Diphtheria--Will This Dreaded Childhood Disease Make a Comeback? Be Prepared!

When vaccines are no longer available, vaccine-preventable diseases will make a comeback, especially among the most vulnerable—children.  As Dr. Cynthia Koelker writes (and this is to parents who have chosen not to immunize their children, but the same would be true if vaccines are no longer available),

“the reason your children haven’t been exposed to one of these deadly diseases [diphtheria, tetanus, typhus, polio, and other vaccine-preventable diseases] is because the other children have been immunized.  When this “herd immunity” becomes diluted through lack of universal vaccination, your children will be susceptible as these infections re-emerge in the population.”[1]

As I have written in posts on other communicable childhood diseases for which we currently immunize, the following information comes from The Ship’s Medicine Chest and Medical Aid at Sea, a US government publication which may be freely reproduced.  Sometimes it’s better not to re-invent the wheel.  Additional information from more current sources is provided in the notes that follow.

Diphtheria

Incubation Period: 2 to 5 days.

Isolation Period:  14 days after onset.

Diphtheria is a serious acute infectious disease that is caused by the Corynebacterium diphtheria bacillus.  The bacteria grow in the throat, nose, or windpipe, and give off a toxin (poison) that causes an illness of the entire body.

Diphtheria once was a very common cause of sickness and death among infants and children, but it is now a rare disease in the United States.  It may be prevented by diphtheria toxoid injection with booster doses every ten years.  Most crew members have been inoculated as children.  Before signing on, a check should be made to assure that booster doses have been maintained.  

The early symptoms of diphtheria are like those in most communicable diseases:  overall body discomfort, restlessness, weakness, loss of appetite, headache, chilliness, and constipation.  Soon there is a sore throat or sore mouth with increasing fever to 103 degrees F (39.4 degrees C), prostration, vomiting, and convulsions in some cases.  On the laryngeal (windpipe) type of the disease, dirty gray patches of an adherent membrane form in the back of the nose and throat, over the tonsils and in the windpipe itself.  These patches resemble dead skin.  If attempts are made to brush off patches with a cotton swab, they come away with difficulty and leave tiny bleeding points in the uncovered mucosa membrane.  There may be a bloody nasal discharge and a “croupy” cough.

The most serious complications include (1) suffocation, due to the mechanical blocking of the windpipe by the diphtheritic membrane; and (2) an overwhelming systemic poisoning due to the toxin.  Because of a special affinity for certain nerves, the toxin may produce paralysis of the throat, eyes, or extremities; or death from heart failure.

Making the diagnosis of diphtheria at sea is difficult.  Anyone with a severe sore throat, together with the severe systemic symptoms mentioned earlier, should be considered to have diphtheria until examined by a physician.  Medical advice by radio should be obtained.

That concludes the entry from The Ship’s Medicine Chest.

Notes from other references:

There is a slow onset of sore throat and fever.  It can be difficult to differentiate between a mild case of diphtheria and strep throat.  If the airway is obstructed, the patient may require a surgical airway.  Historically, the caregiver reached into the back of the patient’s mouth and scraped the whitish-gray membrane out.  Diphtheria may present in other ways, like skin sores, but this will be difficult to diagnose.[2]

Currently, a case of diphtheria would be treated with antibiotics as well as antitoxin.  Unfortunately, if the medical system collapses, antitoxin will not be available.[3]

Other signs of diphtheria are a swollen neck and very bad breath.[4]

Adults through age 64 should receive diphtheria booster every 10 years, which is usually given with tetanus and pertussis (whooping cough).  Though diphtheria may not be a life-threatening disease in healthy adults, it can still be transmitted to vulnerable children.

Treatment

Isolate the patient. 

Physicians advise penicillin, 400,000 units, three times per day for older children.  Gargle with warm salt water.  Breathe steam often or continually.  If the child begins to choke or turn blue, remove the membrane from his throat using a finger wrapped with a clean cloth.[5]

There is precious little information available on how exactly the following herbs were historically used to treat diphtheria. 

• Houttuynia[6] 
• Lomatium[7]
• Japanese barberry, Oregon grape, and other berberines[8]
• Usnea[9]
• Echinacea angustifolia:  1 teaspoon Echinacea angustifolia root tincture in a little water every 30 minutes until improvement is seen.  If the tincture is held in the mouth for 60 seconds, it will enter the bloodstream faster.  If taken 30 minutes after piperine is administered, it will enter the bloodstream even more quickly.[10]

Links to related posts:

Penicillin

Colds, Influenza, and Illnesses That Look Like Colds

Lomatium

Japanese Barberry

Usnea

Echinacea

Piperine

For further reading:

 https://www.smithsonianmag.com/science/science-diphtheria-plague-among-children-180978572/?utm_source=pocket-newtab

References:

[1] Cynthia Koelker, Armageddon Medicine, 28.

[2]  Survival and Austere Medicine, 3^rd Edition, 294-95.

[3] Armageddon Medicine, 146.

[4]  David Werner, Where There Is No Doctor, 313-14.

[5] Ibid.

[6]  Stephen Buhner, Herbal Antivirals, 185.

[7]  Ibid, 234.

[8]  Stephen Buhner, Herbal Antibiotics, 164.

[9]  Ibid, 197.

[10]  Ibid, 271.

 11.4.20