Tag: diphtheria deaths

When Was the Last Case of Diphtheria?

Believe it or not, measles isn’t the only vaccine-preventable disease that is still around.

While you likely aren’t too surprised about the flu deaths and the cases of meningococcal disease, did you know that kids still get Hib, babies still get hepatitis B, and that there were three cases of human rabies and a case of diphtheria in the United States last year?

When Was the Last Case of Diphtheria?

Yes, diphtheria.

Diphtheria strikes unprotected children.

That’s despite the fact that the diphtheria vaccine has been around for over 100 years, long before it was combined with the first whole cell pertussis vaccine and the tetanus vaccine to form the DPT vaccine.

A vaccine that helped control respiratory diphtheria, which could lead to the formation of a pseudomembrane in a child’s airway, giving diphtheria the nickname of the “strangling angel.”

The last big outbreaks of diphtheria in the United States occurred in the 1970s, although sporadic cases had continued since, albeit at lower and lower levels each year. Eventually, endemic respiratory diphtheria was declared eliminated in 2009.

Still, we know that there have been some recent cases of diphtheria in the United States.

In April of 2014, a teen from Montgomery County, Ohio developed diphtheria.

And again in April of 2018, someone in Oklahoma developed diphtheria.

Why do we care about a few isolated cases?

Because we know how quickly diphtheria can come back if we stop vaccinating our kids!

Just look at what is happening in many other countries that once had these diseases under good control:

  • a 22-year-old unvaccinated women who died in Australia (2011)
  • an unvaccinated 3-year-old who died in Belgium (2016)
  • a family that became infected in South Africa in which at least one child died (August 2017)
  • at least 7 cases of diphtheria in Ukraine (2018)
  • an unvaccinated man in Australia who died (2018)
  • a case in Canada (2018)
  • 8 cases and 3 deaths in Columbia (2018)

Not to mention the large number of diphtheria deaths in Yemen, Venezuela, Haiti, and among Rohingya refugees.

Let’s not bring these diseases back. Vaccines are safe, with few risks, and obviously necessary.

More on the Last Case of Diphtheria

Have Normal Childhood Diseases Become More Deadly?

Weren’t measles and chicken pox once a rite of passage for kids?

Yes, in the pre-vaccine era, almost all kids got measles, chicken pox, and other now vaccine-preventable diseases in early childhood.

It was considered a rite of passage.

That she doesn't understand survivorship bias doesn't mean that you shouldn't vaccinate your kids.
That she doesn’t understand survivorship bias doesn’t mean that you shouldn’t vaccinate your kids.

But these diseases were never benign.

They were considered a rite of passage only because we all had to endure them. They weren’t something anyone looked forward to.

Benign diseases don't kill kids.
Benign diseases don’t kill kids.

After all, you don’t typically die from a benign disease.

Have Normal Childhood Diseases Become More Deadly?

But what about the idea that folks never used to worry about these diseases, at least not until vaccines were developed? Or that we only fear diseases that are vaccine-preventable?

It’s easy to say that no one worried about measles in the pre-vaccine era when you are just trying to scare folks away from getting vaccinated.

That’s one of the more ridiculous arguments anti-vaccine folks make.

A measles epidemic hit New York City in 1951, as this front page NYTimes article reports.
A measles epidemic hit New York City in 1951 and made headlines in the New York Times. That’s not surprising, as there were 683 measles deaths in the United States that year.

And also one of the easiest to refute.

When was the last time that you saw a headline warning about congenital rubella syndrome?
When was the last time that you saw a headline warning about congenital rubella syndrome?

These diseases that are now vaccine-preventable routinely made headlines in the pre-vaccine era.

Even the schools were closed in San Antonio when polio came to Texas in 1946.
Even the schools were closed in San Antonio when polio came to Texas in 1946.

And it was surviving these diseases that was considered a rite of passage, at least for those who were fortunate enough to survive.

So no, childhood diseases have not become deadlier.

They have always been serious and life-threatening!

Of course, not everyone died who got them, but they were rarely a walk in the park. Remember, even a mild case of measles includes a high fever for 4 to 7 days. That’s why folks often end up seeking medical attention multiple times, even if they don’t end up having any complications and don’t need to get admitted to the hospital

Lassie got shot, but ended up saving the day, getting help for Timmy, after they ran out of gas taking a short cut rushing home.
The Lassie episode about measles, in 1958, was called ‘The Crisis.” There were 552 measles deaths in the United States that year.

But what about the Brady Bunch measles episode, Is There a Doctor in the House? Is that really why you think vaccine-preventable diseases are mild?

In 1969, when that episode first aired, there were 25,826 reported cases and 41 deaths from measles in the United States.

Why don’t we see that many deaths now?

That’s easy.

We don’t see as much measles now. Most folks are vaccinated and protected.

If more people skip or delay their vaccines though, we will see more and more outbreaks, with greater chances that people will die.

Believe it or not, we still don’t have cures for measles, chicken pox, congenital rubella syndrome, and hepatitis B, etc. So while these diseases haven’t become any more deadly, they haven’t become any less deadly either, even with all of the advances of modern medicine.

More on Childhood Diseases as a Rite of Passage

Diphtheria in Canada

Breaking News – there is a new case of diphtheria in Canada (June 2018), and no, according to health officials, this one is not cutaneous diphtheria.

A lot of people were surprised by the news of a case of diphtheria in Canada last year.

Some folks were quick to blame the anti-vaccine movement, assuming it was in an unvaccinated child.

News soon came that the child was vaccinated!

“I’ve always been on top of that, I’m a firm believer in immunizations.”

Mother of 10-year-old with diphtheria

What happened next?

Anti-vaccine folks began using the fact that he was vaccinated, but still developed diphtheria, as some kind of proof that vaccines don’t work.

The Case of Diphtheria in Canada

They are wrong.

The diphtheria vaccines have worked very well to control and eliminate diphtheria from Canada, just like it has in the United States.

Diphtheria has become rare since the pre-vaccine era.
Diphtheria has become rare since the pre-vaccine era.

So how did a vaccinated child in Canada get diphtheria?

It’s simple.

He has cutaneous diphtheria, not respiratory diphtheria.

What’s the difference?

“Extensive membrane production and organ damage are caused by local and systemic actions of a potent exotoxin produced by toxigenic strains of C. diphtheriae. A cutaneous form of diphtheria commonly occurs in warmer climates or tropical countries.”

Vaccines Seventh Edition

Cutaneous diphtheria occurs on your skin. It is usually caused by non-toxigenic strains of Corynebacterium diphtheriae.

On the other hand, respiratory diphtheria is usually caused by toxigenic strains of Corynebacterium diphtheriae.

Diphtheria strikes unprotected children.The diphtheria vaccine (the ‘D’ in DTaP and Tdap), a toxoid vaccine, covers toxigenic strains. More specifically, it covers the toxin that is produced by toxigenic strains of Corynebacterium diphtheriae. It is this toxin that produces the pseudomembrane that is characteristic of diphtheria.

It was the formation of this pseudomembrane in a child’s airway that gave diphtheria the nickname of the “strangling angel.”

So why the fuss over this case in Canada? They likely don’t yet know if it is a toxigenic strain. If it is, then it could be a source of respiratory diphtheria.

But remember, even if these kids developed an infection with the toxigenic strain of Corynebacterium diphtheriae, those that are fully vaccinated likely wouldn’t develop respiratory diphtheria. Again, it is the toxin that the bacteria produces that cause the symptoms of diphtheria. The vaccine protects against that toxin.

For example, when an intentionally unvaccinated 6-year-old in Spain was hospitalized with severe diphtheria symptoms a few years ago, although many of his friends also got infected, non of them actually developed symptoms because they were all vaccinated.

Diphtheria Is Still Around

Diphtheria is DeadlyTragically though, especially since diphtheria is still endemic in many countries, we are starting to see more and more lethal cases of diphtheria, including cases in many more countries where it was previously under control:

  • at least 142 diphtheria deaths in Venezuela since 2016, among about 1,602 cases
  • at least 85 deaths in Yemen, among about 1,584 cases since 2017
  • at least six deaths among Rohingya refugees in Bangladesh
  • at least two cases of diphtheria in Ukraine
  • a family that became infected in South Africa in which at least one child died (August 2017)
  • an unvaccinated 3-year-old who died in Belgium (2016)
  • a 22-year-old unvaccinated women who died in Australia (2011)

It is even more tragic that diphtheria is not under control in so many more countries.

In 2016, the WHO reported that there were just over 7,000 cases of diphtheria worldwide. While that is down from the 30,000 cases and 3,000 deaths in 2000, thanks to improved vaccination rates, there is still work to be done.

And as this recent case in Canada shows, diphtheria is still around in many more places than we would like to imagine.

Get educated. Vaccines are necessary.

What to Know About Diphtheria in Canada

A case of diphtheria in Canada is a good reminder that vaccines are still necessary.

More on Diphtheria in Canada

Updated on June 25, 2018

DTP Vaccines

Diphtheria, tetanus, and pertussis were among the first vaccines that were developed:

  • diphtheria vaccine – 1888
  • first tetanus vaccine – 1914
  • first pertussis vaccine – 1915

It wasn’t until 1949 that they were improved and combined into the DTP vaccine though.

DTP vaccines protects against diphtheria, tetanus, and pertussis.
DTP vaccines protects against diphtheria, tetanus, and pertussis.

A separate Td vaccine was licensed for adults in 1953.

Today, all children get their first dose of the latest DTaP vaccines when they are two months old, completely a three dose primary series by the time they are six months old.

Children get booster doses of DTaP when they are 15 to 18 months old and again at age four to six years.

Remember, we switched to using DTaP in 1997.

A Tdap booster is given at age 11 to 12 years, to adults who have never had it, and with each and every pregnancy.

More on DTP Vaccines