Advertisement

Diphtheria

  • Paul F. Wehrle

Abstract

Diphtheria is an acute infectious and communicable disease involving primarily the tonsils, pharynx, larynx, or nose, and occasionally other mucous membranes or skin. A false membrane is formed in one or more of these locations. This is the site of production of the diphtheria toxin, which is responsible for the general symptomatology and subsequent damage of many organs, including cardiac and central nervous system tissue. Although the incidence of the disease has declined substantially with improved immunization, the continuing occurrence of cases in most countries and the relatively high casefatality ratios of 5–10% emphasize its importance.

Keywords

Diphtheria Toxin Diphtheria Toxoid Toxigenic Strain Mortality Weekly Report Cutaneous Form 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Allen, J. C., and Cluff, L. E., Identification of toxinogenic C. diphtheriae with fluorescent antitoxin: Demonstration of its nonspecificity, Proc. Soc. Exp. Biol. Med. 112:194–199 (1963).PubMedGoogle Scholar
  2. 2.
    Belsey, M. A., and Leblanc, D. R., Skin infections and the epidemiology of diphtheria: Acquisition and persistence of C.diphtheriae infections, Am. J. Epidemiol. 102:179–184 (1975).PubMedGoogle Scholar
  3. 3.
    Belsey, M. A., Sinclair, T. M. M., Roder, M. R., and Leblanc, D. R., Corynebacterium diphtheriae skin infections in Alabama and Louisiana, N. Engl. J. Med. 280:135–141 (1969).PubMedCrossRefGoogle Scholar
  4. 4.
    Blattner, R. J., Epidemiology of diphtheria: Role of cutaneous infection (editorial), J. Pediatr. 74:991–993 (1969).PubMedCrossRefGoogle Scholar
  5. 5.
    Bray, J. P., Burt, E. G., Potter, E. V., Poon-King, T., and Earle, D. P., Epidemic diphtheria and skin infections in Trinidad, J. Infect. Dis. 126:34–40 (1972).PubMedCrossRefGoogle Scholar
  6. 6.
    Brown, G. C., Volk, V. K., Gottshall, R. Y., Kendrick, P. L., and Erson, H. D., Responses of infants to Dtp-P vaccine used in nine injection schedules, Public Health Rep. 79:585–601 (1964).PubMedCrossRefGoogle Scholar
  7. 7.
    Butler, W. T., Rossen, R. D., and Wende, R. D., Effect of physical state and route of inoculation of diphtheria toxoid on the formation of nasal secretory and serum antibodies in man, J. Immunol. 104:1396–1400 (1970).PubMedGoogle Scholar
  8. 8.
    Doege, T. C., Heath, C. W., Jr., and Sherman, I. L., Diphtheria in the United States, 1959–19660, Pediatrics 30:194–205 (1962).PubMedGoogle Scholar
  9. 9.
    Doull, J. A., Stokes, W. R., and Mcginnes, G. F., The incidence of clinical diphtheria among family contacts subsequent to the discovery of carriers, J. Prev. Med. 11:191–204 (1928).Google Scholar
  10. 10.
    Dowling, H. F., Diphtheria as a model, J. Am. Med. Assoc. 226:550–553 (1973).CrossRefGoogle Scholar
  11. 11.
    Gill, D. M., Pappenheimer, A. M., Jr., Brown, R., and Kurnick, J. T., Studies on the mode of action of diphtheria toxin. VII. Toxin-stimulated hydrolysis of nicotinamide adenine dinucleotide in mammalian cell extracts, J. Exp. Med. 129:1–21 (1969).PubMedCrossRefGoogle Scholar
  12. 12.
    Gottlieb, S., Martin, M., Mclaughlin, F. X., Panaro, R. J., Levine, L., and Edsall, G., Long-term immunity to diphtheria and tetanus: A mathematical model, Am. J.Epidemiol. 85:207–218 (1967).PubMedGoogle Scholar
  13. 13.
    Gray, R. D., and James, S. M., Occult diphtheria infection in a hospital for the mentally subnormal, Lancet 1:1105–1106 (1973).PubMedCrossRefGoogle Scholar
  14. 14.
    Heath, C. W., Jr., and Zusman, J., An outbreak of diphtheria among skid-row men, N. Engl. J. Med. 267:809–812 (1962).CrossRefGoogle Scholar
  15. 15.
    Lang, W. S., Diphtheria at the present time, Laryngoscope 75:1092–1102 (1965).PubMedCrossRefGoogle Scholar
  16. 16.
    Ledbetter, M. K., Cannon, A. B., II, and Costa, A. F., The electrocardiogram in diphtheritic myocarditis, Am. Heart J. 68:559–611 (1964).CrossRefGoogle Scholar
  17. 17.
    Marcuse, E. K., and Grand, M. G., Epidemiology of diphtheria in San Antonio, Texas, 1970, J. Am. Med. Assoc. 224:305–310 (1973).CrossRefGoogle Scholar
  18. 18.
    Mcguinness, A. C., Diphtheria in preventive medicine in World War II, Vol. Iv (J. B. Coates, J.R., ed.), Office of the Surgeon General, Department of the Army, Washington, D.C., 1958.Google Scholar
  19. 19.
    Millian, S. J., Cherubin, C. E., Sherwin, R., and Fuerst, H. T., A serologic survey of tetanus and diphtheria immunity in New York City, Arch. Environ. Health 15:776–781 (1967).PubMedGoogle Scholar
  20. 20.
    Morales, A. R., Vichitbandha, P., Chandruang, P., Evans, H., and Bourgeois, C. H., Pathological features of cardiac condition disturbance in diphtheric myocarditis, Arch. Pathol. 91:7 (1971).Google Scholar
  21. 21.
    Munford, R. S., Ory, H. W., Brooks, G. F., and Feldman, R. A., Diphtheria deaths in the United States, 1959–1970, J. Am. Med. Assoc. 229:1890–1893 (1974).CrossRefGoogle Scholar
  22. 22.
    Naiditch, M. J., and Bower, A. G., Diphtheria, Am. J. Med. 17:229–245 (1954).PubMedCrossRefGoogle Scholar
  23. 23.
    Nelson, L. A., Peri, B. A., Rieger, C. H. L., Newcomb, R. W., and Rothberg, R. M., Immunity to diphtheria in an urban population, Pediatrics 61:703–710 (1978).PubMedGoogle Scholar
  24. 24.
    Pappenheimer, A. M., Jr., and Brown, R., Studies of the mode of action of diphtheria toxin. Vi. Site of the action of toxin in living cells, J. Exp. Med. 127:073–1986 (1969).Google Scholar
  25. 25.
    Pappenheimer, A. M., Jr., and Gill, D. M., Diphtheria, Science 182:353–358 (1973).PubMedCrossRefGoogle Scholar
  26. 26.
    Powars, D., Mathies, A., and Wehrle, P., Diphtheria: Thrombocytopenia, myocarditis and peripheral polyneuritis, Clin. Res. 20:272 (1972) (abstract).Google Scholar
  27. 27.
    Ruben, F. L., Nagel, J., and Fireman, P., Antitoxin responses in the elderly to tetanus-diphtheria (Td) immunization, Am. J. Epidemiol. 108:145–149 (1948).Google Scholar
  28. 28.
    Sheffield, F. W., Ironside, A. G., and Abbott, J. D., Immunization of adults against diphtheria, Br. Med. J. 2:249–250 (1978).PubMedCrossRefGoogle Scholar
  29. 29.
    Sisk, C. W., and Lewis, C. E., Reactions to tetanus-diphtheria toxoid (adult), Arch. Environ. Health 11:34–36 (1965).PubMedGoogle Scholar
  30. 30.
    Stewart, J. C., Jr., Analysis of the diphtheria outbreak in Austin, Texas, 1967–69, Public Health Rep. 85:949–954 (1970).PubMedCrossRefGoogle Scholar
  31. 31.
    Whitaker, J. A., Nelson, J. D., and Fink, C. W., The fluorescent antitoxin test for the immediate diagnosis of diphtheria, Pediatrics 27:214–218 (1961).PubMedGoogle Scholar
  32. 32.
    Worchester, J., and Cheever, F. S., The Schick status of 18,000 young adult males, N. Engl. J. Med. 240:954 (1949).CrossRefGoogle Scholar
  33. 33.
    Centers for Disease Control, Morbidity and Mortality Weekly Report, Annual Summary 1977, Hew Publication No. (Cdc) 78–8241, Vol. 26, No. 53, September 1978.Google Scholar
  34. 34.
    Centers for Disease Control, Morbidity and Mortality Weekly Report, Hew Publication No. (Cdc) 78–8017, Vol. 26, No. 49, December 9, 1977.Google Scholar
  35. 35.
    Centers for Disease Control, Diphtheria Surveillance, Dhew Publication No. (Hsm) 72–8087, Report No. 11, 1969–1970 Summary, December 31, 1971.Google Scholar
  36. 36.
    Centers for Disease Control, Diphtheria Surveillance, Hew Publication No. (Cdc) 78–8087, Report No. 12, 1971–1975 Summary, July 1978.Google Scholar

Suggested Reading

  1. Benenson, A. S., Control of Communicable Diseases in Man, 11th ed., American Public Health Association, New York, 1970.Google Scholar
  2. Burnet, M., and White, D. O., Natural History of Infectious Disease, 4th ed., Cambridge University Press, London, 1972.Google Scholar
  3. Davis, B. D., Dulbecco, R., Eisen, H. N., Ginsberg, H. S., and Wood, W. B., Jr., Microbiology, 2nd ed., Harper & Row, Hagerstown, Maryland, 1973.Google Scholar
  4. Harper, P. A., Preventive Pediatrics, Appleton-Century Crofts, New York, 1962.Google Scholar
  5. Report of the Committee on Infectious Diseases, 19th ed., American Academy of Pediatrics, Evanston, Illinois, 1982.Google Scholar
  6. Wehrle, P. F. and Top, F. H., Sr., Communicable and Infectious Diseases, 9th ed., C. V. Mosby, St. Louis, 1981.Google Scholar

Copyright information

© Springer Science+Business Media New York 1982

Authors and Affiliations

  • Paul F. Wehrle
    • 1
    • 2
  1. 1.Department of PediatricsUniversity of Southern CaliforniaLos AngelesUSA
  2. 2.Los Angeles CountyUniversity of Southern California Medical CenterLos AngelesUSA

Personalised recommendations