I recently came across a postcard from 1913. It was sent by "Helen" to "Ms. Mabel." The postcard read:
"I am at home now. Schools have been closed for 2 wks on account of "dyphtheria --" Why don't you write -- almost positive that you owe me. Amy is at Bellaire. If you come to Rapid City next year -- you can come and pay me a visit. Please write -- with love -- Helen." (Errors were left in the message as is.)
A scan of the postcard is at the end of this blog post.
is a bacterial infection caused by Corynebacterium diphtheriae. Droplets transmit the bacteria from one person to another. The signs and symptoms of infection are somewhat flu-like: fever, malaise, chills, tiredness, runny nose. But one symptom in particular stands out. As the bacteria grows in the throat, a collection of bacteria and white blood cells begins to grow over the affected area. This "pseudomembrane" can grow to the point of obstructing the throat and destroying the tissues around the windpipe, suffocating the victim. For this reason, diphtheria has been called “.”
At the time of the mailing of that postcard, a successful vaccine against the infection did not exist. Instead, physicians at the time relied on from one of several private laboratories in the nation. The antitoxin was created by giving the diphtheria toxin to a large mammal -- usually a horse -- and then taking the animals antibodies and giving them to a person with diphtheria. This was not a vaccination, as it did not prevent an infection. It just treated the symptoms of the bacterial toxin.
In 1914 -- one year after the postcard was mailed -- . The antitoxin would neutralize the harmful effects of the toxin, while the toxin would create its own immune response; and one that would create memory cells and antibodies for the long run. This "toxin-antitoxin" method was replaced in the early 1920s, when the toxin was inactivated in the laboratory before being given. It was known as a "toxoid" vaccine, because the toxin was not capable of causing disease, only the immune response. It eliminated the need for the antitoxin step, which was capable of causing allergic responses of its own.
The toxoid vaccine arrived just in time, too. In the early 1920s, there was a surge in cases of diphtheria among children, with a large nationwide outbreak that reached children as far away as Alaska. (.) The antitoxin, toxin-antitoxin, and toxoid vaccine were all pressed into service. Large organizations banded together to promote vaccination. By 1938, only a few cases of diphtheria were reported in the United States.
Today, diphtheria is rare in developed nations. The highly-effective vaccine prevents cases in countries where the vaccine can be easily given to children. The introduction of antibiotics during World War II ensured that deaths from diphtheria were rare in developed nations. But that is not the case in low to middle income countries, or in places affected by war or civil strife. In 2018, the World Health Organization reported a spike in cases worldwide, .
Today, in the United States, there are no closings of schools for two weeks due to diphtheria, like back in 1913. The combined DTap () vaccines have ended those days, along with preventing tetanus and pertussis (whooping cough). With the diphtheria bacteria only found in humans, it is a candidate for eradication. So maybe, just maybe, the day will come when no child is strangled by this invisible monster.