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. 1998 May;88(5):787–791. doi: 10.2105/ajph.88.5.787

Respiratory diphtheria in the United States, 1980 through 1995.

K M Bisgard 1, I R Hardy 1, T Popovic 1, P M Strebel 1, M Wharton 1, R T Chen 1, S C Hadler 1
PMCID: PMC1508941  PMID: 9585746

Abstract

OBJECTIVES: The purpose of this study was to describe the epidemiologic, laboratory, and clinical features of respiratory diphtheria cases reported in the United States during 1980 through 1995. METHODS: Respiratory diphtheria cases reported to the Centers for Disease Control and Prevention were reviewed. Cases were defined as physician-diagnosed cases with signs and symptoms compatible with respiratory diphtheria, including the presence of a pseudomembrane without other apparent cause. RESULTS: From 1980 through 1994, 41 respiratory diphtheria cases were reported; none were reported in 1995, and no secondary cases were identified. Nine (22%) case patients were 4 years of age or younger, and 28 (68%) were 15 years of age or older. None of the case patients were up to date with diphtheria vaccination; 4 unvaccinated children died. Seventeen (43%) of 40 case patients had positive culture results. CONCLUSIONS: Available surveillance data suggest that respiratory diphtheria has become a rare disease in the United States. However, importation and circulation of toxigenic strains continue to present a threat and require achieving and maintaining high coverage with diphtheria toxoid-containing vaccines in both children and adults.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BARKSDALE L., GARMISE L., HORIBATA K. Virulence, toxinogeny, and lysogeny in Corynebacterium diphtheriae. Ann N Y Acad Sci. 1960 Nov 21;88:1093–1108. doi: 10.1111/j.1749-6632.1960.tb20099.x. [DOI] [PubMed] [Google Scholar]
  2. CRAIG J. P. Diphtheria: prevalence of inapparent infection in a nonepidemic period. Am J Public Health Nations Health. 1962 Sep;52:1444–1452. doi: 10.2105/ajph.52.9.1444. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Chen R. T., Broome C. V., Weinstein R. A., Weaver R., Tsai T. F. Diphtheria in the United States, 1971-81. Am J Public Health. 1985 Dec;75(12):1393–1397. doi: 10.2105/ajph.75.12.1393. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Cutts F. T., Zell E. R., Mason D., Bernier R. H., Dini E. F., Orenstein W. A. Monitoring progress toward US preschool immunization goals. JAMA. 1992 Apr 8;267(14):1952–1955. [PubMed] [Google Scholar]
  5. Farizo K. M., Strebel P. M., Chen R. T., Kimbler A., Cleary T. J., Cochi S. L. Fatal respiratory disease due to Corynebacterium diphtheriae: case report and review of guidelines for management, investigation, and control. Clin Infect Dis. 1993 Jan;16(1):59–68. doi: 10.1093/clinids/16.1.59. [DOI] [PubMed] [Google Scholar]
  6. Fedson D. S. Adult immunization. Summary of the National Vaccine Advisory Committee Report. JAMA. 1994 Oct 12;272(14):1133–1137. doi: 10.1001/jama.272.14.1133. [DOI] [PubMed] [Google Scholar]
  7. Gergen P. J., McQuillan G. M., Kiely M., Ezzati-Rice T. M., Sutter R. W., Virella G. A population-based serologic survey of immunity to tetanus in the United States. N Engl J Med. 1995 Mar 23;332(12):761–766. doi: 10.1056/NEJM199503233321201. [DOI] [PubMed] [Google Scholar]
  8. Hardy I. R., Dittmann S., Sutter R. W. Current situation and control strategies for resurgence of diphtheria in newly independent states of the former Soviet Union. Lancet. 1996 Jun 22;347(9017):1739–1744. doi: 10.1016/s0140-6736(96)90811-9. [DOI] [PubMed] [Google Scholar]
  9. Harnisch J. P., Tronca E., Nolan C. M., Turck M., Holmes K. K. Diphtheria among alcoholic urban adults. A decade of experience in Seattle. Ann Intern Med. 1989 Jul 1;111(1):71–82. doi: 10.7326/0003-4819-111-1-71. [DOI] [PubMed] [Google Scholar]
  10. Izurieta H. S., Strebel P. M., Youngblood T., Hollis D. G., Popovic T. Exudative pharyngitis possibly due to Corynebacterium pseudodiphtheriticum, a new challenge in the differential diagnosis of diphtheria. Emerg Infect Dis. 1997 Jan-Mar;3(1):65–68. doi: 10.3201/eid0301.970109. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kleinman L. C. To end an epidemic. Lessons from the history of diphtheria. N Engl J Med. 1992 Mar 12;326(11):773–777. doi: 10.1056/NEJM199203123261118. [DOI] [PubMed] [Google Scholar]
  12. Koblin B. A., Townsend T. R. Immunity to diphtheria and tetanus in inner-city women of childbearing age. Am J Public Health. 1989 Sep;79(9):1297–1298. doi: 10.2105/ajph.79.9.1297. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Mikhailovich V. M., Melnikov V. G., Mazurova I. K., Wachsmuth I. K., Wenger J. D., Wharton M., Nakao H., Popovic T. Application of PCR for detection of toxigenic Corynebacterium diphtheriae strains isolated during the Russian diphtheria epidemic, 1990 through 1994. J Clin Microbiol. 1995 Nov;33(11):3061–3063. doi: 10.1128/jcm.33.11.3061-3063.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Popovic T., Wharton M., Wenger J. D., McIntyre L., Wachsmuth I. K. Are we ready for diphtheria? A report from the Diphtheria Diagnostic Workshop, Atlanta, 11 and 12 July 1994. J Infect Dis. 1995 Apr;171(4):765–767. doi: 10.1093/infdis/171.4.765. [DOI] [PubMed] [Google Scholar]
  15. Santos M. R., Gandhi S., Vogler M., Hanna B. A., Holzman R. S. Suspected diphtheria in an Uzbek national: isolation of Corynebacterium pseudodiphtheriticum resulted in a false-positive presumptive diagnosis. Clin Infect Dis. 1996 Apr;22(4):735–735. doi: 10.1093/clinids/22.4.735. [DOI] [PubMed] [Google Scholar]
  16. Sargent R. K., Rossing T. H., Dowton S. B., Breyer M. D., Levine L., Weinstein L. Diphtheria immunity in Massachusetts--a study of three urban patient populations. Am J Med Sci. 1984 Mar-Apr;287(2):37–39. doi: 10.1097/00000441-198403000-00008. [DOI] [PubMed] [Google Scholar]
  17. Thacker S. B., Berkelman R. L. Public health surveillance in the United States. Epidemiol Rev. 1988;10:164–190. doi: 10.1093/oxfordjournals.epirev.a036021. [DOI] [PubMed] [Google Scholar]
  18. Weiss B. P., Strassburg M. A., Feeley J. C. Tetanus and diphtheria immunity in an elderly population in Los Angeles County. Am J Public Health. 1983 Jul;73(7):802–804. doi: 10.2105/ajph.73.7.802. [DOI] [PMC free article] [PubMed] [Google Scholar]

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