PEDIATRICS Vol. 3 No. 5 May 1949, pp. 630-638
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THE CHANGED STATUS OF DIPHTHERIA IMMUNITY

PHILIP COHEN M.D.1, HERMAN SCHNECK M.D.1, EMANUEL DUBOW M.D.1, and SIDNEY Q. COHLAN M.D.1

1 The Pediatric Service of Dr. Philip Cohen, Beth Israel Hospital, New York, N.Y.

These studies and data indicate a considerable diminution of immunity to diphtheria among the present young adult generation of this city. The same seems to hold true for other sections of this country. While the increase of diphtheria morbidity has not been alarming in this country, it is not wise or expedient to delay the correction of this lost or waning immunity until diphtheria assumes threatening epidemic proportions. Since the soil may be prepared for the spread of diphtheria by loss of humoral immunity, a change in one of the other factors affecting the epidemiology of this disease may effect a sudden and serious increase of diphtheria. The validity of the Schick test has been reestablished as an index of humoral immunity by once more demonstrating its close correlation with an adequate antitoxin content of the blood. The reliability of the Schick test, since it is simple, easy to perform and interpret and always available, is stressed.

The restoration of humoral immunity to diphtheria and the excitation of cellular immunity by periodic stimulating inoculations will cause a decline in diphtheria susceptibility and morbidity. These ends can be attained by continuing, during childhood and early adult life, recall doses at periodic intervals, thus converting the potential protection of cellular immunity into the active protection of the humoral immunity. In the case of women it may be wise to increase such immunity to an adequate level during pregnancy to safeguard the newborn with similarly adequate immunity.

Submitted on July 11, 1948