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Diphtheria prevented by immunisation

Diphtheria prevented by immunisation

In 1888 Pierre Roux and Alexandre YersinANCHOR showed that the liquid in which the bacterium Corynebacterium diphtheriae had been grown caused all the well-known effects of diphtheria, by injecting it into guinea pigs, rabbits, dogs, cats and horses.

These effects were shown by Emil von Behring and Shibasaburo Kitasato to be caused by the toxin released by the bacteria, which remained in the liquid even after the bacteria had been removed. An antiserum to the toxin, known as an antitoxin, was developed, and this protected animals from fatal doses of diphtheria  toxin.ANCHOR The antitoxin was first used to treat a seriously ill girl in 1891, who subsequently recovered.

Production of the antitoxin on a large scale was achieved in horses, with both the diphtheria serum and the antiserum being standardised using guinea pigs. Widespread use of the antitoxin followed, and studies in rabbits showed that it had to be administered soon after infection to be effective.ANCHOR Despite delays in administering the antitoxin, several studies carried out during the 1890’s showed that deaths from diphtheria were approximately halved.

Despite use of the antitoxin, death rates from diphtheria were still high in the early 1900s and the need for a vaccine was clear. In 1913 von Behring had produced long lasting immunity in guinea pigs, monkeys and asses using a carefully balanced mixture of toxin and antitoxin.ANCHOR This was used in the first vaccination studies on humans. A widespread immunization programme followed the development of formalin-inactivated toxin by A. T. Glenny and Barbara HopkinsANCHOR and Gaston RamonANCHOR in the early 1920s.


References

  1. Roux & Yersin (1888) Ann l Inst Pasteur 2, 629-661
  2. von Behring & Kitasato (1890) Deutsche Med Wochenschr 16, 1113-1114
  3. Zinsser (1931) Textbook of Bacteriology, 6th Ed, Appleton
  4. von Behring (1913) Deutsch Med Wochenschr 39, 873-876
  5. Glenny & Hopkins (1923) Br J Exp Pathol 4, 283-288
  6. Ramon (1924) Ann l Inst Pasteur 38, 1-10



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