Diphtheria

 

Background

Diphtheria is a toxin-mediated disease caused by the bactera Corynebacterium diphtheriae. Only toxigenic strains can cause severe disease.

Human carriers are the reservoir for C. diphtheriae and are usually asymptomatic.  Susceptible hosts may develop clinical diphtheria. In these cases the organism produces a toxin that causes local tissue destruction and pseudomembrane formation. The toxin produced at the site of the membrane is absorbed into the bloodstream and then spreads around the body. Most complications of diphtheria, like myocarditis, are attributable to effects of the toxin.

The disease can present as:

1- Respiratory diphtheria - Anterior Nasal Diphtheria, Pharyngeal and Tonsillar Diphtheria, Laryngeal Diphtheria, 

2- Cutaneous (Skin) Diphtheria. 

Transmission

Transmission is usually spread via droplets from the respiratory tract. Rarely, transmission may occur from skin lesions or contact with discharges from lesions of infected persons if virulent bacilli are present. The incubation period following infection is 2–5 days (range, 1–10 days).

Symptoms

Some people only experience mild signs of illness, and others are asymtomatic carriers, they carry the bacteria but do not present with any symptoms. Those that do present with illness show signs and symptoms around  two to five days after infection, they may experience:

  • Fever 

  • Swollen glands (enlarged lymph nodes

  • A sore throat and hoarseness

  • Difficulty breathing or rapid breathing

  • Weakness

  • A thick, gray membrane that covers the throat and tonsils

Diagnosis

Samples of the affected tissue is taken and send it to a laboratory for testing. 

 

Treatment

With the allopathic approach diphtheria antitoxin and antibiotic therapy is used. It is important to note that diphtheria antitoxin does not neutralize toxin that is already bound to tissues, but it will neutralize circulating toxin and with the intention to prevent progression of disease. 

 

Discussion

Diphtheria is a serious disease that requires immediate treatment but severe infections may be avoided if we nurture our biological vessels, building a formidable immune system.  We need a shift from the current paradigm, it's time to challenge contemporary beliefs. Children suffer through an onslaught of interventions, from insidious vaccination schedules to numerous rounds of antibiotics and drugs that suppress the immune system. The chronic neglect has resulted in a weak, feeble generation that lacks the building blocks to fight off illness.  Through this shift we need to recognise the importance of mother nature. If we nourish our every being with good wholesome meals, positive thoughts to ensure a stable psychological state and avoid unnecessary allopathic medication we will reduce our susceptibility to invasive disease.  It is fundamentally important to have the right support for minor ailments, as alternative intervention assists the body to overcome illness without suppressing innate immune responses. By repeatedly attacking the body with unnecessary pharmaceutical drugs we increase our susceptibility to dis-ease.

Prevention is better than cure but this prevention does not come in the form of a needle, prevention comes with a robust terrain that is undesirable for pathogenic invasion.  Misinformed healthcare professionals insist that herd immunity is required to prevent spread of this disease, yet this is untrue. Diphtheria vaccines do not contain the bacteria C. diphtheria. The vaccine is composed of the tetanus toxoid, the idea is that one mounts an immune response to the TOXIN, and this is intended to "prevent" one from developing symptoms to the diphtheria toxin.  Diphtheria vaccination cannot be enforced to protect the herd as the vaccine is incapable of preventing the recipient from carriage and transmission of diphtheria. 

  • The vaccinated can still carry  AND TRANSMIT the bacteria TO THE UNVACCINATED.

  • The world health organization admits that no clinical trial has ever established the efficacy of the tetanus toxoid in preventing diphtheria.

  • Regardless of vaccination, people can still die from diphtheria.

  • Adults who do not receive routine boosters are basically unvaccinated due to waning "immunity"

Below are a few statements extracted from the WHO Strategic Advisory Group of Experts on immunization meeting held in April 2017;

 

"Diphtheria vaccination prevents symptomatic infections,  though it does not prevent carriage or spread of diphtheria." 

"The United States Immunization Practices Advisory Committee (ACIP) states, that vaccination "does not eliminate carriage of C. diphtheriae in the pharynx, nose or on the skin"

"No controlled clinical trial of the efficacy of the toxoid in preventing diphtheria has ever been conducted."  

"Probably no level of circulating antitoxin confers absolute protection; Ipsen reported two cases of fatal diphtheria

in patients with antitoxin levels above 30 IU/mL the day after onset of symptoms. The WHO Immunological Basis

Series for Diphtheria Immunization confirm that there is no sharply defined level of antitoxin that gives complete protection from diphtheria. "

"After three doses of primary diphtheria toxoid immunization, most children achieve antitoxin titers greater than the minimally protective level. However, in the absence of ongoing exposure, immunity wanes over time, requiring booster doses of diphtheria toxoid to maintain protective antitoxin levels. In the absence of a booster dose at 4 to 6 years, protection may not be maintained throughout the school-age years. In countries with long-standing childhood immunization programs, adults who have neither been exposed to diphtheria nor received booster doses of diphtheria toxoid may become susceptible to diphtheria as a result of waning immunity." 

The majority assume vaccination is scientifically proven to be effective, yet it is clear that the science is not settledAn interesting concept is the idea of inherited immunity, something that is practically unheard of today. Here is an interesting observation made in the early 1900's in the American Journal of Public Health Vol. VI MMY, 1916 No. 5,  the author suggests a possibility of hereditary immunity, something that definitely deserves further investigation, but with the financial conflicts of interest it is doubtful anyone will be funding such a study. 

"These striking facts are additional proofs that there are factors, possibly hereditary in character, which in the absence of infections with C diphtheria , give rise to the presence of the so-called natural antitoxin. The large amount of antitoxin which is present in some of the cases is hard to explain; for example, two young children,six and one-half and three years of age, who had -no history of clinical diphtheria, showed respectively fifteen and nineteen units of natural antitoxin per cc. of serum. The large proportion of older children and adult persons having antitoxin adds to the difficulty of considering the natural antitoxin as usually due to a previous infection' with diphtheria bacilli either as a case or as a carrier." 

Diphtheria is serious and once invasive disease has taken hold emergency medical treatment is required but we can avoid these situations by seeking alternative assistance for our children while their immune systems navigate the minor childhood ailments. By embracing the holistic approach we give our families the best start with solid foundations of health and the resulting robust immune system is less likely to be susceptible to invasive conditions.

The South African vaccinations

Diphtheria vaccination has been used in South Africa since 1940, the diphtheria toxoid is combined with tetanus toxoid (as DT) as a paediatric vaccine, or the adult formulation (as Td) and with the acellular pertussis vaccine as DTaP and TDap. 

Here is a list of the vaccines available in South Africa.

Adacel quadra

Boostrix tetra

Diftavax

Hexaxim

Infanrix hexa

Tetavax

Tetraxim