Diphtheria or Plague of the Children 

  Exactly 203 years ago in 1821 one of humanity’s most deadly diseases was given a name: Diphtheria. The malady is named for a false membrane that the disease produces that covers the soft palette of the throat. The membrane looks like a piece of leather hide on the back of the throat so “leather” is what Diphtheria means in English. The infection produces poison and the leather like membrane grows and eventually suffocates the victim. Adults could get the disease and die from it, but children and their little throats are particularly vulnerable, so the disease was especially lethal among children. 

 Diphtheria is contagious and is passed by droplets from person to person. In the late 1800’s, germ theory was limited. American physicians didn’t really buy into the theory, but they knew children were dying of the plague. British scientists warned that people were spreading the disease with a “kiss of death” when they kissed their suffocating children. They were correct, but what parent can resist kissing their child as the child’s blue face contorts in agony? 

Leather-like Membrane Suffocating Victim

 No region of the world was safe from Diphtheria. No economic class was safe. Queen Victoria’s daughter, Princess Alice (age 35) and Alice’s daughter both died of the disease. The queen, like countless other parents and grandparents, was devastated. Of course, the disease spread like wildfire through densely populated cities like London and New York. The low-income tenements were a fertile environment for the plague. 

Princess Alice of the United Kingdom

 The hospital wards were full of dying children and wailing parents. In New York City, in 1873, two physicians entered the fray on behalf of the working poor in the city’s crowded neighborhoods. The husband-and-wife team of Abraham Jacobi and Mary Putnam were angels of mercy in the crowded and deadly wards. These advocates for public health agencies actually created a new field of medicine known as “Pediatrics.” The idea was that children are not simply smaller versions of an adult but are separate beings with their own issues. The chief issue at that time was Diphtheria. The doctors’ own family was not immune to Diphtheria as they lost their beloved seven-year-old. This only spurred the doctors’ efforts to promote public health standards and sanitation for everyone, including the poor. 

Dr. Mary Putnam Jacobi, Mother of Pediatrics
Dr. Abraham Jacobi, Father of Pediatrics

 In 1888, the Pasteur Institute of Paris had two scientists that isolated the pathogen that produced the poison. That led to a Japanese scientist developing a process for making an antitoxin. The Pasteur Institute followed the process and developed an antitoxin from the blood of horses. It included infecting the horses with tetanus and their systems produced an antitoxin for Diphtheria. 

 This equine based treatment for Diphtheria was a huge breakthrough and the scientists involved won the Nobel Prize in 1901. The fatality rate among children fell to 25% with the horse antibodies treatment. The world had some hope! Obviously, in our modern world a lethality rate 

of 25% is not a good thing, but the celebrations of the new treatment were worldwide and heartfelt. Of course, the availability of the treatment was a whole new problem. Many vulnerable populations still suffered without the treatments. President Grover Cleveland’s daughter, “Baby Ruth” (the candy bar is named for her), died even with the treatment. One of the most famous efforts to make the treatment available to children took place in Alaska in 1925. It involved a 674-mile dog sled race to Nome that is memorialized now by the Iditarod Race. The lead dog of the original race, “Balto”, has a statue in New York’s Central Park. 

“Balto” statue, Central Park, New York City

The treatment for Diphtheria also doubled as a vaccination to give people, especially children, immunity from the dreaded disease. Vaccination campaigns were successful until the supply chains were disrupted by World War Two. Fifty thousand Europeans died in 1943 because they could not access the lifesaving antitoxin/vaccine. 

In 1948, the Diphtheria Pertussis Tetanus (DPT) vaccination was developed and distributed worldwide. The World Health Organization administers the vaccine to developing countries. The elimination of Diphtheria is a goal of all civilized nations. Sadly, the vaccine pipeline has been interrupted in countries where violence and corruption reign. Diphtheria is making a comeback in unvaccinated children. If one contracts Diphtheria, the treatment is basically the same as it was 100 years ago—horse blood created antitoxin. 

Unfortunately, the memories of families being decimated by Diphtheria and the euphoria of a 25% fatality rate have faded from our consciousness. I say “unfortunately” because many of us have lost our respect for the deadly repercussions of the so-called “childhood diseases.” We have forgotten what our ancestors experienced not so long ago. Vaccines are simply an inconvenient trip to the doctor’s office to have a shot placed on our children’s immunization record. Diphtheria has been relegated to the dustbin of history by scientists working tirelessly on behalf of their own children, many of whom succumbed to the deadly disease. The President of the United States and the Queen of England watched their own children being choked to death in gruesome scenes nobody wants to see repeated. 

Modern Diphtheria Victim

I thank God and His agents, the physicians and scientists, for their heroic work on behalf of our greatest asset—our children. I pray for the little ones who have no access to vaccines and are contracting diseases in Yemen and Venezuela where Diphtheria is now rearing its ugly head. As populations of unvaccinated children move from one crowded refugee camp to another, it is inevitable that tragic outbreaks will occur. My hope is that the benefits of vaccines, clean water, and sanitation can be infused into the lives of these unfortunate people who live in filth and uncertain conditions that breed pestilence. This is what the medical pioneers of germ theory desired a hundred years ago. In most areas, we have come a long way from the dominance of Diphtheria, but in others, we have a long way to go. 

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