Diphtheria in Jordan: a diminishing yet important paediatric disease

Twenty-seven cases of diphtheria (15 male, 12 female) admitted over a 2-year period, 1977-1978, at the Jordan University Hospital were reviewed. The majority were admitted during autumn and were in the 2-9-year age group. Eleven patients were not vaccinated and six were questionably vaccinated; of these seven died. In 10 patients who were partially or completely vaccinated, only one died. Antitoxin was given to 23 patients at varying intervals after the onset of the disease. No antitoxin was given to the patients who were admitted after the tenth day of the illness. Fourteen complications developed in 13 patients. One patient died with upper airway obstruction, four died with myocarditis, and three patients died with the respiratory complications of polyneuritis. The case fatality rate was 29%. While in Jordan the incidence rate of diphtheria has been decreasing steadily, limited outbreaks are likely to continue to occur unless a higher immunization rate is achieved.