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Diphtheria is one of those diseases that doesn’t get much press- unlike measles and pertussis. So why do we vaccinate for diphtheria? Well, this is one of those diseases that many people actually did die from 100+ years ago.
The bacteria Cornybacterium diphtheriae causes diphtheria. It primarily infects the mucous membranes of the nose and throat. Breathing problems and heart and nerve damage can all complicate diphtheria and cause death. The Mayo Clinic explains that diphteria used to be lethal in about 3% of cases. The Office of Vital Statisitcs from 1953 shows a death rate of approximately 30 per 100,000 from diphtheria in 1900– most of which were children under 15. (It’s worth noting that this report shows typhoid to have actually been deadlier than diphtheria- and the decrease in typhoid deaths has not been attributed to a mass vaccination program. Another example from history of how vaccines may be one way, but not the only or best way to control infectious diseases.)
The introduction of diphtheria antitoxin in 1900 is credited with drastically reducing deaths from diphtheria- when it wasn’t causing them. In 1901, diphtheria antitoxin made from a horse infected with tetanus was given to children who subsequently developed tetanus and died.
The DTP vaccine came into usage in 1920, but death rates from diphtheria had already dropped dramatically. In 1900 the death rate from diphtheria was about 30 per 100,000, but by 1920 it had dropped to about 8 per 100,000. Between 1920 and 1930, the death rate from diphtheria dropped slightly from about 8 per 100,000 to about 5 per 100,000 and the slowly declined to <1 per 100,000 in 1950. Also of interest from the CDC on diphtheria: “Circulation appears to continue in some settings even in populations with more than 80% childhood immunization rates. An asymptomatic carrier state can exist even among immune individuals.” In other words, diphtheria is still circulating and you may have it and not even know it.