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HISTORY OF C. DIPHTHERIAE
Diphtheria was discovered in 1884 by two German bacteriologists Klebs and Loeffler hence the bacteria is also known as Klebs-Loeffler bacillus. Loeffler was the first to find in 1884 that the diphtheriae bacteria can only be cultured and grown when retrieved from the nasopharyngeal cavity (Murphy, 2020). Loeffler found that the bacteria caused damage to the internal organs using a soluble toxin that the bacteria created while causing the disease (Murphy, 2020).
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In 1888 experiments were done on animals where they were given a sterile form of C. Diphtheriae, the showed that the pathology of the organs in the animals was identical to that of humans. This experiment showed that the exotoxin produced was the main virulence factor of the disease (Hien and White, 2014). It was in 1890 that a form of anti-toxin was produced from horses it was produced by injecting the horse with high amounts of diphtheriae toxin which then caused an immune response in the horse and white blood cells could be processed to make an anti-toxin that helps to stop the progression of the disease (Diphtheria, 2020).
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The anti-toxin could not prevent the disease or stop it from spreading. Bela Schick developed a test called the Schick test in 1910 which could be used to detect if the person has immunity towards Diptheria it was used to give out vaccinations to people who did not have immunity. During the start of the 19th century in the early 1900s, many attempts of making vaccines or toxoid for diphtheria was made using toxin-antitoxin mixtures, it was only in 1921 after approximately 22 years that a toxoid was discovered (Millward, 2020). Even though a toxoid was discovered in 1921, its widespread use was only established in the early 1930s, and from the year 1940, it was incorporated into the pertussis vaccine and tetanus toxoid and used more regularly (Millward, 2020).
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Children below the age of 15 were the ones that were affected heavily by the spread of diphtheria. The spread of diphtheria was very prominent in countries such as England and Wales wherein these countries there were years where more than 40,000 children were killed by diphtheria. After the widespread use of the toxoid the rate of death had decreased from around 40,000 to 962, it was the first free vaccine that was administered to the British public (2020). In 1974 the WHO (World Health Organisation) decided to add vaccination for diphtheria into their extended immunisation program for developing countries (Timeline | History of Vaccines, 2020).
During 1949 due to improper manufacturing of vaccine aluminium phosphate toxoid many children died. It took more than 50 years for effective immunisation of diptheria to occur as the widespread use of the toxoid started around 1949 and effective immunisation was achieved in the early 2000s (Timeline | History of Vaccines, 2020).
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One of the largest outbreaks that had occurred recently is the diphtheria outbreak in the Soviet Union which was from 1990-98 there were more than 155,000 cases and around 5,000 deaths that had occurred during the eight years of the large outbreak in the Soviet Union that has been last recorded incidence of a large outbreak, in the present-day few cases are recorded mostly a rare occurrence in developed countries (Murphy, 2020).
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References
Cdc.gov. 2020. [online] Available at: <https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/dip.pdf> [Accessed 1 December 2020].
Hien, T. and White, N., 2014. Diphtheria. Manson's Tropical Infectious Diseases, pp.416-420.e1.
Historyofvaccines.org. 2020. Timeline | History Of Vaccines. [online] Available at: <https://www.historyofvaccines.org/timeline/diphtheria> [Accessed 1 December 2020].
Millward, G., 2020. Diphtheria. [online] Ncbi.nlm.nih.gov. Available at: <https://www.ncbi.nlm.nih.gov/books/NBK545997/#:~:text=In%201940%2C%20diphtheria%20became%20the,deaths%20from%202%2C480%20to%2049> [Accessed 1 December 2020].
Murphy, J., 2020. Corynebacterium Diphtheriae. [online] Ncbi.nlm.nih.gov. Available at: <https://www.ncbi.nlm.nih.gov/books/NBK7971/> [Accessed 1 December 2020].
Museumofhealthcare.ca. 2020. Diphtheria. [online] Available at: <https://www.museumofhealthcare.ca/explore/exhibits/vaccinations/diphtheria.html#:~:text=The%20diphtheria%20bacterium%20was%20first,large%20doses%20of%20diphtheria%20toxin> [Accessed 1 December 2020].
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