Quarantine, isolation and terminal disinfection methods for the control of diphtheria, together with a thorough knowledge of its etiology, diagnosis and mode of transmission, have not lessened the prevalence of this disease. Thirty years' experience with a specific diphtheria antitoxin for its treatment and for the purpose of securing passive immunity has not lowered the death rate from diphtheria to the extent that it should.
Three important factors are undoubtedly responsible for this failure: First, too much reliance on the laboratory diagnosis with the consequent failure to give antitoxin on the receipt of a negative report. Second, the failure to give antitoxin in clinical cases without waiting for a laboratory diagnosis. Third, the delay on the part of parents and guardians in calling a physician during the early manifestations of the disease, and frequently their opposition to the administration of antitoxin until the child is in a practically hopeless condition.
SEARS FW. RESULTS OF DIPHTHERIA IMMUNIZATION IN CENTRAL NEW YORK. Am J Dis Child. 1926;32(5):718-724. doi:10.1001/archpedi.1926.04130110080010