29

Diphtheria

7.1 Read the following four paragraphs and label them using the words: etiology, symptoms,
complications, treatment

(a) The toxin can be neutralized with a specific antitoxin; in many countries diphtheria has been
reduced by routine immunization of children. The Schick test is a minute injection of toxin into
the skin. If the subject is immune, the dose is promptly neutralized. Treatment

(b) The membrane (if it is around the entrance to the trachea) may obstruct the airway. Another
possibility is poisoning by toxins. The commonest effects are defective function of heart muscle
or of the kidneys. There is also the possibility of localized paralysis resembling poliomyelitis.
Complications

(c) The disease is contracted either from a patient or from a carrier who harbours the bacteria, by
air-borne infection from coughs and sneezes. A few cases have been traced to infected milk.
Etiology

(d) Within a week, the patient develops fever and sore throat. The typical sign is a soft crust
(membrane, pseudomembrane) that forms over the affected mucous membrane. The inflamed
tissues are swollen and painful; the lymph nodes at the sides of the neck are commonly involved.
Symptoms

Exercises

7.2 To which of the paragraphs above would you add the following items?

(a) It is important to immunize all children. Treatment

(b) The incubation period is about 3 days. Etiology

(c) The diphtheria toxin is particularly poisonous to the heart. Complications

(d) The child becomes ill and pale-looking. Symptoms

(e) Wounds may also be infected. Complications

(f) The temperature is raised to 99 or 101 F. Symptoms

(g) The onset is not sudden but insidious. Symptoms

(h) It may be contracted from direct contact. Etiology

7.3 Say whether the following are true or false

(a) Infected milk is commonly a cause of diphtheria. False

(b) Localized paralysis may result from diphtheria. True

(c) The lymph nodes are rarely affected. True

(d) The affected mucous membrane is usually covered by a soft crust. True

(e) A dose of toxin is quickly neutralized if the patient is immune. True

7.4 Find words in the text (including Exercise 7.2) which mean:

(a) Very small : few

(b) Normal, common : commonly, commonest

(c) Quickly : promptly

(d) Faulty, imperfect : defective

(e) Similar to : resembling

(f) Gradual, slow :

(g) Person being treated, patient : The subject, The child

(h) Phase : forms

7.5 In the following sentences choose the appropriate word from the words given in brackets

(a) The disease is (contracted, infected) from a patient.

(b) Within a wee the patient (grows, develops) fever.

(c) The Schick test is a minute (inoculation, injection) of toxin.

(d) Diphtheria may (lead, cause) to paralysis of the eyes.

(e) A soft crust forms over the (defective, affected) membrane.

 30

Mumps and influenza

Mumps (Epidemic parotitis)

After an incubation period of 14 to 28 days, onset is marked by chilly sensation,

headache, anorexia and malaise. This is accompanied by a low to moderate fever which may last
from 12 to 24 hours before any involvement of the salivary glands is noted. In mild cases, these
prodromal symptoms may be absent. Pain on chewing or swallowing is the earliest symptom of
the parotitis. It often becomes aggravated by swallowing acid liquids, such as vinegar or lemon
juice. There is marked sensitivity to pressure over the angle of the jaw. With development of
parotitis, the temperature frequently rises to 103 or 104 F. Swelling of the gland reaches its
maximum about the 2nd day below the ear. In most cases, both parotid glands are involved.
Occasionally, the submaxilary and sublingual glands also may be swollen or more rarely may be
the only glands affected. In such cases there is swelling of the neck beneath the jaw. The oral
openings of ducts of the involved glands are pouting and slightly inflamed. The skin over the
glands may become tense and shiny. Involved glands are acutely tender during the febrile period,
which lasts from 24 to 72 hours.

Influenza (Flu)

The onset usually is sudden and often marked by chills or chilly sensations and fever.
Constitutional symptoms are prominent and consist chiefly of prostration, generalize aches and
pains most pronounced in the back and legs, headache, weakness and anorexia. There is an
subjective sense of axiety. Symptoms in the respiratory tract usually are moderate, with sire
throat, unproductive cough, mild substernal distress and sometimes coryza. The soft palate,
posterior part of the hard palate, tonsillar pillars and posterior pharyngeal wall may be reddened,
but exudates is not seen unless a secondary bacterial infection also is present.

In mild cases, the temperature rises to 101 to 102 F and lasts for 2 or 3 days; in severe
cases, it reaches 103 to 104 F and continues with a corresponding degree of prostration for 4 or 5
days. Acute symptoms usually subside rapidly with the cessation of fever, although weakness,
sweating and fatigue may continue for several days and occasionally for weeks.
 Exercises

9.2 Complete the table below by ticking () the appropriate box. Student 1 read Mumps, student 2
influenza, then exchange information by asking each other questions.

Signs Symptoms Mumps Flu

Onset sudden

Prostration

Headache

Anxiety

Fever

Anorexia

Sore throat

Sweating

Chilly sensation

Swallowing painful

9.3 Looking only at the table above, fill in the blanks in the following sentences. Use only one
word.

(a) The onset in influenza is usually sudden.

(b) Pain on chewing or swallowing is the first symptom of parotitis.

(c) Constitutional symptom is accompanied by a feeling of prostration.

(d) Both mumps and influenza are accompanied by fever.

9.4 Make true/false statements based on the table above and correct others false statements.

9.5 Match the words in list (a) below with their definitions in (b)

(a) (i)Prominent (b) (i)Become less, return to normal

(ii)Prostration (ii)When something stops

(iii)Parotid (iii)Ooze liquid

(iv)Malaise (iv)Extreme exhaustion

(v)Exudates (v)Easily seen or felt

(vi)Subside (vi)Near the ear

(vii)Cessation (vii)General feeling of illness

(viii)Aggravate (viii)Make worse

(ix)Acute (ix)Severe

(x)Febrile (x)Relating to fever

9.6 Make nouns from the following verbs:

(i) Swell: swell because of sprained foot

(ii) Inflame: her tongue looks inflamed

(iii) Involve: the lymph nodes at the sides of the neck are commonly involved

(iv) Enlarge: he enlarging problem

(v) Occur: that name occurs in the story

(vi) Cease: The noised finally ceased

9.8 Underline the word which is different from the others

(a) Usually frequently rarely often

(b) Slight acute mild moderate

(c) Incubation onset inoculation prodromal

(d) Prominent pronounced marked slight

(e) Subside continue cease withdraw

9.9 Make complete sentences by combining items from list (a) with list (b)

(a) (i) The onset is sudden (b) (i) are usually moderate with sore throat,
unproductive cough and occasionally
coryza

(ii) Pain on chewing or swallowing (ii) and often marked by chilly sensation

(iii) Symptoms in the respiratory tract (iii) may become tense and shiny

(iv) The skin over the glands (iv) is the earliest symptom of parotitis

(v) Constitutional symptoms are prominent (v) and consist chiefly of prostration,
generalized pain and anorexia