Abstract
In 1971 there was a localised outbreak diphtheria in Manchester, caused by a toxigenic strain of Corynebacterium diphtheriæ mitis, with the unusual property of fermenting sucrose. One adult and eight children were affected. The first patient, in whom diphtheria was not diagnosed at the time, died from respiratory obstruction, but the remainder recovered. Nose and throat swabs were taken from more than 3000 contacts, and 28 carriers of toxigenic organisms were found, mostly in a single primary school. A further 19 carriers of non-toxigenic C. diphtheriæ mitis were detected and also a single case of Corynebacterium ulcerans infection. The cases and carriers were isolated in hospital, where erythromycin eradicated the organisms rapidly. 81,500 children under the age of sixteen years were immunised in a month, about 20% being primary immunisations. 64 of the children immunised had been unnecessarily refused immunisation in infancy because of allergic conditions, notably asthma and eczema.
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