Diphtheria Infection and Morbidity in Cleveland, 1937-1939

Abstract

FOLLOWING a period of high mortality, unprecedented in the statistical record and exceeding 300 per 100,000 in 1877, the decline of diphtheria in Cleveland was heralded by a precipitate fall in the death rate in 1879. After 5 years at a level of about 180, a gradual decline commenced, which continued, with some interruptions, to 1909, when the rate was 12.4. In the succeeding 18 years, with the exception of 1924, higher rates were experienced. Then, after 1927, the decline was resumed and greatly accelerated. Since 1930 mortality has been at a very low level. In 1938 the rate was only 0.5, a reduction of 97 per cent from that of 1927. The number of cases reported in each year, since 1910, has varied directly with the number of deaths. Thus there has been no evidence of decreasing severity of the disease. The case fatality was 7.6 per cent for the period 1910-1914; 7.9 for 1915-1919; 8.2 for 1920-1924; 7.2 for 1925-1929; 7.0 for 1930-1934, and 8.5 for 1935-1938.