Diphtheri Acute Toxin-Mediated Disease

Many people, if they heard the name diphtheria today, might refer back to the frustration they experienced concerning this disease on the computer game, The Oregon Trail. In this game, it was probable that at some point along the journey, travelers would contract diphtheria and eventually die (Forman, 2012). However, in this day and age, diphtheria is not as common an occurrence and is typically solely known of in the medical or historical spheres of knowledge. Before the first successful vaccine in the 20th century, diphtheria was one of the major causes of death, predominantly in children (Diphtheria, 2008). The Centers for Disease Control and Prevention (CDC) expresses diphtheria as an acute toxin-mediated disease caused by the bacterium

It was not until 1826 that a French physician introduced a name for this disease (Diphtheria 2008). Since the early to mid-20th century, the number of diphtheria cases has declined considerably, especially in developed areas like the United States owing to the invention of the DTaP vaccine (CDC, 2015). One of the most recent epidemics of diphtheria began in the late 1980’s and prevailed for another decade into the late 1990’s, and occurred in the Newly Independent States (NIS), previously known as the Soviet Union (Galazka, 2000). According to the CDC there had been no cases of diphtheria in the United States since 2003 until a single case occurred in 2012 in upstate New York (2014). However, in 2014, there were other areas still suffering significantly as a result of diphtheria, such as India and

During the 1920’s there were on average 100,000 to 200,000 cases every year with 13,000 to 15,000 of those cases resulting in death (Diphtheria, 2008). The incidence rate during this time was 191 per 100,000 people with the mortality rate being 14.3 per 100,000 people, bringing the case-fatality rate to 7.5 percent. Around the 1940’s, the diphtheria toxoid was introduced to the population causing a rapid decrease in cases (CDC, 2015). During the span of the next 70 years, despite the decline of the incidence and mortality rates, the case-fatality remained in the same range (Evans &Brachman, 1998). As of today, the incidence rate cannot be zero, because diphtheria is not completely eradicated. However, diphtheria rates have dropped so significantly that between 1981 and 2012, a span of 30 years, there were only 53 cases (CDC, 2014). Globally, however, things took place differently. Before the 1970’s, when a diphtheria vaccine was introduced worldwide via the Expanded Programme on Immunization (EPI), an estimated 1 million people contracted diphtheria annually. Of those 1 million, 50,000 to 60,000 resulted in mortality, which calculates out to be a case-fatality rate of 5.5 percent (Evans & Brachman, 1998). India has had the highest number of cases year after year and still does to this date.