These infections are very serious. Even with high quality medical care, over 3 percent of cases of diphtheria are fatal. Occasionally the membrane obstructs the airway, requiring intubation (placement of a tube down the throat to allow air to pass). In addition, the bacteria’s toxin can affect the heart and some nerves. Treatment includes both antibiotics and a special treatment using horse antitoxin.
Tetanus can be serious if untreated. The World Health Organization estimated that over 180,000 newborns died of neonatal tetanus in 2002. These deaths occurred because of poor hygiene at the delivery. In addition, the lack of tetanus vaccinations for the mother meant that she had no protective antibodies to pass to her newborn baby.
However, in the United States, tetanus is very treatable. Tetanus immune globulin (an injection of antibodies that will directly attack the bacteria), antibiotics, and appropriate wound care are the mainstay of treatment. Specific medications are also helpful in controlling the pain of muscle spasms.
Pertussis is most severe in infants younger than six months old. About 1 percent of hospitalized children die, and up to 20 percent have pneumonia, seizures, or brain damage. Treatment for these children requires antibiotics and supportive care, such as managing their oxygen, fluids, and nutrition while they are trying to breathe. Sometimes ICU care is required.
Older children and adults have milder cases of pertussis. They might have lingering coughs for weeks to months but usually only require oral antibiotics at home.