Abstract
In the 1990s, the Newly Independent and Baltic States of the former Soviet Union experienced the largest diphtheria outbreak since the 1960s; it was caused by Corynebacterium diphtheriae strains of a unique clonal group. To address its origin, we studied 47 clinical isolates from Russia and demonstrated that this clonal group was an integral part of the endemic reservoir that existed in Russia at least 5 years before the epidemic began.
Highlights
I n the pre-vaccine era, diphtheria was a major cause of childhood illness and death worldwide
Toxigenicity status was determined by the Elek test, as recommended by World Health Organization (WHO) [9], and by the polymerase chain reaction (PCR), which targeted both A and B subunits of the tox gene [10]
Epidemic RT G4 was seen in six toxigenic C. diphtheriae isolates collected from 1984 through 1987 in four distant regions of Russia (Moscow and Moscow region, Anapa, Smolensk, and Sverdlovsk) from both diphtheria patients and carriers; four of these isolates were members of the ET8 complex
Summary
I n the pre-vaccine era, diphtheria was a major cause of childhood illness and death worldwide. These isolates were collected from both carriers (n=37) and patients (n=10) in different regions of Russia. All the strains were characterized by ribotyping as previously described [11]. A difference in one band was defined as an individual ribotype (RT).
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