Commercial use of Burkholderia cepacia.

Letters toxicity, no antidiphtheria serum was administered. The patient became well and was discharged on day 4. In the first case, a throat culture could not be done because the patient had already received local antiseptic paint. However, the diagnosis was clinically consistent with classic diphtheria with features of toxicity. In the second case, diphtheria was suspected only after bacteriologic examination. Unlike patient 1, patient 2 had no evident features of systemic toxicity. Hence the isolate could be nontoxigenic. Localized diphtheria due to nontoxigenic C. diphtheriae is known to occur (1). The two patients did not give a complete history of immunization and may not have been vaccinated (or may have been partially vaccinated) with DPT. On the Indian subconti-nent, DPT vaccination coverage is reported to be 80%. However, it may not be so in all areas, and immunization may have decreased to approximately 50% in certain areas of Southeast Asia (2). This may also be true in certain areas of eastern Nepal. An immunization status survey done in midwestern Nepal from 1989 to 1990 showed that DPT coverage was unsatisfactory (3). Lack of sustained immunization may even result in outbreaks. The recent epidemics of diphtheria in the Ukraine, Russian Federation, and other countries of the former Soviet Union are examples of resurgence due to ineffectively maintained immunization programs (4,5). Diphtheria, still occasionally seen in many Southeast Asian countries including India and Nepal, is thought to be declining in these areas. However, accurate data have not been recently available, particularly from Nepal, because reporting is infrequent, laboratory confirmation is not available, and the extent of carriers is not clearly known (2). These two cases show the persistence of diphtheria in a population in Nepal immunized with DPT and underscore the need for careful surveillance, laboratory documentation of clinical diphtheria, and increased immunization of children in this area. critical appraisal of current EPI status and future prospects. In: Immunizing agents for tropics: success, failure and some practical issues (BPKIHS Monograph Series 1). To the Editor: In their review of the potential threat to human health by the commercial use of Burkholderia cepacia, Holmes et al. (1) focus on the biopesticidal uses of this bacterium in agriculture. By virtue of its ability to antagonize a number of soilborne plant pathogens, B. cepacia is an attractive natural alternative to currently used chemical pesticides, such as captan, mancozeb, and metalaxyl. The replacement of these …