Diphtheria is caused by the release of a toxin from the bacteria Corynebacterium diphtheria.  The toxin can cause myocarditis and paralysis of the soft palate.

There are several strains of C. diphtheria; most strains do not produce the disease causing toxin.

Only when the specific disease causing strain of bacteria has been infected by a specific virus, called a B phage, will the bacteria be able to produce the toxin.

CDC: Epidemiology and Prevention, the Pink Book, 6th Ed. Ch. 6: Pertussis, p. 69. 

Between 1900 and 1920 the mortality rate from diphtheria declined by 50% before the widespread use of diphtheria vaccine.

Incidence of Diphtheria in the U.S.:

  • In the 1920’s: 150 cases / 100,000
  • By 1945: 15 cases / 100,000
  • 1970-1979: 196 cases / year
  • 1980-1999: 3 cases / year

The vaccine for Diphtheria was introduced in 1920, but widespread use of the toxoid did not begin until 1948.

Since C. Diphtheria is a bacterium, it is treatable with antibiotics, and it is sensitive to the most commonly prescribed antibiotics.  Widespread use of antibiotics began in the 1950’s.

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