METHODS' for the purification of diphtheria toxoid may be divided into two classes; those which give a moderate degree of purification and a high yield, and those which give a high degree of purification and a yield which varies within wide limits. Among the latter is the method first applied to toxin by Glenny and Walpole [1915] and later modified by Watson and Wallace [1924] for toxin and by ...

Pneumococcal conjugate vaccine (PCV) has the potential to interact with other vaccines containing diphtheria toxin-like antigens (such as those found in the DTP vaccine) upon sequential administration. This is attributed to the similarity of the diphtheria toxoid antigen to the carrier protein used to make PCV, (known as cross reactive material [CRM]) to diphtheria toxin 197 or CRM197. The inte...

© 2005 The Medicine Publishing Company Ltd 31 MEDICINE 33:7 Diphtheria is caused by superficial infection of the respiratory tract or skin with toxin-producing strains of the bacterium Corynebacterium diphtheriae. The organisms do not actively invade deep tissue or the blood, but multiply locally, producing diphtheria toxin. This results in necrosis of the mucosal cells and production of a thic...

and Wales from 1993 to 2000, an estimated 2–10 secondary cases would have been prevented if attack rates were 5% and each patient had 4 contacts. The number of index cases needed to be detected to prevent 1 death (assuming 6%–10% case-fatality ratio) would have been 150–180 with attack rates of 5% and 50–83 with attack rates of 30%. Thus, deaths were not likely to have been prevented during thi...

TO THE EDITOR—We read with great interest Plotkin’s excellent article, “The Pertussis Problem,” and we agree wholeheartedly that there is an obvious need for improvements in the acellular pertussis vaccine if we are to ultimately prevent what was once believed to be a completely preventable disease [1]. However, we believe his article misses on the second half of the story, which is the dismall...

The successful completion of early childhood immunizations is a proxy for overall quality of early care. Immunization statuses are usually assessed by up-to-date (UTD) rates covering combined series of different immunizations. However, series UTD rates often only bear on which single immunization is missing, rather than the success of all immunizations. In the US, most series UTD rates are limi...

The number of pertussis cases reported to the CDC increased from 5158 in 1995 to 21,503 in 2005. Most of the increase was in individuals greater than 10 years of age. This increase occurred also in other developed nations despite high coverage of infants and young children with the acellular pertussis vaccine. In Goteborg Sweden, virtual elimination of pertussis occurred following immunization ...