When was the diphtheria vaccine introduced? Explore the comprehensive history of diphtheria and the development of the vaccine that has almost eliminated this once-deadly disease in the United States.

Diphtheria’s Storied Past

Diphtheria, a serious bacterial infection, has a long and complex history. It was not until the 19th century that the disease was finally identified and named. In 1613, a Spanish epidemic of the disease was recorded, and in 1735, it was referred to as “The Plague Among Children.” It was French physician Pierre Bretonneau who, in 1826, gave the disease its official name, “diphtheria,” derived from the Greek word for “leather” or “hide,” which describes the characteristic coating that appears in the throat of those affected.

Bretonneau also distinguished diphtheria from scarlet fever and recorded the first successful use of tracheotomy, a procedure involving cutting an opening in the trachea to allow passage of air and removal of secretions. Another French physician, Armand Trousseau, later showed a survival rate of about 25% in the tracheotomies he performed on diphtheria sufferers.

The Identification of the Diphtheria Bacterium

It was not until 1883 that the diphtheria bacterium, Corynebacterium diphtheriae, was finally identified. Two years later, in 1885, French scientists Émile Roux and Alexandre Yersin investigated the diphtheria bacterium and discovered that it secreted a powerful toxin, which was responsible for the disease’s devastating effects.

The Pursuit of a Diphtheria Vaccine

With the bacterium identified, the search for a vaccine began. In 1890, scientists developed an antitoxin that could neutralize the diphtheria toxin, but a vaccine remained elusive. In 1894, the New York City Board of Health took steps to ensure the purity and potency of diphtheria antitoxins sold in the city, as most of the antitoxin at the time came from two suppliers in Germany.

The development of a diphtheria vaccine took another crucial step forward in 1901 when the issue of antitoxin contamination was addressed, and in 1905, the phenomenon of “serum sickness” associated with the use of antitoxin was described.

The Breakthrough in Diphtheria Vaccination

The real breakthrough in diphtheria vaccination came in 1914 when William Hallock Park, a New York City public health official, discovered a way to produce a safe and effective diphtheria vaccine. Park’s work led to the launch of a large-scale diphtheria vaccination campaign in New York City in 1921, and soon, the insurance company Metropolitan Life joined the effort, donating $15,000 and using various tactics, including door-to-door polling, radio and print advertisements, essay contests, and parades, to spread the message of immunization.

The Modern Diphtheria Vaccine and Its Impact

With the development of a modern vaccine formulation, diphtheria, along with tetanus and pertussis, came under control in different countries. In 1974, the World Health Organization (WHO) advocated for the use of the diphtheria-tetanus-pertussis (DTP) vaccine, which became a standard part of childhood immunization programs worldwide.

The impact of the diphtheria vaccine was profound. In the United States, respiratory diphtheria has almost disappeared, with the CDC recording no cases since 2004. In fewer than 75 years, diphtheria, once the leading cause of premature death in children, was virtually eliminated in the United States.

Diphtheria Today and the Ongoing Fight

While diphtheria is now a rarity in the United States, the disease still poses a threat in other parts of the world. Outbreaks have occurred in the Russian Federation and other regions, underscoring the importance of continued vigilance and vaccination efforts globally.

The remarkable journey of the diphtheria vaccine, from its early beginnings to its widespread adoption and impact, is a testament to the power of scientific research, public health initiatives, and the unwavering commitment to eradicating this once-deadly disease.

Diphtheria Symptoms and Transmission

Diphtheria is caused by the bacteria Corynebacterium diphtheriae, which secrete a powerful toxin that damages body tissues. Early symptoms of diphtheria include sore throat, loss of appetite, and fever. As the disease progresses, a thick gray substance called a pseudomembrane may form and spread over the nasal tissues, tonsils, larynx, and/or pharynx, potentially obstructing breathing.

Diphtheria is transmitted from person to person, usually via respiratory droplets. An infected person, unless treated with antibiotics, is infectious for two to three weeks.

Diphtheria Complications and Treatment

The diphtheria toxin can travel to the heart, muscles, kidneys, and liver, causing temporary or permanent damage to these organs. Complications from diphtheria may include myocarditis (damage to the heart muscle), neuritis (inflammation of nerves, which may contribute to nerve damage, paralysis, respiratory failure, and pneumonia), airway obstruction, and ear infection.

Treatment for diphtheria involves antibiotics to kill the bacteria, as well as antitoxin to neutralize the toxins secreted by the bacteria. Diphtheria patients are typically kept in isolation until they are no longer capable of infecting others, usually about 48 hours after antibiotic treatment begins.