0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Reviews |

Diphtheria among Alcoholic Urban Adults: A Decade of Experience in Seattle

James P. Harnisch, MD; Evelyn Tronca, MS; Charles M. Nolan, MD; Marvin Turck, MD; and King K. Holmes, MD, PhD
[+] Article and Author Information

Grant Support: Partial support by National Institutes of Health grants AMO-05250 and AI-12192 and by a grant from the CIBA Foundation.

Current Author Addresses: Dr. Harnisch: 1600 116th Avenue Northeast, Suite 306, Bellevue, WA 98004.

Ms. Tronca: 12415 NE 6th Place, Bellevue, WA 98005.

Dr. Nolan: 1200 Public Safety Building, Seattle, WA 98104.

Dr. Turck: Journal of Infectious Diseases, HL-20, 1910 Fairview Avenue East, Seattle, WA 98102.

Dr. Holmes: Harborview Medical Center, 325 Ninth Avenue, Seattle, WA 98104.


© 1989 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1989;111(1):71-82. doi:10.7326/0003-4819-111-1-71
Text Size: A A A

Three outbreaks of Corynebacterium diphtheriae infection occurred in Seattle's Skid Road from 1972 through 1982. The first involved a single toxigenic, intermedius biotype clone, whereas the second and third outbreaks involved non-toxigenic mitis and gravis strains. Of 1100 total infections, 947 (86%) were cutaneous. The incidence was highest in winter and spring. In Skid Road, the estimated attack rate during 17 months in 1974 to 1975 was 5% for whites and 27% for native Americans. Streptococcus pyogenes was isolated from 73% of diphtheritic and 41% of nondiphtheritic skin lesions (P < 0.001). Skin infection and environmental contamination by C. diphtheriae were correlated. Complications occurred in 21% of symptomatic nasopharyngeal and 3% of cutaneous toxigenic intermedius infections (P < 0.001), and were significantly correlated with ages 60 years or more. Preferential use of erythromycin for diphtheria and pyodermas preceded plasmid-mediated resistance to erythromycin in C. diphtheriae. Diphtheria outbreaks in urban alcoholic persons are associated with poor hygiene, crowding, season, contaminated fomites, underlying skin disease, hyperendemic streptococcal pyoderma, and introduction of new strains from exogenous reservoirs.

Topics

diphtheria

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Topic Collections
PubMed Articles

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)