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DIPHTHERIA is a potentially severe illness; among unvaccinated persons, the case-fatality rate may be 5%-10%, even with appropriate treatment. During 1990-1995, approximately 4000 deaths resulted from the ongoing diphtheria epidemic in the former Soviet Union.1 In the United States, respiratory diphtheria is rare: during 1980-1995, only 41 cases were reported. Serologic studies in the 1970s and 1980s indicated that 20%-60% of U.S. adults aged ≥20 years lacked immunity to diphtheria.2,3 This report describes a recent case of respiratory diphtheria caused by a toxin-producing strain of Corynebacterium ulcerans. The case occurred in a resident of Indiana, and an investigation by public health authorities indicated that acquisition of the organism occurred locally in the state.
On October 24, 1996, a 54-year-old woman residing in Terre Haute, Indiana, had onset of fever, sore throat, and difficulty swallowing. On October 26, she was examined in an outpatient clinic and reported
Respiratory Diphtheria Caused by Corynebacterium ulcerans—Terre Haute, Indiana, 1996. JAMA. 1997;277(21):1665-1666. doi:10.1001/jama.1997.03540450021011