Diphtheria, the cause of infant mortality in the world at the beginning of the 20th century, show off again in Indonesia. Disease should be the memory is easily transmitted and virulent. In addition to interfere with breathing, diphtheria germs also cause complications in heart and muscle paralysis.
Extraordinary occurrence (KLB) of diphtheria were reported in East Java, early October 2011, with 330 cases and 11 deaths. Previously, the Ministry of Health noted, outbreaks of diphtheria occurred 34 times with 106 cases in 2004. 2008 there were 77 outbreaks with 123 cases, including in East Java with 73 cases. People with diphtheria usually children.
"The number of diphtheria cases was down 20 years ago, is now emerging again," said consultant pediatrician and pediatric infectious tropical diseases as well as members of the Pediatric Association of Indonesia (IDAI), Irawan Hindra Satari, in a seminar about diphtheria, April.
Diphtheria is an upper respiratory infection (ARI) caused by Corynebacterium diphtheriae. These bacteria are commonly found in temperate and tropical regions.
Hindra said, the bacteria are resistant to freezing and air dried. "That's why (the bacteria) is difficult to remove from the earth's surface," he said.
The bacteria are spread by splashing of the airway when the patient coughs or sneezes. Germs can also spread through food, such as contaminated milk.
Diphtheria can be mild or severe. Healing process was slow and the death rate from disease was 10 percent. Diphtheria Symptoms appear 2-5 days after the bacteria enter the body. Some symptoms, such Hindra include bluish skin, bloody discharge from the nose, tightness, rapid breathing, breath sounds, chills, dry cough, airway congestion, fever, painful swallowing, and sometimes sores on the skin. There are also people with no symptoms while carrying germs on its body.
On the way, the bacteria attacks the mucous membranes, such as the mouth, nose, throat, and esophagus. In patients formed a layer of gray or blackish on the throat or esophagus. Artificial membranes were formed from the waste and bacterial proteins. Layers is so hard and bleeding can occur if the layers are forced off.
The attack on the throat of the child shortness of breath. "Breath sounds grak-grok and often dry cough. If the membrane is detached, it will clog the airway and can be deadly, "he said. In the severe cases, the throat must be punched and placed on a ventilator.
In addition, there was enlargement of cervical lymph nodes, neck swelling, and swelling of the throat. To make a diagnosis made in the laboratory breeding of germs. The bacteria can also invade through the skin and ears, although rarely.
Complication
Bacterial infection can cause complications. The action of bacteria in the body produce toxins (poisons). Sri Murniyati in Diphtheria (I) Praanalitik to Pascaanalitik writing, influenced the formation of toxin by the bacteria in the body iron content, osmotic pressure, amino acid levels, acidity, and the availability of carbon and nitrogen sources. Diphtheria toxin is absorbed into the mucous membranes caused the death of the epithelium and form a false membranes. Pseudo-throw attempt will damage the capillary membrane and cause bleeding.
The toxin is absorbed disrupt organ, such as heart muscle, kidney, and liver. Prone to cause damage to nerve toxins. Hindra say, a frequent complication is inflammation of the heart muscle and nervous system disorders that lead to paralysis. "If the affected heart muscle, the heart can be stopped and there was sudden death," said Hindra.
Treatment of diphtheria without waiting for laboratory results. Toxins deactivated and neutralized immediately with an injection of antitoxin.
Bacterial infections treated using antibiotics, like penicillin and erythromycin. "Early treatment to reduce the risk and prevent transmission. Dosage should be appropriate to prevent the shock body, "said Hindra.
Patients with diphtheria should be hospitalized due to need intravenous fluids, oxygen delivery, cardiac monitoring, installation of a ventilator, and the release of airway obstruction. Generally takes a break for 2-3 weeks for healthy patients.
All persons who have contact with patients or carriers should be given diphtheria immunization or immunizations repeated. The germ carriers who showed no symptoms were given the drug.
Primary prevention of diphtheria in the vaccine. The first vaccine is given at ages 2 months because there is immunity from the mother's stored in the body of the baby for two months. In Indonesia, carried out by administering diphtheria immunization "package" of diphtheria, pertussis, tetanus, and hepatitis B in infants aged 0-11 months. Other immunizations to prevent diphtheria and tetanus were in children aged 12-13 years.
Chairman IDAI Badriul Hegar said the dominant infectious diseases as the cause of death of children under the age of five. Infectious diseases such as diphtheria, can be prevented by immunization. Additionally, environmental improvements, sanitation, and nutrition should also be noted that Indonesia can say goodbye to this ancient disease.
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