A survey was made of the monthly incidence of diphtheria patients who visited the clinic of National Taiwan University Hospital, sites of diphtherial lesions and tracheotomy during two arbitrarily chosen periods, i.e. September, 1959-December, 1960 and June, 1963-January, 1965. At the same time, the numbers of specimens subjected to bacteriological examinations, and those bacteriologically confirmed were indicated for each month. In general, the peak of epidemic was from late autumn to early spring of the following year, (October, November, December and January), although sporadic cases were observed during interepidemic periods.
Among the 41 strains of
C. diphtheriae isolated during the period, September, 1959-December, 1960, 78% belonged to
intermedius type and the rest (22%) belonged to
mitis type. In contrast, among 105 strains isolated during the period June, 1963-January, 1965, only 8.7% belonged to
intermedius type, while 91.3% showed characteristics of
mitis type. No
gravis type strains were isolated. All of these strains showed sensitivity to penicillin, streptomycin, chlortetracycline, oxytetracycline, chloramphenicol, erythromycin, sigmamycin, ampicillin, and cloxacillin.
All the strains showed toxigenicity when tested by intradermal virulence test in rabbits, although there were differences in the grades of virulence among these strains. However, by Elek test 21% showed negative reaction. Among the strains which showed positive Elek test, those which required shorter time to produce bands of precipitin reaction tended to be more virulent in rabbit virulence test. There was no correlation between the types and virulence of these strains. Generally, there was no shift in the grades of virulence during these two periods of observation, although during September, 1959-December, 1960, more strains of
intermedius type with greater virulence were isolated as compared with those strains of the same type isolated during the period June, 1963-Junuary, 1965 (0.05>P>0.01).
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