Paolo Pandolfi, director of the Public Health Department of Ausl, the case of the girl who died in Palermo from suspected diphtheria has brought the spotlight back on this disease. What is it about?
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“We are talking about a disease known for a long time, now eradicated in our countries thanks to vaccination, initially recommended and then made mandatory. The last indigenous case in Italy dates back to ’96: however, in some parts of the world diphtheria is still endemic and cases that occur in countries where it is rare can often be linked to contacts with people coming from these areas.”
How does it act?
“It is linked to a bacterium, Corynebacterium diphtheriae, which can produce the toxin responsible for the disease. This acts specifically in certain organs of our body, particularly at the pharyngeal and laryngeal level, but it can also cause complications affecting vital systems such as the heart, kidney, and central nervous system.”
What are the symptoms and after how many days do they appear?
“About 2-5 days after infection, which mostly occurs through the air, less frequently by contact. Initially, there may be rather generic symptoms, such as headache and malaise, followed by an infection of the pharynx, with redness and swelling. Throat pain can cause dysphagia, that is difficulty swallowing, as well as odynophagia, that is pain during swallowing. A typical symptom of diphtheria, however, is the appearance of some grayish membranes in the throat: a characteristic symptom not to be underestimated.”
How can it be treated?
“With antitoxin therapy, followed by antibiotics. At the same time, all people who have been around the infected person must be protected with the vaccine.”
Why can it be fatal?
“The most serious element is the risk of developing so-called croup, which consists of an airway obstruction: generally, with the serum, such developments are avoided. But if there are complications, the situation becomes more complex, so much so that about 10% of cases have a fatal outcome: complications can indeed involve the heart, with myocarditis, or cause kidney problems or complications affecting the nervous system.”
How important is vaccination?
“It is not only important but fundamental. Children are the most vulnerable in this regard, as they have smaller and more easily obstructed airways, but adults must also protect themselves. Vaccination is a fundamental element to protect oneself but also to have a “herd” coverage to prevent the circulation of the bacterium. In Emilia-Romagna we have achieved excellent results, with a vaccination coverage of 97%, but it is important to reiterate the appeal to those who have not yet been vaccinated.”
