Prompt reporting of minor respiratory symptoms to the dispensary.
Early diagnosis, followed by prompt and adequate treatment of
streptococcal infection
Education of personnel in the importance of the practice of good personal
hygiene and environmental sanitation
Administration of prophylactic dosages of penicillin to persons at special
risk as conditions warrant.
3-12. BACTERIAL INFECTIONS: DIPHTHERIA
Although diphtheria is not now common in the United States because of a widespread
immunization program, it is highly endemic in many areas of the world. Diphtheria is
caused by the bacteria C. diphtheriae.
a. In the Military. Because the disease exists in many countries, it is of
potential military importance.
Clinical disease is seen most often in temperate zones during autumn
and winter, but infection rates in the tropics are comparable.
During World War II, approximately 5,700 cases among US Army
personnel were reported, 125 terminating fatally.
b. Symptoms/Fatalities. Most of the general symptoms and fatalities of this
acute febrile infection are caused by the toxin produced by Corynebacterium
diphtheriae. The local lesion produced in the clinical form is typified by a grayish
membrane or patches on the pharynx, soft palate, and tonsils. The toxins enter the
bloodstream and may affect the heart, brain, kidneys, or other organs.
c. Transmission. Transmission is by contact with a case or carrier, with
discharges from the respiratory tract or skin lesions; with contaminated fomites; or by
consumption of milk containing C. diphtheriae.
d. Diagnosis. Clinical diagnosis is sufficient basis for immediate isolation and
specific treatment of cases at bed rest, without waiting for confirmation by
bacteriological examination.
e. Specific Treatment. Specific treatment is prompt administration of diphtheria
antitoxin.
f. Prevention. Prevention relies chiefly on mass immunization plus search for
carriers, atypical cases, and contaminated milk during an outbreak.
MD0152
3-13
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