Dogs and horses saved the day

with millions of unscreened migrants let in by Biden's policies, it may be only a matter of time that we start seeing diseases not seen in the US for a century start popping up.

 there has been cases of Diphtheria in migrants in Europe. because many of these were not vaccinated in their own country. 

But ironically many who caught diphtheria caught it  in Europe, meaning that there are clusters of mild cases, or carriers, i.e. patients who carry the germ and spread it to others in communities where migrants are living.

 

so far, unlike Europe, the USA seems to be safe from epidemics:

from Grok:

Diphtheria is extremely rare in the United States due to widespread vaccination. ...    

- In 2019, two cases were reported,   (https://ourworldindata.org/grapher/diphtheria-cases-in-the-united-states) - 

A 2020 case report described a 33-year-old unvaccinated man in Georgia with respiratory diphtheria, likely linked to his recent incarceration and lack of childhood vaccinations. (https://pmc.ncbi.nlm.nih.gov/articles/PMC7753149/)

These cases are exceptions, often tied to unvaccinated or under-vaccinated individuals, international travel, or contact with travelers from areas where diphtheria is more common, like parts of Africa, Asia, or conflict zones. The disease remains under control in the U.S. thanks to high vaccination coverage with DTaP, Tdap, or Td vaccines. ...

more here.

 and the bad news is that unless your doctor worked or trained overseas, if you come down with diphtheria, they might not recognize it in time for the correct treatment. 

Of course, if you go to an old fashioned doctor who gives antibiotics for sore throats, you might have it cured before you develop proper symptoms.

what inspired this blog post was a book I ran across while checking Project Gutenberg: a 1919 describing the public health approach to diphtheria.

 And there was a cure: Anti toxin. 

Depending on the way it is treated, diphtheria is one of the least dangerous or one of the most dangerous diseases. It is one of the least dangerous when promptly treated with antitoxin; it is one of the most[8] dangerous when the antitoxin treatment is not given, or is delayed or insufficient.

In the days before we had antitoxin one out of every three children who had diphtheria died. Now, if antitoxin is used on the first or second day of the disease ninety-eight out of every hundred children recover. The sooner diphtheria is attended to the more certain is a cure.

The toxin is the reason for those tough membranes that cause choking. 

 Diphtheria-causing bacteria may produce a toxin. This toxin damages tissue in the immediate area of infection — usually, the nose and throat. At that site, the infection produces a tough, gray membrane made up of dead cells, bacteria and other substances. This membrane can obstruct breathing.

there is also a real danger of myocarditis and neurological complications from the toxin produced by the germ.

Nowadays, there is treatment: antibiotics and anti toxin.

 

Alas, diphtheria is still present here in the Philippines, and seen in various Asian and African countries,    

when I first started medical school in the 1960s, we still had an infectious disease hospital in our city and outside there was a bell. We were told if a child came in choking from the membrane, they could be saved by immediate tracheostomy, so they would ring the bell and any doctor in the area would come to the ER and do it.

And I add: Even though I have lived and worked in third world countries (and in areas of the USA that were essentially third world levels of poverty) I never saw Diphtheria. Maybe because our hospitals also had active outreach to immunize children.

The history of treatment of diphtheria goes back to the 1890s: here:

In 1890, an effective treatment for diphtheria – antitoxin – was discovered by Shibasaburo Kitasato and Emil von Behring in Germany...

more HERE. 

it was made by giving the toxin to horses, starting with a small dose then increasing the dosage until the horse provided lots of antibodies, which then were removed and purified to give to people

Horse serums have a danger of severe allergic reactions that can be fatal, but is available at the CDC: but now newer technology is being used to produce antibodies with a lower danger of allergic side effects. 

the life saving anti toxin became famous after there was an outbreak of diphtheria in Nome Alaska in 1925:

 

Balto, one of the dogs who carried the serum, became the poster child for publicizing that there was a treatment for diphtheria, (but some purists correctly point out that Togo was actually the first dog to arrive with the serum)

Wikipedia article has a lot of details: not a one time delivery, but several deliveries of the needed vaccine.

the Iditarod race commemorates this dangerous sled journey to save lives.

And Balto became the poster dog for those who risked their lives to save the children of Nome.

This blog has the photo of Balto's statue in Central ParkA low-relief plaque bears the words 

“Dedicated to the indomitable spirit of the sled dogs that relayed antitoxins 660 miles over rough ice, across treacherous waters, through Arctic blizzards from Nenana to the relief of stricken Nome in the winter of 1925.”

 ...........................

a longer version of this post is on my medical blog.