the transmembrane domain into the membrane and the facilitated delivery of the catalytic domain to the cytosol, and (4) the ADP-ribosylation of EF-2, which results in the irreversible inhibition of protein synthesis. […] The control of diphtheria depends upon adequate immunization with diphtheria toxoid: formaldehyde-inactivated diphtheria toxin that remains antigenically intact.

• #18 Diphtheria: Symptoms, Treatment, and How It Spread

  https://www.verywellhealth.com/overview-of-diphtheria-4175810

  Diphtheria can be caused by one of several strains of bacteria called Corynebacterium diphtheria. These strains release a poisonous substance called diphtheria toxin that is responsible for the severe symptoms of infection. […] Generally, the more toxins released, the sicker a person will be. A fatal dose in humans is about 0.1 micrograms (g) of toxin per kilogram of body weight. Death is most commonly the result of necrosis (tissue death) of the heart or liver.

• #19 Diphtheria – Wikipedia

  https://en.wikipedia.org/wiki/Diphtheria

  Diphtheria is an infection caused by the bacterium Corynebacterium diphtheriae. […] Different strains of C. diphtheriae are the main cause in the variability of lethality, as the lethality and symptoms themselves are caused by the exotoxin produced by the bacteria. […] Diphtheria toxin (DT) is produced only by C. diphtheriae infected with a certain type of bacteriophage. […] Toxinogenicity is determined by phage conversion (also called lysogenic conversion); i.e., the ability of the bacterium to make DT changes as a consequence of infection by a particular phage. […] The chromosome of C. diphtheriae has two different but functionally equivalent bacterial attachment sites (attB) for integration of prophage into the chromosome. […] The diphtheria toxin precursor is a protein of molecular weight 60 kDa. […] Fragment A inhibits the synthesis of new proteins in the affected cell by catalyzing ADP-ribosylation of elongation factor EF-2a protein that is essential to the translation step of protein synthesis.

• #20 Corynebacterium diphtheriae – Wikipedia

  https://en.wikipedia.org/wiki/Corynebacterium_diphtheriae

  Corynebacterium diphtheriae is a Gram-positive pathogenic bacterium that causes diphtheria. […] These bacteria are usually harmless, unless they are infected by a bacteriophage carrying a gene which gives rise to a toxin. This toxin causes the disease. Diphtheria is caused by the adhesion and infiltration of the bacteria into the mucosal layers of the body, primarily affecting the respiratory tract and causing the subsequent release of an exotoxin. […] The strains that are toxigenic are ones which have been infected with a bacteriophage. […] The diphtheria toxin gene is encoded by the bacteriophage found in toxigenic strains, integrated into the bacterial chromosome. […] The first step of C. diphtheriae infection involves the toxigenic bacteria colonizing a mucosal layer. […] The diphtheritic lesion is often covered by a pseudomembrane composed of fibrin, bacterial cells, and inflammatory cells. Diphtheria toxin can be proteolytically cleaved into two fragments: an N-terminal fragment A (catalytic domain), and fragment B (transmembrane and receptor binding domain). […] Once the bacteria have localized in one area, they start multiplying and create the inflammatory pseudomembrane.

• #21 Corynebacterium Diphtheriae – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK7971/

  Corynebacterium diphtheriae infects the nasopharynx or skin. Toxigenic strains secrete a potent exotoxin which may cause diphtheria. […] The pathogenesis of diphtheria is based upon two primary determinants: (1) the ability of a given strain of C diphtheriae to colonize in the nasopharyngeal cavity and/or on the skin, and (2) its ability to produce diphtheria toxin. […] The structural gene for diphtheria toxin, tox, is carried by a family of closely related corynebacteriophages of which the -phage is the most extensively studied. […] Diphtheria toxin is extraordinarily potent; in sensitive species (e.g., humans, monkeys, rabbits, guinea pigs) as little as 100 to 150 ng/kg of body weight is lethal. […] The intoxication of a single eukaryotic cell by diphtheria toxin involves at least four distinct steps: (1) the binding of the toxin to its cell surface receptor; (2) clustering of charged receptors into coated pits and internalization of the toxin by receptor-mediated endocytosis; following acidification of the endocytic vesicle by a membrane-associated, ATP-driven proton pump, (3) the insertion of the transmembrane domain into the membrane and the facilitated delivery of the catalytic domain to the cytosol, and (4) the ADP-ribosylation of EF-2, which results in the irreversible inhibition of protein synthesis. […] The control of diphtheria depends upon adequate immunization with diphtheria toxoid: formaldehyde-inactivated diphtheria toxin that remains antigenically intact.

• #22 Diphtheria – Wikipedia

  https://en.wikipedia.org/wiki/Diphtheria

  Diphtheria is an infection caused by the bacterium Corynebacterium diphtheriae. […] Different strains of C. diphtheriae are the main cause in the variability of lethality, as the lethality and symptoms themselves are caused by the exotoxin produced by the bacteria. […] Diphtheria toxin (DT) is produced only by C. diphtheriae infected with a certain type of bacteriophage. […] Toxinogenicity is determined by phage conversion (also called lysogenic conversion); i.e., the ability of the bacterium to make DT changes as a consequence of infection by a particular phage. […] The chromosome of C. diphtheriae has two different but functionally equivalent bacterial attachment sites (attB) for integration of prophage into the chromosome. […] The diphtheria toxin precursor is a protein of molecular weight 60 kDa. […] Fragment A inhibits the synthesis of new proteins in the affected cell by catalyzing ADP-ribosylation of elongation factor EF-2a protein that is essential to the translation step of protein synthesis.

• #23 Diphtheria – Wikipedia

  https://en.wikipedia.org/wiki/Diphtheria

  Diphtheria is an infection caused by the bacterium Corynebacterium diphtheriae. […] Different strains of C. diphtheriae are the main cause in the variability of lethality, as the lethality and symptoms themselves are caused by the exotoxin produced by the bacteria. […] Diphtheria toxin (DT) is produced only by C. diphtheriae infected with a certain type of bacteriophage. […] Toxinogenicity is determined by phage conversion (also called lysogenic conversion); i.e., the ability of the bacterium to make DT changes as a consequence of infection by a particular phage. […] The chromosome of C. diphtheriae has two different but functionally equivalent bacterial attachment sites (attB) for integration of prophage into the chromosome. […] The diphtheria toxin precursor is a protein of molecular weight 60 kDa. […] Fragment A inhibits the synthesis of new proteins in the affected cell by catalyzing ADP-ribosylation of elongation factor EF-2a protein that is essential to the translation step of protein synthesis.

• #24 Diphtheria: Causes, symptoms, and treatment

  https://www.medicalnewstoday.com/articles/159534

  Diphtheria is a serious and contagious infection caused when the bacteria Corynebacterium diphtheriae release toxins. […] Diphtheria is a highly contagious bacterial infection that occurs due to variants of Corynebacterium diphtheriae (C. diphtheriae). […] Diphtheria is an infectious disease that occurs due to C. diphtheriae. It is the toxin this bacterium produces that causes people to become very ill. […] According to a 2019 article, some variants of this bacterium produce a toxin called an exotoxin. This causes the most serious complications associated with diphtheria. The toxin inhibits the production of proteins and leads to cell and tissue death. […] If the toxin enters the bloodstream, it can damage the kidneys, heart, and nerves. […] Other variants of C. diphtheriae do not produce the toxin. This results in less severe disease, typically causing a sore throat and, in rare cases, pharyngitis. […] Potentially life threatening complications can occur if the toxin enters the bloodstream and damages other vital tissues. […] Diphtheria is a bacterial infection that can lead to severe complications, including death.

• #25 Corynebacterium Diphtheriae – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK7971/

  Corynebacterium diphtheriae infects the nasopharynx or skin. Toxigenic strains secrete a potent exotoxin which may cause diphtheria. […] The pathogenesis of diphtheria is based upon two primary determinants: (1) the ability of a given strain of C diphtheriae to colonize in the nasopharyngeal cavity and/or on the skin, and (2) its ability to produce diphtheria toxin. […] The structural gene for diphtheria toxin, tox, is carried by a family of closely related corynebacteriophages of which the -phage is the most extensively studied. […] Diphtheria toxin is extraordinarily potent; in sensitive species (e.g., humans, monkeys, rabbits, guinea pigs) as little as 100 to 150 ng/kg of body weight is lethal. […] The intoxication of a single eukaryotic cell by diphtheria toxin involves at least four distinct steps: (1) the binding of the toxin to its cell surface receptor; (2) clustering of charged receptors into coated pits and internalization of the toxin by receptor-mediated endocytosis; following acidification of the endocytic vesicle by a membrane-associated, ATP-driven proton pump, (3) the insertion of the transmembrane domain into the membrane and the facilitated delivery of the catalytic domain to the cytosol, and (4) the ADP-ribosylation of EF-2, which results in the irreversible inhibition of protein synthesis. […] The control of diphtheria depends upon adequate immunization with diphtheria toxoid: formaldehyde-inactivated diphtheria toxin that remains antigenically intact.

• #26 Diphtheria: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/17870-diphtheria

  Diphtheria is a highly contagious, infectious disease caused by a bacterium called Corynebacterium diphtheriae. […] Diphtheria is caused by bacteria adhering to the lining of your respiratory system. These bacteria generate a toxin that damages your respiratory tissue cells. […] Diphtheria is a contagious infection caused by a bacterium called Corynebacterium diphtheriae. The bacterium releases a toxin that causes a buildup of grey tissue in your throat, leading to problems with swallowing and breathing. […] Diphtheria is a highly contagious disease thats spread through airborne droplets or contaminated personal items.

• #27 Diphtheria: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/782051-overview

  Corynebacterium ulcerans is a relatively rare species that more frequently causes cutaneous diphtheria; however, this species may rarely cause respiratory symptoms. […] Overcrowding, poor health, substandard living conditions, incomplete immunization, and immunocompromised states facilitate susceptibility to diphtheria and are risk factors for transmission of this disease. […] Human carriers are the main reservoir of infection; however, case reports have linked diphtheria to livestock. […] C diphtheria adheres to mucosal epithelial cells where the exotoxin, released by endosomes, causes a localized inflammatory reaction followed by tissue destruction and necrosis. […] Local tissue destruction enables the toxin to be carried lymphatically and hematologically to other parts of the body. Elaboration of the diphtheria toxin may affect distant organs such as the myocardium, kidneys, and nervous system.

• #28 Diphtheria: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/782051-overview

  Corynebacterium ulcerans is a relatively rare species that more frequently causes cutaneous diphtheria; however, this species may rarely cause respiratory symptoms. […] Overcrowding, poor health, substandard living conditions, incomplete immunization, and immunocompromised states facilitate susceptibility to diphtheria and are risk factors for transmission of this disease. […] Human carriers are the main reservoir of infection; however, case reports have linked diphtheria to livestock. […] C diphtheria adheres to mucosal epithelial cells where the exotoxin, released by endosomes, causes a localized inflammatory reaction followed by tissue destruction and necrosis. […] Local tissue destruction enables the toxin to be carried lymphatically and hematologically to other parts of the body. Elaboration of the diphtheria toxin may affect distant organs such as the myocardium, kidneys, and nervous system.

• #29 Diphtheria: Causes, symptoms, and treatment

  https://www.medicalnewstoday.com/articles/159534

  Diphtheria is a serious and contagious infection caused when the bacteria Corynebacterium diphtheriae release toxins. […] Diphtheria is a highly contagious bacterial infection that occurs due to variants of Corynebacterium diphtheriae (C. diphtheriae). […] Diphtheria is an infectious disease that occurs due to C. diphtheriae. It is the toxin this bacterium produces that causes people to become very ill. […] According to a 2019 article, some variants of this bacterium produce a toxin called an exotoxin. This causes the most serious complications associated with diphtheria. The toxin inhibits the production of proteins and leads to cell and tissue death. […] If the toxin enters the bloodstream, it can damage the kidneys, heart, and nerves. […] Other variants of C. diphtheriae do not produce the toxin. This results in less severe disease, typically causing a sore throat and, in rare cases, pharyngitis. […] Potentially life threatening complications can occur if the toxin enters the bloodstream and damages other vital tissues. […] Diphtheria is a bacterial infection that can lead to severe complications, including death.

• #30 Diphtheria: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/782051-overview

  Corynebacterium ulcerans is a relatively rare species that more frequently causes cutaneous diphtheria; however, this species may rarely cause respiratory symptoms. […] Overcrowding, poor health, substandard living conditions, incomplete immunization, and immunocompromised states facilitate susceptibility to diphtheria and are risk factors for transmission of this disease. […] Human carriers are the main reservoir of infection; however, case reports have linked diphtheria to livestock. […] C diphtheria adheres to mucosal epithelial cells where the exotoxin, released by endosomes, causes a localized inflammatory reaction followed by tissue destruction and necrosis. […] Local tissue destruction enables the toxin to be carried lymphatically and hematologically to other parts of the body. Elaboration of the diphtheria toxin may affect distant organs such as the myocardium, kidneys, and nervous system.

• #31 Diphtheria | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/healthyliving/diphtheria

  Diphtheria is a serious bacterial disease that causes severe inflammation of the nose, throat and windpipe (trachea). […] Diphtheria is caused by the bacterium Corynebacterium diphtheriae. […] The bacteria produce toxins that cause an abnormal membrane to grow in the throat, which can lead to suffocation. […] Other dangerous complications include paralysis and heart failure if the toxins spread throughout the body. […] Diphtheria is extremely rare in most developed countries, including Australia, because of the widespread use of the diphtheria vaccine.

• #32

  https://historyofvaccines.org/history/diphtheria/overview/

  Diphtheria is caused by bacteria called Corynebacterium diphtheriae. The bacteria secrete a powerful toxin that causes damage to body tissues. […] The pseudomembrane is formed from waste products and proteins related to the toxin secreted by the bacteria. […] Diphtheria treatment involves antibiotics to kill the diphtheria bacteria, plus antitoxin to neutralize the toxins secreted by the bacteria.

• #33 What to Know About Diphtheria

  https://www.webmd.com/a-to-z-guides/what-to-know-diphtheria-causes

  In the U.S., youre only at risk for the disease if you havent gotten the diphtheria vaccine. […] Diphtheria infections of the skin are common in tropical countries. […] When the diphtheria bacteria grows in the moist inner lining of your nose and throat, it begins to make large amounts of a toxin. This toxin kills your cells and creates a thick gray coating called a pseudomembrane from dead cells, bacteria, waste products, and proteins. […] From your throat, the toxin can get into your bloodstream and cause lots of damage to other tissues and organs throughout your body. […] Without treatment, respiratory diphtheria (the type that infects body parts involved in breathing) can lead to severe health problems, like blocked airway, heart damage (myocarditis), nerve damage (polyneuropathy), losing your ability to move (paralysis), and kidney failure.

• #34 Diphtheria: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/17870-diphtheria

  Diphtheria is a highly contagious, infectious disease caused by a bacterium called Corynebacterium diphtheriae. […] Diphtheria is caused by bacteria adhering to the lining of your respiratory system. These bacteria generate a toxin that damages your respiratory tissue cells. […] Diphtheria is a contagious infection caused by a bacterium called Corynebacterium diphtheriae. The bacterium releases a toxin that causes a buildup of grey tissue in your throat, leading to problems with swallowing and breathing. […] Diphtheria is a highly contagious disease thats spread through airborne droplets or contaminated personal items.

• #35 Factsheet about diphtheria

  https://www.ecdc.europa.eu/en/diphtheria/facts

  Diphtheria is an acute disease caused by toxin-producing strains of Corynebacterium diphtheriae (in some cases also by Corynebacterium ulcerans) bacteria, that is known to colonise mucous membranes. […] Diphtheria is a disease caused by bacteria Corynebacterium diphtheriae and Corynebacterium ulcerans. […] Diphtheria can cause toxins to be released into the circulatory system and tissues that can cause extensive organ damage. […] The most common cause of death is suffocation by aspiration of the membrane. […] Diphtheria is caught by coming into contact with droplets from the respiratory tract of an infected person particularly spread by coughing or sneezing. […] Diphtheria can be treated with antitoxin and antibiotics. […] An effective vaccine is available against diphtheria and mass immunisation has led to the reduction in the number of cases in Europe.

• #36 Factsheet about diphtheria

  https://www.ecdc.europa.eu/en/diphtheria/facts

  Diphtheria is an acute disease caused by toxin-producing strains of Corynebacterium diphtheriae (in some cases also by Corynebacterium ulcerans) bacteria, that is known to colonise mucous membranes. […] Diphtheria is a disease caused by bacteria Corynebacterium diphtheriae and Corynebacterium ulcerans. […] Diphtheria can cause toxins to be released into the circulatory system and tissues that can cause extensive organ damage. […] The most common cause of death is suffocation by aspiration of the membrane. […] Diphtheria is caught by coming into contact with droplets from the respiratory tract of an infected person particularly spread by coughing or sneezing. […] Diphtheria can be treated with antitoxin and antibiotics. […] An effective vaccine is available against diphtheria and mass immunisation has led to the reduction in the number of cases in Europe.

• #37 Chapter 7: Diphtheria | Pink Book | CDC

  https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-7-diphtheria.html

  Diphtheria is an acute, bacterial disease caused by toxin-producing strains of Corynebacterium diphtheriae. […] Toxin production (toxigenicity) occurs only when the bacillus is itself infected (lysogenized) by specific viruses (corynebacteriophages) carrying the genetic information for the toxin (tox gene). […] The toxin produced at the site of the membrane is absorbed into the bloodstream and then distributed to the tissues of the body. […] The toxin is responsible for major complications such as myocarditis, polyneuropathies, and nephritis, and can also cause thrombocytopenia. […] Most complications of diphtheria, including death, are caused by effects of the toxin. […] The severity of the disease and complications are generally related to the extent of local disease. […] The most frequent complications of diphtheria are myocarditis and neuritis.

• #38 Diphtheria – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-bacilli/diphtheria

  Diphtheria is an acute pharyngeal or cutaneous infection caused mainly by toxigenic strains of the gram-positive bacillus Corynebacterium diphtheriae and rarely by other, less common Corynebacterium species. […] Diphtheria strains infected by a beta-phage, which carries a toxin-encoding gene, produce a potent toxin. […] Nontoxigenic strains of C. diphtheriae can also cause nasopharyngeal infection and sometimes systemic disease (eg, endocarditis, septic arthritis). […] Humans are the only known reservoir for C. diphtheriae. […] A carrier state is common in endemic regions but not in high-income countries. […] Poor personal and community hygiene contributes to the spread of cutaneous diphtheria. […] The main complications of diphtheria are cardiac and neurologic. […] Myocarditis is usually evident by the 10th to 14th day but can appear any time during the 1st to the 6th week, even while local respiratory symptoms are subsiding; risk of cardiac toxicity is related to degree of local infection.

• #39 Diphtheria – Infectious Disease Advisor

  https://www.infectiousdiseaseadvisor.com/ddi/diphtheria/

  Diphtheria is a potentially fatal disease caused by infection with toxin-producing strains of Corynebacterium diphtheriae, a Gram-positive bacillus. […] Diphtheria is most caused by infection with C diphtheriae, and occasionally by toxigenic C ulcerans and C pseudotuberculosis strains. […] Diphtheria toxin causes the manifestations of diphtheria. Specifically, this toxin block protein synthesis, cause local tissue destruction, and drives the formation of the hallmark pseudomembrane. […] Most complications from diphtheria infection are caused by the diphtheria toxin. […] The most common complications associated with diphtheria infections are neuritis, myocarditis, and polyneuropathy.

• #40 Chapter 7: Diphtheria | Pink Book | CDC

  https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-7-diphtheria.html

  Diphtheria is an acute, bacterial disease caused by toxin-producing strains of Corynebacterium diphtheriae. […] Toxin production (toxigenicity) occurs only when the bacillus is itself infected (lysogenized) by specific viruses (corynebacteriophages) carrying the genetic information for the toxin (tox gene). […] The toxin produced at the site of the membrane is absorbed into the bloodstream and then distributed to the tissues of the body. […] The toxin is responsible for major complications such as myocarditis, polyneuropathies, and nephritis, and can also cause thrombocytopenia. […] Most complications of diphtheria, including death, are caused by effects of the toxin. […] The severity of the disease and complications are generally related to the extent of local disease. […] The most frequent complications of diphtheria are myocarditis and neuritis.

• #41 Diphtheria – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-bacilli/diphtheria

  Nervous system toxicity is uncommon (about 5%) and limited to patients with severe respiratory diphtheria. […] In severe cases, acute renal failure may occur because the toxin damages the kidneys. […] Overall mortality is 3%; it is higher in those with any of the following: Delayed presentation, Acute renal failure, Myocarditis, Age 40 years. […] Diphtheria antitoxin must be given early without waiting for culture confirmation because the antitoxin neutralizes only toxin not yet bound to cells. […] Antibiotics are required to eradicate the organism and prevent spread; they are not substitutes for antitoxin. […] Vaccination is required after recovery for patients who had diphtheria because infection does not guarantee immunity. […] The vaccine for diphtheria contains diphtheria toxoid; it is available only in combination with other vaccines. […] Nasopharyngeal and throat cultures for C. diphtheriae should be done regardless of immunization status because the vaccine protects only against the effects of diphtheria toxin; it does not prevent infection with C. diphtheriae.

• #42 Diphtheria – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-bacilli/diphtheria

  Nervous system toxicity is uncommon (about 5%) and limited to patients with severe respiratory diphtheria. […] In severe cases, acute renal failure may occur because the toxin damages the kidneys. […] Overall mortality is 3%; it is higher in those with any of the following: Delayed presentation, Acute renal failure, Myocarditis, Age 40 years. […] Diphtheria antitoxin must be given early without waiting for culture confirmation because the antitoxin neutralizes only toxin not yet bound to cells. […] Antibiotics are required to eradicate the organism and prevent spread; they are not substitutes for antitoxin. […] Vaccination is required after recovery for patients who had diphtheria because infection does not guarantee immunity. […] The vaccine for diphtheria contains diphtheria toxoid; it is available only in combination with other vaccines. […] Nasopharyngeal and throat cultures for C. diphtheriae should be done regardless of immunization status because the vaccine protects only against the effects of diphtheria toxin; it does not prevent infection with C. diphtheriae.

• #43 Chapter 7: Diphtheria | Pink Book | CDC

  https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-7-diphtheria.html

  Diphtheria is an acute, bacterial disease caused by toxin-producing strains of Corynebacterium diphtheriae. […] Toxin production (toxigenicity) occurs only when the bacillus is itself infected (lysogenized) by specific viruses (corynebacteriophages) carrying the genetic information for the toxin (tox gene). […] The toxin produced at the site of the membrane is absorbed into the bloodstream and then distributed to the tissues of the body. […] The toxin is responsible for major complications such as myocarditis, polyneuropathies, and nephritis, and can also cause thrombocytopenia. […] Most complications of diphtheria, including death, are caused by effects of the toxin. […] The severity of the disease and complications are generally related to the extent of local disease. […] The most frequent complications of diphtheria are myocarditis and neuritis.

• #44 Chapter 7: Diphtheria | Pink Book | CDC

  https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-7-diphtheria.html

  Diphtheria is an acute, bacterial disease caused by toxin-producing strains of Corynebacterium diphtheriae. […] Toxin production (toxigenicity) occurs only when the bacillus is itself infected (lysogenized) by specific viruses (corynebacteriophages) carrying the genetic information for the toxin (tox gene). […] The toxin produced at the site of the membrane is absorbed into the bloodstream and then distributed to the tissues of the body. […] The toxin is responsible for major complications such as myocarditis, polyneuropathies, and nephritis, and can also cause thrombocytopenia. […] Most complications of diphtheria, including death, are caused by effects of the toxin. […] The severity of the disease and complications are generally related to the extent of local disease. […] The most frequent complications of diphtheria are myocarditis and neuritis.

• #45 Chapter 7: Diphtheria | Pink Book | CDC

  https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-7-diphtheria.html

  The estimated overall case fatality ratio for diphtheria is 5% to 10%. […] Humans are the reservoir for C. diphtheriae. […] Transmission is most often person-to-person through respiratory droplets. […] Transmission may also occur from exposure to infected skin lesions or articles soiled with discharges from these lesions.

• #46 Diphtheria – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-bacilli/diphtheria

  Diphtheria is an acute pharyngeal or cutaneous infection caused mainly by toxigenic strains of the gram-positive bacillus Corynebacterium diphtheriae and rarely by other, less common Corynebacterium species. […] Diphtheria strains infected by a beta-phage, which carries a toxin-encoding gene, produce a potent toxin. […] Nontoxigenic strains of C. diphtheriae can also cause nasopharyngeal infection and sometimes systemic disease (eg, endocarditis, septic arthritis). […] Humans are the only known reservoir for C. diphtheriae. […] A carrier state is common in endemic regions but not in high-income countries. […] Poor personal and community hygiene contributes to the spread of cutaneous diphtheria. […] The main complications of diphtheria are cardiac and neurologic. […] Myocarditis is usually evident by the 10th to 14th day but can appear any time during the 1st to the 6th week, even while local respiratory symptoms are subsiding; risk of cardiac toxicity is related to degree of local infection.

• #47 Chapter 7: Diphtheria | Pink Book | CDC

  https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-7-diphtheria.html

  The estimated overall case fatality ratio for diphtheria is 5% to 10%. […] Humans are the reservoir for C. diphtheriae. […] Transmission is most often person-to-person through respiratory droplets. […] Transmission may also occur from exposure to infected skin lesions or articles soiled with discharges from these lesions.

• #48 About Diphtheria | Diphtheria | CDC

  https://www.cdc.gov/diphtheria/about/index.html

  People most commonly spread C. diphtheriae by coughing or sneezing, which creates small respiratory droplets that contain the bacteria. Other people can get infected if they breathe in those droplets. […] The best way to prevent diphtheria is to get vaccinated. […] Diphtheria antitoxin stops the toxin from causing more damage to the body. Antibiotics kill and get rid of the bacteria.

• #49 Chapter 7: Diphtheria | Pink Book | CDC

  https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-7-diphtheria.html

  The estimated overall case fatality ratio for diphtheria is 5% to 10%. […] Humans are the reservoir for C. diphtheriae. […] Transmission is most often person-to-person through respiratory droplets. […] Transmission may also occur from exposure to infected skin lesions or articles soiled with discharges from these lesions.

• #50 Diphtheria: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/782051-overview

  Corynebacterium ulcerans is a relatively rare species that more frequently causes cutaneous diphtheria; however, this species may rarely cause respiratory symptoms. […] Overcrowding, poor health, substandard living conditions, incomplete immunization, and immunocompromised states facilitate susceptibility to diphtheria and are risk factors for transmission of this disease. […] Human carriers are the main reservoir of infection; however, case reports have linked diphtheria to livestock. […] C diphtheria adheres to mucosal epithelial cells where the exotoxin, released by endosomes, causes a localized inflammatory reaction followed by tissue destruction and necrosis. […] Local tissue destruction enables the toxin to be carried lymphatically and hematologically to other parts of the body. Elaboration of the diphtheria toxin may affect distant organs such as the myocardium, kidneys, and nervous system.

• #51 Diphtheria Clinical Presentation: History, Physical, Causes

  https://emedicine.medscape.com/article/782051-clinical

  Low socioeconomic status […] Large-scale population movements – Implicated in the spread of the epidemic in the Newly Independent States of the former Soviet Union […] Poor healthcare care system infrastructure […] Overcrowding – Military barracks, homeless shelters, jails […] Domestic animals such as cats may act as reservoir for human infection.

• #52 Diphtheria – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-bacilli/diphtheria

  Diphtheria is an acute pharyngeal or cutaneous infection caused mainly by toxigenic strains of the gram-positive bacillus Corynebacterium diphtheriae and rarely by other, less common Corynebacterium species. […] Diphtheria strains infected by a beta-phage, which carries a toxin-encoding gene, produce a potent toxin. […] Nontoxigenic strains of C. diphtheriae can also cause nasopharyngeal infection and sometimes systemic disease (eg, endocarditis, septic arthritis). […] Humans are the only known reservoir for C. diphtheriae. […] A carrier state is common in endemic regions but not in high-income countries. […] Poor personal and community hygiene contributes to the spread of cutaneous diphtheria. […] The main complications of diphtheria are cardiac and neurologic. […] Myocarditis is usually evident by the 10th to 14th day but can appear any time during the 1st to the 6th week, even while local respiratory symptoms are subsiding; risk of cardiac toxicity is related to degree of local infection.

• #53 Diphtheria: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/782051-overview

  C diphtheria is responsible for both endemic and epidemic diseases, and it was first described in the 5th century BC by Hippocrates. Diphtheria manifests as either an upper respiratory tract or cutaneous infection and is caused by the aerobic gram-positive bacteria, Corynebacterium diphtheria. […] People who are most susceptible to infection are those who are not completely immunized or have low antitoxin antibody levels and have been exposed to a carrier or diseased individual. A carrier is someone whose cultures are positive for the diphtheria species but does not exhibit signs and symptoms. […] Exotoxins are associated with both invasive localized and systemic forms of this disease; however, case reports of invasive disease in absence of the exotoxin release have been documented. […] The 3 isolated strains of C diphtheria include gravis, intermedius, and mitis. Intermedius is thought to be responsible for systemic elaboration of the disease, as it is most often associated with the exotoxin.

• #54 Diphtheria – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diphtheria/symptoms-causes/syc-20351897

  Diphtheria is caused by the bacterium Corynebacterium diphtheriae. The bacterium usually multiplies on or near the surface of the throat or skin. C. diphtheriae spreads through: […] People who have been infected by the diphtheria bacteria and who haven’t been treated can infect people who haven’t had the diphtheria vaccine even if they don’t show any symptoms.

• #55 What to Know About Diphtheria

  https://www.webmd.com/a-to-z-guides/what-to-know-diphtheria-causes

  Diphtheria is a serious, sometimes deadly bacterial infection that forms in the moist inner lining of your nose and throat, and occasionally on the skin. […] A type of bacteria called Corynebacterium diphtheriae causes it. This bacteria is unique because it makes a toxin that kills your cells. That makes diphtheria deadlier than some other types of bacterial infections. […] The bacteria usually spreads through droplets that fly out of your nose or mouth when you sneeze or cough. […] People with diphtheria are highly contagious until 48 hours after they start getting antibiotic treatment. […] Its also possible to get the bacteria from someone whos infected but doesnt have any symptoms. […] If you catch diphtheria from a carrier, the bacteria can still turn into a serious infection, even though it was spread by someone who felt fine.

• #56 Diphtheria: Symptoms, Treatment & Prevention | Diphtheria Vaccine

  https://resources.healthgrades.com/right-care/infections-and-contagious-diseases/diphtheria

  Diphtheria is a bacterial infection with Corynebacterium diphtheriae. It spreads through respiratory droplets from sneezing, coughing or laughing. When someone inhales the droplets, the bacteria begin growing and multiplying in the tissues of the nose, mouth and throat. […] Diphtheria spreads very easily from person to person, especially in crowded conditions. Diphtheria can also spread through contact with infected sores or contaminated objects, such as tissues, towels or countertops. […] It is possible to carry diphtheria and not be sick. Carriers can pass along the infection to others who have not gotten the diphtheria vaccine. Without treatment, people remain contagious for up to four weeks.

• #57 Diphtheria – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560911/

  Diphtheria is a toxin-mediated infection primarily caused by Corynebacterium diphtheriae, a member of the Corynebacterium species. […] The pathogenic impact of exotoxins extends to both localized and systemic manifestations of the disease. […] The pathogenesis of diphtheria involves various etiological factors, including: Incomplete or absent immunization, waning immunity over time, low herd immunity, travel to endemic areas, travel to regions experiencing current epidemics, immunocompromised states, low socioeconomic status, large-scale population movements, overcrowded conditions, and domestic animals. […] The organism’s pathogenicity hinges on the production of exotoxins, which can lead to severe complications, primarily affecting the heart muscle and nervous system. […] Three distinct strains of Corynebacterium diphtheriae, gravis, intermedius, and mitis have been isolated, and all 3 are capable of toxin production.

• #58 Diphtheria Clinical Presentation: History, Physical, Causes

  https://emedicine.medscape.com/article/782051-clinical

  The following factors may predispose to diphtheria infection: […] Incomplete or absent immunization, which is especially important in the adult population, and the pediatric population in underdeveloped countries, may predispose to infection. In some cases, immunity does not prevent infection but lessens the severity of the disease. […] Antitoxin titers decrease over time and immunity wanes, thus older people who have not received booster vaccination are more susceptible to contract the disease from carriers. […] Low herd immunity, possibly leading to increasing prevalence of diphtheria infections […] Travel to endemic areas or regions with current epidemics […] Immunocompromised states – Due to pharmacologic immune suppression, disease states including HIV, or relative compromise such as from diabetes or alcoholism

• #59 Diphtheria Clinical Presentation: History, Physical, Causes

  https://emedicine.medscape.com/article/782051-clinical

  The following factors may predispose to diphtheria infection: […] Incomplete or absent immunization, which is especially important in the adult population, and the pediatric population in underdeveloped countries, may predispose to infection. In some cases, immunity does not prevent infection but lessens the severity of the disease. […] Antitoxin titers decrease over time and immunity wanes, thus older people who have not received booster vaccination are more susceptible to contract the disease from carriers. […] Low herd immunity, possibly leading to increasing prevalence of diphtheria infections […] Travel to endemic areas or regions with current epidemics […] Immunocompromised states – Due to pharmacologic immune suppression, disease states including HIV, or relative compromise such as from diabetes or alcoholism

• #60 Diphtheria Clinical Presentation: History, Physical, Causes

  https://emedicine.medscape.com/article/782051-clinical

  The following factors may predispose to diphtheria infection: […] Incomplete or absent immunization, which is especially important in the adult population, and the pediatric population in underdeveloped countries, may predispose to infection. In some cases, immunity does not prevent infection but lessens the severity of the disease. […] Antitoxin titers decrease over time and immunity wanes, thus older people who have not received booster vaccination are more susceptible to contract the disease from carriers. […] Low herd immunity, possibly leading to increasing prevalence of diphtheria infections […] Travel to endemic areas or regions with current epidemics […] Immunocompromised states – Due to pharmacologic immune suppression, disease states including HIV, or relative compromise such as from diabetes or alcoholism

• #61 Diphtheria Clinical Presentation: History, Physical, Causes

  https://emedicine.medscape.com/article/782051-clinical

  The following factors may predispose to diphtheria infection: […] Incomplete or absent immunization, which is especially important in the adult population, and the pediatric population in underdeveloped countries, may predispose to infection. In some cases, immunity does not prevent infection but lessens the severity of the disease. […] Antitoxin titers decrease over time and immunity wanes, thus older people who have not received booster vaccination are more susceptible to contract the disease from carriers. […] Low herd immunity, possibly leading to increasing prevalence of diphtheria infections […] Travel to endemic areas or regions with current epidemics […] Immunocompromised states – Due to pharmacologic immune suppression, disease states including HIV, or relative compromise such as from diabetes or alcoholism

• #62 Diphtheria Clinical Presentation: History, Physical, Causes

  https://emedicine.medscape.com/article/782051-clinical

  The following factors may predispose to diphtheria infection: […] Incomplete or absent immunization, which is especially important in the adult population, and the pediatric population in underdeveloped countries, may predispose to infection. In some cases, immunity does not prevent infection but lessens the severity of the disease. […] Antitoxin titers decrease over time and immunity wanes, thus older people who have not received booster vaccination are more susceptible to contract the disease from carriers. […] Low herd immunity, possibly leading to increasing prevalence of diphtheria infections […] Travel to endemic areas or regions with current epidemics […] Immunocompromised states – Due to pharmacologic immune suppression, disease states including HIV, or relative compromise such as from diabetes or alcoholism

• #63 Diphtheria Clinical Presentation: History, Physical, Causes

  https://emedicine.medscape.com/article/782051-clinical

  The following factors may predispose to diphtheria infection: […] Incomplete or absent immunization, which is especially important in the adult population, and the pediatric population in underdeveloped countries, may predispose to infection. In some cases, immunity does not prevent infection but lessens the severity of the disease. […] Antitoxin titers decrease over time and immunity wanes, thus older people who have not received booster vaccination are more susceptible to contract the disease from carriers. […] Low herd immunity, possibly leading to increasing prevalence of diphtheria infections […] Travel to endemic areas or regions with current epidemics […] Immunocompromised states – Due to pharmacologic immune suppression, disease states including HIV, or relative compromise such as from diabetes or alcoholism

• #64 Diphtheria Clinical Presentation: History, Physical, Causes

  https://emedicine.medscape.com/article/782051-clinical

  Low socioeconomic status […] Large-scale population movements – Implicated in the spread of the epidemic in the Newly Independent States of the former Soviet Union […] Poor healthcare care system infrastructure […] Overcrowding – Military barracks, homeless shelters, jails […] Domestic animals such as cats may act as reservoir for human infection.

• #65 Diphtheria Clinical Presentation: History, Physical, Causes

  https://emedicine.medscape.com/article/782051-clinical

  Low socioeconomic status […] Large-scale population movements – Implicated in the spread of the epidemic in the Newly Independent States of the former Soviet Union […] Poor healthcare care system infrastructure […] Overcrowding – Military barracks, homeless shelters, jails […] Domestic animals such as cats may act as reservoir for human infection.

• #66 Diphtheria Clinical Presentation: History, Physical, Causes

  https://emedicine.medscape.com/article/782051-clinical

  Low socioeconomic status […] Large-scale population movements – Implicated in the spread of the epidemic in the Newly Independent States of the former Soviet Union […] Poor healthcare care system infrastructure […] Overcrowding – Military barracks, homeless shelters, jails […] Domestic animals such as cats may act as reservoir for human infection.

• #67 Diphtheria: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/782051-overview

  Corynebacterium ulcerans is a relatively rare species that more frequently causes cutaneous diphtheria; however, this species may rarely cause respiratory symptoms. […] Overcrowding, poor health, substandard living conditions, incomplete immunization, and immunocompromised states facilitate susceptibility to diphtheria and are risk factors for transmission of this disease. […] Human carriers are the main reservoir of infection; however, case reports have linked diphtheria to livestock. […] C diphtheria adheres to mucosal epithelial cells where the exotoxin, released by endosomes, causes a localized inflammatory reaction followed by tissue destruction and necrosis. […] Local tissue destruction enables the toxin to be carried lymphatically and hematologically to other parts of the body. Elaboration of the diphtheria toxin may affect distant organs such as the myocardium, kidneys, and nervous system.

• #68 Diphtheria: For Health Professionals – Canada.ca

  https://www.canada.ca/en/public-health/services/immunization/vaccine-preventable-diseases/diphtheria/health-professionals.html

  Diphtheria is caused by the toxin-producing strains of the bacterium Corynebacterium diphtheriae. […] Diphtheria occurs worldwide and remains endemic in many countries. […] Diphtheria can be prevented by immunization.

• #69 Diphtheria: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/782051-overview

  Since the introduction and widespread use of diphtheria toxoid in the 1920s, respiratory diphtheria has been well controlled, with an incidence of approximately 1000 cases reported annually. […] Diphtheria epidemics remain a health threat in developing nations. […] This epidemic caused more than 157,000 cases and 5000 deaths according to WHO reports. […] Most cases were registered in unvaccinated adults. […] The most widely quoted diphtheria mortality rate is 5-10%. It may reach higher than 20% in children younger than 5 years and adults older than 40 years. […] Historically, diphtheria has been primarily a disease of childhood, affecting populations younger than 12 years. Infants become susceptible to the disease at age 6-12 months after their transplacentally derived immunity wanes. […] Recently, however, diphtheria has shifted into the adolescent and adult population, most notably those in ages 40 and older accounting for most new cases.

• #70 Diphtheria: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/782051-overview

  Since the introduction and widespread use of diphtheria toxoid in the 1920s, respiratory diphtheria has been well controlled, with an incidence of approximately 1000 cases reported annually. […] Diphtheria epidemics remain a health threat in developing nations. […] This epidemic caused more than 157,000 cases and 5000 deaths according to WHO reports. […] Most cases were registered in unvaccinated adults. […] The most widely quoted diphtheria mortality rate is 5-10%. It may reach higher than 20% in children younger than 5 years and adults older than 40 years. […] Historically, diphtheria has been primarily a disease of childhood, affecting populations younger than 12 years. Infants become susceptible to the disease at age 6-12 months after their transplacentally derived immunity wanes. […] Recently, however, diphtheria has shifted into the adolescent and adult population, most notably those in ages 40 and older accounting for most new cases.

• #71 Diphtheria – MD Searchlight

  https://mdsearchlight.com/infectious-disease/diphtheria/?utm_source=pubmedlink&utm_campaign=MDS&utm_content=112524

  Diphtheria is an illness caused by a bacterium known as Corynebacterium diphtheriae. […] C. diphtheriae is a type of bacteria that does not form spores and is not able to move or encapsulate. […] The health-related impacts of exotoxins, which are toxins released by bacteria, can affect both localised and whole-body aspects of the disease. […] Many factors can contribute to the development of diphtheria, such as: Incomplete or lack of vaccinations, Weakening immunity over time, which makes older people without booster shots more likely to get infected, Low immunity in the community, Traveling to areas where the disease is common, Traveling to regions currently experiencing outbreaks, Having a weakened immune system, Low social economic status, Massive movements of people, Overcrowding, like in military barracks, prisons, and homeless shelters, Domestic animals. […] Diphtheria is still a challenge in developing countries and cases are still higher in specific areas like Southeast Asia and Africa. […] If a person doesnt get regular shots and booster doses, their immunity to diphtheria naturally goes down, raising their risk of getting the disease.

• #72 Diphtheria is back in Australia, here’s why – and how vaccines can prevent its spread | NCIRS

  https://ncirs.org.au/diphtheria-back-australia-heres-why-and-how-vaccines-can-prevent-its-spread

  Diphtheria is a potentially deadly infection caused by toxins produced by certain strains of Corynebacterium bacteria. […] The bacterial toxin can also damage the heart, kidneys, brain and nerves. […] The diphtheria bacteria spread through respiratory droplets, for example, from coughing or sneezing. […] Diphtheria vaccination prevents disease but doesn’t fully prevent people carrying the bacteria in the back of their throat without symptoms. […] Increases in diphtheria are a now a real risk as vaccination rates have declined globally.

• #73

  https://www.who.int/news-room/fact-sheets/detail/diphtheria

  Diphtheria is a disease caused by a bacterium that affects the upper respiratory tract and less often the skin. It also produces a toxin that damages the heart and the nerves. […] Diphtheria is a contagious disease that is caused by toxin producing bacteria. […] The diphtheria toxin causes damage to the respiratory tract and can spread throughout the body. […] Most severe disease and deaths from diphtheria occur as a result of the diphtheria toxin and its effects. […] Diphtheria has seen resurgences any time immunization coverage becomes low. […] Under vaccination in successive cohorts of children can lead to cases and outbreaks of diphtheria. […] In recent years, there have been outbreaks of diphtheria due to inadequate vaccine coverage.

• #74 Diphtheria: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/782051-overview

  Since the introduction and widespread use of diphtheria toxoid in the 1920s, respiratory diphtheria has been well controlled, with an incidence of approximately 1000 cases reported annually. […] Diphtheria epidemics remain a health threat in developing nations. […] This epidemic caused more than 157,000 cases and 5000 deaths according to WHO reports. […] Most cases were registered in unvaccinated adults. […] The most widely quoted diphtheria mortality rate is 5-10%. It may reach higher than 20% in children younger than 5 years and adults older than 40 years. […] Historically, diphtheria has been primarily a disease of childhood, affecting populations younger than 12 years. Infants become susceptible to the disease at age 6-12 months after their transplacentally derived immunity wanes. […] Recently, however, diphtheria has shifted into the adolescent and adult population, most notably those in ages 40 and older accounting for most new cases.

• #75 Chapter 7: Diphtheria | Pink Book | CDC

  https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-7-diphtheria.html

  The estimated overall case fatality ratio for diphtheria is 5% to 10%. […] Humans are the reservoir for C. diphtheriae. […] Transmission is most often person-to-person through respiratory droplets. […] Transmission may also occur from exposure to infected skin lesions or articles soiled with discharges from these lesions.

• #76 Diphtheria: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/782051-overview

  Since the introduction and widespread use of diphtheria toxoid in the 1920s, respiratory diphtheria has been well controlled, with an incidence of approximately 1000 cases reported annually. […] Diphtheria epidemics remain a health threat in developing nations. […] This epidemic caused more than 157,000 cases and 5000 deaths according to WHO reports. […] Most cases were registered in unvaccinated adults. […] The most widely quoted diphtheria mortality rate is 5-10%. It may reach higher than 20% in children younger than 5 years and adults older than 40 years. […] Historically, diphtheria has been primarily a disease of childhood, affecting populations younger than 12 years. Infants become susceptible to the disease at age 6-12 months after their transplacentally derived immunity wanes. […] Recently, however, diphtheria has shifted into the adolescent and adult population, most notably those in ages 40 and older accounting for most new cases.

• #77 Diphtheria – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-bacilli/diphtheria

  Nervous system toxicity is uncommon (about 5%) and limited to patients with severe respiratory diphtheria. […] In severe cases, acute renal failure may occur because the toxin damages the kidneys. […] Overall mortality is 3%; it is higher in those with any of the following: Delayed presentation, Acute renal failure, Myocarditis, Age 40 years. […] Diphtheria antitoxin must be given early without waiting for culture confirmation because the antitoxin neutralizes only toxin not yet bound to cells. […] Antibiotics are required to eradicate the organism and prevent spread; they are not substitutes for antitoxin. […] Vaccination is required after recovery for patients who had diphtheria because infection does not guarantee immunity. […] The vaccine for diphtheria contains diphtheria toxoid; it is available only in combination with other vaccines. […] Nasopharyngeal and throat cultures for C. diphtheriae should be done regardless of immunization status because the vaccine protects only against the effects of diphtheria toxin; it does not prevent infection with C. diphtheriae.

• #78 Diphtheria: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/782051-overview

  Since the introduction and widespread use of diphtheria toxoid in the 1920s, respiratory diphtheria has been well controlled, with an incidence of approximately 1000 cases reported annually. […] Diphtheria epidemics remain a health threat in developing nations. […] This epidemic caused more than 157,000 cases and 5000 deaths according to WHO reports. […] Most cases were registered in unvaccinated adults. […] The most widely quoted diphtheria mortality rate is 5-10%. It may reach higher than 20% in children younger than 5 years and adults older than 40 years. […] Historically, diphtheria has been primarily a disease of childhood, affecting populations younger than 12 years. Infants become susceptible to the disease at age 6-12 months after their transplacentally derived immunity wanes. […] Recently, however, diphtheria has shifted into the adolescent and adult population, most notably those in ages 40 and older accounting for most new cases.

• #79 Diphtheria: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/782051-overview

  Since the introduction and widespread use of diphtheria toxoid in the 1920s, respiratory diphtheria has been well controlled, with an incidence of approximately 1000 cases reported annually. […] Diphtheria epidemics remain a health threat in developing nations. […] This epidemic caused more than 157,000 cases and 5000 deaths according to WHO reports. […] Most cases were registered in unvaccinated adults. […] The most widely quoted diphtheria mortality rate is 5-10%. It may reach higher than 20% in children younger than 5 years and adults older than 40 years. […] Historically, diphtheria has been primarily a disease of childhood, affecting populations younger than 12 years. Infants become susceptible to the disease at age 6-12 months after their transplacentally derived immunity wanes. […] Recently, however, diphtheria has shifted into the adolescent and adult population, most notably those in ages 40 and older accounting for most new cases.

• #80 Diphtheria – MD Searchlight

  https://mdsearchlight.com/infectious-disease/diphtheria/?utm_source=pubmedlink&utm_campaign=MDS&utm_content=112524

  Diphtheria is an illness caused by a bacterium known as Corynebacterium diphtheriae. […] C. diphtheriae is a type of bacteria that does not form spores and is not able to move or encapsulate. […] The health-related impacts of exotoxins, which are toxins released by bacteria, can affect both localised and whole-body aspects of the disease. […] Many factors can contribute to the development of diphtheria, such as: Incomplete or lack of vaccinations, Weakening immunity over time, which makes older people without booster shots more likely to get infected, Low immunity in the community, Traveling to areas where the disease is common, Traveling to regions currently experiencing outbreaks, Having a weakened immune system, Low social economic status, Massive movements of people, Overcrowding, like in military barracks, prisons, and homeless shelters, Domestic animals. […] Diphtheria is still a challenge in developing countries and cases are still higher in specific areas like Southeast Asia and Africa. […] If a person doesnt get regular shots and booster doses, their immunity to diphtheria naturally goes down, raising their risk of getting the disease.

• #81 About Diphtheria | Diphtheria | CDC

  https://www.cdc.gov/diphtheria/about/index.html

  People most commonly spread C. diphtheriae by coughing or sneezing, which creates small respiratory droplets that contain the bacteria. Other people can get infected if they breathe in those droplets. […] The best way to prevent diphtheria is to get vaccinated. […] Diphtheria antitoxin stops the toxin from causing more damage to the body. Antibiotics kill and get rid of the bacteria.

• #82 Corynebacterium Diphtheriae – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK7971/

  Corynebacterium diphtheriae infects the nasopharynx or skin. Toxigenic strains secrete a potent exotoxin which may cause diphtheria. […] The pathogenesis of diphtheria is based upon two primary determinants: (1) the ability of a given strain of C diphtheriae to colonize in the nasopharyngeal cavity and/or on the skin, and (2) its ability to produce diphtheria toxin. […] The structural gene for diphtheria toxin, tox, is carried by a family of closely related corynebacteriophages of which the -phage is the most extensively studied. […] Diphtheria toxin is extraordinarily potent; in sensitive species (e.g., humans, monkeys, rabbits, guinea pigs) as little as 100 to 150 ng/kg of body weight is lethal. […] The intoxication of a single eukaryotic cell by diphtheria toxin involves at least four distinct steps: (1) the binding of the toxin to its cell surface receptor; (2) clustering of charged receptors into coated pits and internalization of the toxin by receptor-mediated endocytosis; following acidification of the endocytic vesicle by a membrane-associated, ATP-driven proton pump, (3) the insertion of the transmembrane domain into the membrane and the facilitated delivery of the catalytic domain to the cytosol, and (4) the ADP-ribosylation of EF-2, which results in the irreversible inhibition of protein synthesis. […] The control of diphtheria depends upon adequate immunization with diphtheria toxoid: formaldehyde-inactivated diphtheria toxin that remains antigenically intact.

• #83 Diphtheria: A-to-Z Guide from Diagnosis to Treatment to Prevention | DrGreene

  https://www.drgreene.com/articles/diphtheria

  Diphtheria is a bacterial illness that has been known to plague children since the 4th century B.C. The bacteria can cause inhalational or cutaneous forms of the disease. They can also enter the body through the eyes, ears, or genitals. […] The bacteria multiply and produce a powerful toxin that causes tissue death in the immediate vicinity. In some cases the toxin may be pumped throughout the body in the blood vessels or lymph system. […] Diphtheria causes disease only in humans. […] Unlike anthrax, diphtheria is highly contagious. It may be spread by direct contact with someone who has diphtheria, or by a carrier. It can be carried in the nose, throat, or on the skin. Skin carriers appear to be the most dangerous. […] The diphtheria vaccine is stunningly successful at preventing diphtheria, if peoples vaccines remain current. The vaccine is against the toxin. Therefore, fully immunized children might still get or carry the bacteria, but the risk of illness is minimal.

• #84

  https://www.health.vic.gov.au/infectious-diseases/diphtheria

  Diphtheria is an acute bacterial infection caused by toxigenic strains of Corynebacterium diphtheriae. […] Corynebacterium diphtheriae of the gravis, mitis, intermedius or belfanti biotypes is an aerobic gram-positive bacillus. Toxin production results when the bacteria are infected by a bacteriophage containing the diphtheria toxin gene tox+. […] Diphtheria occurs worldwide and is more prevalent in winter months in temperate zones. […] Diphtheria vaccination is part of the standard childhood immunisation schedule. Primary vaccination is achieved with three doses of a diphtheria toxoid-containing vaccine at 2, 4 and 6 months of age. […] Lifelong immunity is usually, but not always, acquired after disease or inapparent infection. A primary course of toxoid vaccination provides long-lasting, but not lifelong, immunity. […] Natural infection with C. diphtheriae does not guarantee ongoing immunity.

• #85 Diphtheria – Infections – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/infections/bacterial-infections-gram-positive-bacteria/diphtheria

  Diphtheria is a contagious, sometimes fatal infection of the upper respiratory tract caused by the gram-positive, rod-shaped bacteria Corynebacterium diphtheriae. […] Diphtheria is caused by a bacterial infection that is now rare in countries where immunization is widespread. […] Some types of Corynebacterium diphtheriae release a potent toxin that can damage the heart, kidneys, and nervous system. […] The bacteria that cause diphtheria are usually spread in droplets of moisture coughed into the air. […] A milder form of diphtheria affects only the skin and occurs mainly in adults. […] The diphtheria vaccine protects only against the effects of the diphtheria toxin; it does not prevent infection with diphtheria.

• #86 Diphtheria – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-bacilli/diphtheria

  Nervous system toxicity is uncommon (about 5%) and limited to patients with severe respiratory diphtheria. […] In severe cases, acute renal failure may occur because the toxin damages the kidneys. […] Overall mortality is 3%; it is higher in those with any of the following: Delayed presentation, Acute renal failure, Myocarditis, Age 40 years. […] Diphtheria antitoxin must be given early without waiting for culture confirmation because the antitoxin neutralizes only toxin not yet bound to cells. […] Antibiotics are required to eradicate the organism and prevent spread; they are not substitutes for antitoxin. […] Vaccination is required after recovery for patients who had diphtheria because infection does not guarantee immunity. […] The vaccine for diphtheria contains diphtheria toxoid; it is available only in combination with other vaccines. […] Nasopharyngeal and throat cultures for C. diphtheriae should be done regardless of immunization status because the vaccine protects only against the effects of diphtheria toxin; it does not prevent infection with C. diphtheriae.

• #87 Diphtheria: A-to-Z Guide from Diagnosis to Treatment to Prevention | DrGreene

  https://www.drgreene.com/articles/diphtheria

  Diphtheria is a bacterial illness that has been known to plague children since the 4th century B.C. The bacteria can cause inhalational or cutaneous forms of the disease. They can also enter the body through the eyes, ears, or genitals. […] The bacteria multiply and produce a powerful toxin that causes tissue death in the immediate vicinity. In some cases the toxin may be pumped throughout the body in the blood vessels or lymph system. […] Diphtheria causes disease only in humans. […] Unlike anthrax, diphtheria is highly contagious. It may be spread by direct contact with someone who has diphtheria, or by a carrier. It can be carried in the nose, throat, or on the skin. Skin carriers appear to be the most dangerous. […] The diphtheria vaccine is stunningly successful at preventing diphtheria, if peoples vaccines remain current. The vaccine is against the toxin. Therefore, fully immunized children might still get or carry the bacteria, but the risk of illness is minimal.

• #88

  https://www.health.vic.gov.au/infectious-diseases/diphtheria

  Diphtheria is an acute bacterial infection caused by toxigenic strains of Corynebacterium diphtheriae. […] Corynebacterium diphtheriae of the gravis, mitis, intermedius or belfanti biotypes is an aerobic gram-positive bacillus. Toxin production results when the bacteria are infected by a bacteriophage containing the diphtheria toxin gene tox+. […] Diphtheria occurs worldwide and is more prevalent in winter months in temperate zones. […] Diphtheria vaccination is part of the standard childhood immunisation schedule. Primary vaccination is achieved with three doses of a diphtheria toxoid-containing vaccine at 2, 4 and 6 months of age. […] Lifelong immunity is usually, but not always, acquired after disease or inapparent infection. A primary course of toxoid vaccination provides long-lasting, but not lifelong, immunity. […] Natural infection with C. diphtheriae does not guarantee ongoing immunity.

• #89

  https://www.health.vic.gov.au/infectious-diseases/diphtheria

  Diphtheria is an acute bacterial infection caused by toxigenic strains of Corynebacterium diphtheriae. […] Corynebacterium diphtheriae of the gravis, mitis, intermedius or belfanti biotypes is an aerobic gram-positive bacillus. Toxin production results when the bacteria are infected by a bacteriophage containing the diphtheria toxin gene tox+. […] Diphtheria occurs worldwide and is more prevalent in winter months in temperate zones. […] Diphtheria vaccination is part of the standard childhood immunisation schedule. Primary vaccination is achieved with three doses of a diphtheria toxoid-containing vaccine at 2, 4 and 6 months of age. […] Lifelong immunity is usually, but not always, acquired after disease or inapparent infection. A primary course of toxoid vaccination provides long-lasting, but not lifelong, immunity. […] Natural infection with C. diphtheriae does not guarantee ongoing immunity.

• #90

  https://www.health.vic.gov.au/infectious-diseases/diphtheria

  Diphtheria is an acute bacterial infection caused by toxigenic strains of Corynebacterium diphtheriae. […] Corynebacterium diphtheriae of the gravis, mitis, intermedius or belfanti biotypes is an aerobic gram-positive bacillus. Toxin production results when the bacteria are infected by a bacteriophage containing the diphtheria toxin gene tox+. […] Diphtheria occurs worldwide and is more prevalent in winter months in temperate zones. […] Diphtheria vaccination is part of the standard childhood immunisation schedule. Primary vaccination is achieved with three doses of a diphtheria toxoid-containing vaccine at 2, 4 and 6 months of age. […] Lifelong immunity is usually, but not always, acquired after disease or inapparent infection. A primary course of toxoid vaccination provides long-lasting, but not lifelong, immunity. […] Natural infection with C. diphtheriae does not guarantee ongoing immunity.

• #91 Diphtheria (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/diphtheria.html

  Diphtheria is a bacterial infection. It spreads easily and happens quickly, and mainly affects the nose and throat. […] Diphtheria (dif-THEER-ee-uh) is very rare in the United States and Europe, where children routinely get vaccinated against it. But it’s still common in developing countries where immunizations aren’t given routinely. […] Preventing diphtheria depends almost completely on giving the diphtheria/tetanus/pertussis vaccine to children (DTaP) and non-immunized adolescents and adults (Tdap). […] Most cases of diphtheria happen in people who aren’t vaccinated at all or who didn’t get all their shots. […] Diphtheria is highly contagious. It passes easily from an infected person to others through sneezing, coughing, or even laughing. […] People infected with the diphtheria bacteria, even if they don’t have any symptoms, can infect others for up to 4 weeks. […] After recovery, people who had diphtheria should still get all the diphtheria vaccine shots to protect them from another infection. Having had the disease doesn’t guarantee lifetime immunity.

• #92 Diphtheria – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-bacilli/diphtheria

  Nervous system toxicity is uncommon (about 5%) and limited to patients with severe respiratory diphtheria. […] In severe cases, acute renal failure may occur because the toxin damages the kidneys. […] Overall mortality is 3%; it is higher in those with any of the following: Delayed presentation, Acute renal failure, Myocarditis, Age 40 years. […] Diphtheria antitoxin must be given early without waiting for culture confirmation because the antitoxin neutralizes only toxin not yet bound to cells. […] Antibiotics are required to eradicate the organism and prevent spread; they are not substitutes for antitoxin. […] Vaccination is required after recovery for patients who had diphtheria because infection does not guarantee immunity. […] The vaccine for diphtheria contains diphtheria toxoid; it is available only in combination with other vaccines. […] Nasopharyngeal and throat cultures for C. diphtheriae should be done regardless of immunization status because the vaccine protects only against the effects of diphtheria toxin; it does not prevent infection with C. diphtheriae.

• #93 Diphtheria: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/782051-overview

  C diphtheria is responsible for both endemic and epidemic diseases, and it was first described in the 5th century BC by Hippocrates. Diphtheria manifests as either an upper respiratory tract or cutaneous infection and is caused by the aerobic gram-positive bacteria, Corynebacterium diphtheria. […] People who are most susceptible to infection are those who are not completely immunized or have low antitoxin antibody levels and have been exposed to a carrier or diseased individual. A carrier is someone whose cultures are positive for the diphtheria species but does not exhibit signs and symptoms. […] Exotoxins are associated with both invasive localized and systemic forms of this disease; however, case reports of invasive disease in absence of the exotoxin release have been documented. […] The 3 isolated strains of C diphtheria include gravis, intermedius, and mitis. Intermedius is thought to be responsible for systemic elaboration of the disease, as it is most often associated with the exotoxin.

• #94 Explore

  https://www.museumofhealthcare.ca/explore/exhibits/vaccinations/diphtheria.html

  Diphtheria is a bacterial infection caused by Corynebacterium diphtheria, transmitted through close contact with an infected individual, usually via respiratory secretions spread through the air. […] The diphtheria threat grew significantly during the late 19th century to become one of the major causes of death, fuelled by the industrial revolution and increasingly crowded urban centres. […] The diphtheria bacterium was first identified in the 1880s and in the 1890s diphtheria antitoxin was developed in Germany to treat victims of the disease. […] Despite the broader availability of diphtheria antitoxin in Canada, the disease remained a major public health threat until the introduction of a preventive vaccine known as diphtheria toxoid during the late 1920s. […] Diphtheria toxoid was the first modern vaccine, the first paediatric vaccine, and provided the foundation of public health immunization programs in Canada and elsewhere. […] Diphtheria still exists in many parts of the world and without population-wide vaccination programs it could easily come back to Canada.

• #95 Explore

  https://www.museumofhealthcare.ca/explore/exhibits/vaccinations/diphtheria.html

  Diphtheria is a bacterial infection caused by Corynebacterium diphtheria, transmitted through close contact with an infected individual, usually via respiratory secretions spread through the air. […] The diphtheria threat grew significantly during the late 19th century to become one of the major causes of death, fuelled by the industrial revolution and increasingly crowded urban centres. […] The diphtheria bacterium was first identified in the 1880s and in the 1890s diphtheria antitoxin was developed in Germany to treat victims of the disease. […] Despite the broader availability of diphtheria antitoxin in Canada, the disease remained a major public health threat until the introduction of a preventive vaccine known as diphtheria toxoid during the late 1920s. […] Diphtheria toxoid was the first modern vaccine, the first paediatric vaccine, and provided the foundation of public health immunization programs in Canada and elsewhere. […] Diphtheria still exists in many parts of the world and without population-wide vaccination programs it could easily come back to Canada.

• #96 Explore

  https://www.museumofhealthcare.ca/explore/exhibits/vaccinations/diphtheria.html

  Diphtheria is a bacterial infection caused by Corynebacterium diphtheria, transmitted through close contact with an infected individual, usually via respiratory secretions spread through the air. […] The diphtheria threat grew significantly during the late 19th century to become one of the major causes of death, fuelled by the industrial revolution and increasingly crowded urban centres. […] The diphtheria bacterium was first identified in the 1880s and in the 1890s diphtheria antitoxin was developed in Germany to treat victims of the disease. […] Despite the broader availability of diphtheria antitoxin in Canada, the disease remained a major public health threat until the introduction of a preventive vaccine known as diphtheria toxoid during the late 1920s. […] Diphtheria toxoid was the first modern vaccine, the first paediatric vaccine, and provided the foundation of public health immunization programs in Canada and elsewhere. […] Diphtheria still exists in many parts of the world and without population-wide vaccination programs it could easily come back to Canada.

• #97 Explore

  https://www.museumofhealthcare.ca/explore/exhibits/vaccinations/diphtheria.html

  Diphtheria is a bacterial infection caused by Corynebacterium diphtheria, transmitted through close contact with an infected individual, usually via respiratory secretions spread through the air. […] The diphtheria threat grew significantly during the late 19th century to become one of the major causes of death, fuelled by the industrial revolution and increasingly crowded urban centres. […] The diphtheria bacterium was first identified in the 1880s and in the 1890s diphtheria antitoxin was developed in Germany to treat victims of the disease. […] Despite the broader availability of diphtheria antitoxin in Canada, the disease remained a major public health threat until the introduction of a preventive vaccine known as diphtheria toxoid during the late 1920s. […] Diphtheria toxoid was the first modern vaccine, the first paediatric vaccine, and provided the foundation of public health immunization programs in Canada and elsewhere. […] Diphtheria still exists in many parts of the world and without population-wide vaccination programs it could easily come back to Canada.

• #98 Explore

  https://www.museumofhealthcare.ca/explore/exhibits/vaccinations/diphtheria.html

  Diphtheria is a bacterial infection caused by Corynebacterium diphtheria, transmitted through close contact with an infected individual, usually via respiratory secretions spread through the air. […] The diphtheria threat grew significantly during the late 19th century to become one of the major causes of death, fuelled by the industrial revolution and increasingly crowded urban centres. […] The diphtheria bacterium was first identified in the 1880s and in the 1890s diphtheria antitoxin was developed in Germany to treat victims of the disease. […] Despite the broader availability of diphtheria antitoxin in Canada, the disease remained a major public health threat until the introduction of a preventive vaccine known as diphtheria toxoid during the late 1920s. […] Diphtheria toxoid was the first modern vaccine, the first paediatric vaccine, and provided the foundation of public health immunization programs in Canada and elsewhere. […] Diphtheria still exists in many parts of the world and without population-wide vaccination programs it could easily come back to Canada.

• #99 Diphtheria Causes, Symptoms & Treatment – TMB.ie

  https://www.tmb.ie/blog/diphtheria-causes-symptoms-treatment

  Diphtheria, an infectious disease caused by the bacterium Corynebacterium Diphtheriae, has long been a silent terror, afflicting countless lives across the globe. […] Diphtheria spreads through respiratory droplets, primarily via coughs or sneezes of an infected person. It can also spread through contaminated personal items. Once the bacteria enter the body, they produce a toxin that can lead to the formation of a thick, greyish membrane in the nose, throat, and occasionally other parts of the body. […] Vaccination remains the most effective preventive measure, with the diphtheria vaccine often administered as a combined vaccine with tetanus and pertussis (whooping cough) as part of routine childhood immunization programs. […] While diphtheria has been largely controlled in many developed countries through widespread vaccination, it continues to pose a threat in regions with limited access to healthcare and vaccination programs. […] Despite the progress made in controlling diphtheria, the threat remains ever-present, particularly in regions where immunization programs are lacking and fresh reports of diphtheria outbreaks continue to come in from these regions.

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