Diphtheria
After babyhood has passed, beware of diphtheria. Of all the deaths of children 3 and 4 years of age, more than one-seventh are caused by diphtheria.
Diphtheria is preventable and, when properly treated with antitoxin, is curable. Most of the children who die from diphtheria really lose their lives because of the ignorance and carelessness of their parents.
Diphtheria is a disease most often occurring in children and resembling a sore throat or tonsillitis. It is caused by a small germ called the diphtheria bacillus. The disease may resemble:
A very mild sore throat, the tonsils and back of the mouth being redder than usual, and the person not feeling ill.
It may look like a more severe sore throat or tonsillitis with a white or grayish patch, called a membrane, on the tonsils. There may be only one or a few small distinct patches, and the throat may feel somewhat sore. The glands in the neck, below the tonsils, may be slightly enlarged and may feel about the size of small peas. The patient may feel rather ill.
Or the disease may be like a very severe sore throat, with small or large gray or white patches. Not only the tonsils but also the uvula, the small rounded end of the palate which hangs down between the tonsils, may have on it white or gray patches. (If there is a membrane on the uvula, the disease is almost certainly diphtheria.) With such a throat the person feels very sick. Not only does the throat hurt, but there are usually aches in the back of the neck and in the muscles generally. The glands in the neck may be quite large and feel painful when touched. The soreness in the throat may extend down the windpipe, and membranes may form there. The patient is feverish and often is delirious. The fever, however, is not necessarily high.
In some cases the membranes may form in the larynx (Adam's apple). When this is the case the patient's voice sounds hoarse and croupy, and the child may breathe with difficulty. In small children it is not uncommon, if such cases remain untreated, for this membrane to choke the patient. Therefore, in all cases of croup, send for a doctor immediately.
THROAT CULTURES.
In order to prevent the spread of diphtheria to others it is important always to recognize the presence of the disease, even in mild cases. In order to do this the doctor makes a culture from the throat and nose of the suspected individual. He takes a piece of sterile cotton wrapped around the end of a thin stick of wire and touches this to the throat and tonsils, especially where there are patches or membranes. Then he sends this swab to a laboratory, where cultures are planted from it. The next day these cultures are examined with a microscope to see if diphtheria bacilli, the germs which cause diphtheria, are present.