Diphtheria, Tetanus and Polio
Introduction
Diphtheria
Diphtheria is a serious infection of the respiratory tract or skin. The disease is transmitted by sneezing, coughing or by direct contact with respiratory secretions or by direct contact with skin lesions of an infected person.
The disease remains a problem in the developing world (sub-Saharan Africa, parts of South East Asia and South America).
Tetanus
Tetanus is a serious disease of the central nervous system that is caused by bacteria that is found in soil. The disease is spread through open cuts and wounds that have been contaminated with infected soil.
Tetanus infection is found throughout the world.
Polio
Polio is an acute viral illness that occurs in the gastrointestinal tract. It is spread mainly through person to person (faecal-oral route) contact in areas where sanitation and personal hygiene are poor.
India, Pakistan, Afghanistan and Nigeria are considered the countries with the highest risk of the disease. However, the disease can be spread to individuals in other countries who are not protected against the disease and outbreaks do occur.
The Illness
Diphtheria
Diphtheria can cause serious inflammation of the respiratory tract and is usually identified by a greyish-white membrane seen at the back of the throat. In severe cases the airway can become blocked and death can result due to suffocation.
The bacteria that cause diphtheria can also invade skin injuries and wounds. This form of diphtheria is usually mild and is commonly found on lower legs, feet and hands.
Diphtheria can cause multi-organ failure even if recovery appears to have been made weeks earlier.
Tetanus
Tetanus infection is spread through the bloodstream and can cause serious disease of the central nervous system. Early symptoms of the disease include stiffness of the jaw muscles (lock-jaw), difficulties swallowing and muscle spasms. The disease can spread to affect more muscles in the body including the respiratory muscles. This can cause difficulties with breathing and death can occur due to suffocation.
Polio
Polio virus spreads through the bloodstream to the central nervous system Symptoms of the disease can range from fever and meningitis to paralysis. Polio is a very serious disease, causing life-long paralysis of those affected.
Treatment
Diphtheria
Treatment for diphtheria, both respiratory and cutaneous, is with specific antibiotics and antitoxin. Assisted ventilation may be required for those who suffer from airway obstruction.
Tetanus
Treatment for tetanus usually involves giving immunoglobulin and antibiotics. Those infected will often require intensive care until the effects of the disease wear off.
Polio
Treatment is mainly supportive in those with polio. Assisted ventilation may be required for those who suffer from paralysis of the respiratory muscles.
Recommendations for travellers
There is a combination vaccination available that protects against diphtheria, tetanus and polio. Children normally receive these vaccinations as part of the national schedule. Travellers should ensure that they have had a primary course of vaccine and receive a booster every 10 years if they are travelling to an area where diphtheria, tetanus or polio are considered high risk.