Diphtheria

Diphtheria is an acute contagious disease caused by specific organism bacillus diphtheria.

It is characterized by local inflammation with fibrin formation of the mucous membranes, usually of the upper respiratory tract, with production of a toxin which when absorbed into the blood stream may produce deleterious effects on various parts of the body, especially the heart and peripheral nerves.

The disease exists throughout the world but is more common in temperate zones and during the colder months, autumn and winter. It is commonly spread by direct contact which must be fairly intimate. Dissemination by third objects such as clothes, toys, etc. may also occur and carriage by milk has been reported many times. Healthy carriers may disseminate the disease to susceptible persons and thus constitute a menace to public health. Children appear to be more liable to diphtheria than adults; although the most robust people may be attacked and those whose health is weakened by any cause are especially predisposed.

The incubation period is three to ten days. The disease may be divided into three main forms according to the anatomical distribution of the membrane: a) faucial or pharyngeal; b) laryngeal; c) nasal.

The onset of the disease is insidious with relatively moderate temperature reaction. In general, following an incubation period of about two days, symptoms set in like those commonly accompanying a cold. A slight feeling of uneasiness in the throat is experienced along with some stiffness of the back of the neck. The earliest objective manifestation of the disease is the formation of a thin film of fibrin on the tonsils which increases in thickness to form characteristic yellowish-white or grayish-white pseudomembrane.

The throat appears to be reddened and somewhat swollen. If the pseudomembrane is forcibly removed, it is found to separate from the underlying true mucous membrane with difficulty and leaves a raw, bleeding surface on which in the untreated cases a fresh membrane rapidly reforms. The lesion tends to spread over the pillars and onto the soft palate and uvula. Hence any membranous formation on pharyngeal tissues should immediately be regarded as a suspicion of diphtheria.

Myocarditis is the most dreadful of all complications of diphtheria. It is due to direct action of the toxin on the heart muscle.

Another severe complication is peripheral neuritis. It occurs in the form of paralysis affecting the soft palate and throat. Other forms of paralysis are paralysis of eye or even respiratory muscles, paralysis of a limb or both legs. These symptoms, however, after continuing for a variable length of time, almost always ultimately disappear.

The outcome of the disease depends mainly on one factor, namely, the early administration of adequate doses of antitoxin. Its employment in any recognized or even suspected case of diphtheria is mandatory and no physician can delay its administration. The second important measure is rest, the patient being kept strictly flat.

Patients suffering from diphtheria should be isolated for at least two weeks after the onset of the disease, and then until three successive cultures from the nose and throat taken not less than 48 hours apart are negative.

A diphtheria infection is treated using two types of medication: antibiotics to kill the diphtheria bacteria; antitoxins to neutralise the effects of the toxin produced by the bacteria.

Most people who have diphtheria require a 14-day course of antibiotics. After this time, you'll have tests to find out if all the bacteria have gone. If diphtheria bacteria are still present, you may need to continue taking antibiotics for another 10 days.

You should have the diphtheria vaccination after you've been treated because having diphtheria doesn't always stop you getting the infection again.

Exercise 6. Answer the questions:

1. What is diphtheria caused by?

2. Is it contagious disease?

3. What is the disease characterized by?

4. Where is diphtheria more common?

5. Who is more liable to diphtheria?

6. What is the incubation period of the disease?

7. What are the main forms of diphtheria?

8. What are its main symptoms?

9. What are its main complications?

10.What does the outcome of the disease depend on?

Exercise 7. Match the following English word combinations with Russian ones:

absorbed by blood stream	розповсюджуватись при прямому контактi
produce deleterious effect on	раптовий початок
spread by direct contact	всмоктуватися кровотоком
put in an appearance	виробляти шкiдливу дiю на
healthy carrier	по розположенню
according to the distribution	з’явитися ненадовго
insidious onset	здоровий носiй
affect the soft palate and throat	бути бiльш схильним до дифтерii
a slight feeling of uneasiness	вражати м’яке пiднебiння та горло
to be more liable to diphtheria	легке вiдчуття дискомфорту в горлi

Exercise 8. Match the words with their definitions:

throat	a) very tiny living things which may cause diseases or infections
incubation period	b) a poisonous substance produced within living cells or organisms
toxin	c) the passage from the back of your mouth to the top of the tubes that go down to your lungs and stomach
bacteria	d) a way in which parts of the body react to disease or injury
inflammation	e) the time from the moment of exposure to an infectious agent until signs and symptoms of the disease appear

Exercise 9. Find the equivalents of the following word combinations in the text:

Гoстре інфекційне захворювання, місцеве запалення, всмоктуватися кровотоком, слизова оболонка, шкідливий вплив, у всьому світі, поширюватися при безпосередньому контакті, здоровий носій, бути більш схильним, найздоровіші (міцні) люди, бути особливо схильним, з'являтися ненадовго, відкласти призначення, принаймні, початок захворювання.

Exercise 10. Give English equivalents to the words in braсkets:

1. Diphtheria is an (гoстре інфекційне) disease.

2. It is characterized by (місцевим запаленням) with fibrin formation of the (слизовоi оболонки) of the (верхнiх дихальних щляхiв).

3. The disease exists (по всьому свiтi) but is more common (в помiрнних зонах).

4. It is commonly spread (при прямому контактi).

5. Сhildren appear to be (бiльш схильними) to diphtheria than (дорослi).

6. Most (міцні) people may be (iнфiкованi) and those whose health is weakened by any cause are especially (схильнi).

7. The earliest objective (проявлення) of the disease is the formation of (тонкоi плiвки на мигдалинах).

8. If the pseudomembrane is forcibly removed, it leaves (свiжу кровоточиву) surface.

9. (Результат захворювання) depends largely on one factor, namely, (назначення вiдповiдноi дози антитоксина).

10. Patients suffering from diphtheria should be (изольованi) for at least two weeks after (початку захворювания).

Exercise 11. Fill in the articles where necessary:

1. The old man was seriously ill. He was running … high temperature.

2. I’ve … bad cold in … head. I must have caught … cold yesterday when I ran out into … yard without … cap on.

3. She overworked and had … bad headache. People who do not get enough … sleep often have … headaches.

4. I have only … slight headache. No pills for me, thank you.

5. I have … splitting headache and … bad cold in … head. I must have caught … cold. I am afraid I shall fall ill with … flu.

6. I have … sore throat. I feel … pain in my side. – You must stay in … bed and call … doctor in.

7. Take … table spoonful of … mixture twice … day after … meals.

8. I had … bad cold. I went to bed and drank … cup of hot tea with raspberry jam. It helped to beat down … temperature.

9. … weather was bad yesterday. I must have caught … cold when I was going … home from … work.

10. He stayed at … home and called … doctor in. … doctor diagnosed … case and prescribed him … medicine.

Exercise 12. Put the verbs in brackets in the appropriate tense:

1. Whom … the doctor … at the hospital every day? (treat)

2. What … you … now? (study)

3. What … the surgeon already …? (transfuse)

4. What … the surgeon … for two hours? (perform)

5. What … the lecturer … yesterday at 3 o’clock? (report on)

6. What … you … to do before you saw me? (decide)

7. What … the nurse … for an hour before the surgeon began the operation? (sterilize)

8. What … you … tomorrow at 6 o’clock? (do)

9. What … you … tomorrow? (take part in)

10. How many patients … the doctor … tomorrow by 5 p.m.? (hospitalize)

Exercise 13. Translate the sentences into your native language. Pay attention to the Present Perfect Continious:

1. The patient has been complaining of a considerable muscular pain for some days.

2. The professor has been delivering the lecture for half an hour.

3. The student has been heating hydrogen in the tube for some minutes.

4. The nurse has been giving the injection for five minutes.

5. They have been working at the laboratory for two years.

6. The dentist has been examining the gingival for some minutes.

7. The patients have been receiving the injections of streptomycin for several days.

Exercise 14. Open the brackets using the verbs in the Present Perfect Continious:

1. I (to read) the paragraph on types of immunity for half an hour.

2. She (to write) the test in Histology for ten minutes.

3. The patient (to wait) for the doctor since seven o’clock.

4. How long you (to stay) in hospital?

5. They( to perform) the operation since nine o’clock.

6. What this laboratory assistant (to do) here since morning?

7. How many months they (to build) this polyclinic?

Exercise 15. Put the verbs in brackets into the correct forms of Present Perfect or Present Perfect Continious:

1. She (to be) ill since last week.

2. He (to know) this doctor since childhood. He is a pediatrician.

3. I (to try) to understand your report on the immune response for half an hour.

4. She (to look) for her stethoscope since she came to the hospital.

5. The students (to be) in this academy building since 8 a. m..

6. My sister (to sleep) for ten hours.

Exercise 16. Put questions to the underlined words:

1. The disease may be divided into three main forms according to the anatomical distribution of the membrane.

2. It occurs in the form of paralysis affecting the soft palate and throat.

3. These symptoms, however, after continuing for a variable length of time, almost always ultimately disappear.

4. The outcome of the disease depends mainly on one factor, namely, the early administration of adequate doses of antitoxin.

5. It is commonly spread by direct contact which must be fairly intimate..

6. A slight feeling of uneasiness in the throat is experienced along with some stiffness of the back of the neck.

7. Myocarditis is the most dreadful of all complications of diphtheria.

8. The lesion tends to spread over the pillars and onto the soft palate and uvula.

Exercise 17. Translate into English:

1. Хто з ваших коллег робить операцiю вже п’яту годину поспiль?

2. Вiн мрiяв стати лiкарем з дитинства.

3. З якого часу ви працюeте в цьому диспансерi? – Я працюю тут з 2005.

4. Вони вже пiвтори години обговорюють питання природи набутого iмунiтету.

5. Цей пацieнт гуляe у дворi лiкарнi вже двi години.

6. Скiльки часу ви вивчаeте англiйську мову? – Я вивчаю ii вже три роки.

7. З шостого ранку я переглядаю статтi про такi захворювання, як вiтряна вiспа, кiр та полiомieлiт.