Diphtheria, Symptoms

Pitfalls in the diagnosis of botulism include failure to recognize the symptoms and to institute adequate ventilatory support. Botulism is likely underdiagnosed and can be mistaken for a number of neuromuscular and neurologic disorders. Diphtheria, encephalitis, poliomyelitis, Guillain-Barre syndrome, congenital... 

Hurwitz EL, Morgenstern H. Effects of diphtheria-tetanus-pertussis or tetanus vaccination on allergies and allergy-related respiratory symptoms among children and adolescents in the United States. J Manipnlative Physiol Ther 2000 23(2) 81-90. 

Between 1976 and 1985, seven cases of neurological disease were reported to have occurred in Germany among young children after simultaneous administration of oral pohovirus vaccine and diphtheria-tetanus toxoids or diphtheria-tetanus-pertussis vaccine (31). However, the virological data were incomplete only one case was confirmed by the isolation of a vaccine-like polio virus, and in three cases the clinical symptoms did not correspond to poliomyelitis. The author concluded that in some cases the simultaneous administration of injectable vaccines cannot be excluded as a cause for paralysis. 

Upon entry into the eytoplasm, fragment A catalyzes the ADP ribosylation of the transfer faetor, EF-2, leading to its inaetivation and the interruption of protein synthesis. The ADP-ribose group is donated by NAD+. The ADP ribosylation reaction, catalyzed by the toxin, is specific for EF-2 of eukaryotic cells other proteins of eukaryotic and bacterial eells are not substrates. This speeificity is due to an unusual amino acid residue in EF-2, diphthamide, which is the acceptor of the ADP ribosyl group. Diphthamide derives from the posttranslational modification of histidine. The acute symptoms are treated with antitoxin. The bacteria, which are gram-positive, succumb to a variety of antibiotics, including penicillin. Diphtheria is effectively prevented by immunization with toxoid (inactivated toxin) preparations. 

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