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May 15, 1943


JAMA. 1943;122(3):176. doi:10.1001/jama.1943.02840200032009

During the past fourteen years there have been repeated references in the medical literature to peculiarly severe outbreaks of diphtheria, most of them located in various districts of Europe. A recent review of this subject by McLeod1 indicates not only that there are numerous records of unusually severe diphtheria but also that the results of serum treatment in many of the outbreaks proved singularly disappointing in spite of the great advance in the potency of antitoxic serums. The contrast in effectiveness of serum treatment between the incidence and severity of diphtheria in North America and in many parts of Europe, especially central Europe, has been particularly striking. Does this difference depend, McLeod asks, entirely on the more enthusiastic adoption of prophylactic inoculation in the New World? How far do questions of nutrition play a part? Are there complex and insufficiently understood aspects of the development of mass immunity independent