Last updated on: 2/2/2023 | Author:

Diphtheria, Tetanus (Lockjaw), and Pertussis (Whooping Cough)

Cases and Deaths, and DTaP Vaccination Rates


Diphtheria, according to the CDC, is “a infection caused by Corynebacterium dipheriae” that “causes a thick covering in the back of the throat. It can lead to breathing problems, paralysis, heart failure, and even death.”

Microscopic view of the diphtheria bacterium
Source: Sanofi Pasteur, “Diphtheria Bacterium (Corynebacterum Diphteriae),”, Aug. 7, 2013

In 1826, Pierre Bretonneau, a French physician, called the disease diphtérite and distinguished diphtheria from scarlet fever. In 1883, Swiss-German pathologist, Edwin Klebs, identified the bacterium that causes diphtheria and in 1884, Friedrich Loeffler, first cultivated the bacterium, which resulted in its first name of Klebs-Loeffler bacterium (it is now called Corynebacterium diphtheria). In 1890 Kitasato Shibasaburo, a Japanese physician and bacteriologist, and Emil von Behring, a German physiologist who would win the Nobel Prize in Medicine in 1901 for his work on diphtheria, successfully immunized guinea pigs with a heat-treated diphtheria toxin.

On Oct. 16, 1894 two Cincinnati physicians successfully treated a two-year-old girl with a diphtheria antitoxin. On Dec. 4, 1894 the New York City Board of Health regulated the purity and potency of diphtheria antitoxin. In 1895 the Mulford Company of Philadelphia (later Merck) and the New York City Health Department started producing and testing diphtheria antitoxin using guinea pigs and horses.

In 1897 Paul Ehrlich, a German scientist, developed a method to measure the potency of diphtheria antitoxin. In 1907 Emil von Behring demonstrated that mixing the diphtheria antitoxin and toxin provided a safe immunity to diphtheria in humans. In 1914 William H. Park developed a toxin/antitoxin mixture diphtheria immunization. In 1923 Gaston Ramon, French veterinarian and biologist at the Pasteur Institute in France, developed diphtheria toxoid that could later be used for a toxoid vaccination at the same time as Alexander Thomas Glenny, a London physician at Wellcome Research Laboratories. Glenny would develop the adjuvant (the substance that enhances the body’s immune response to an antigen) for the toxoid vaccine in 1926.


Tetanus, according to the CDC, is “a serious disease that causes painful tightening of the muscles, usually all over the body. It can lead to ‘locking’ of the jaw so the victim cannot open his mouth or swallow. Tetanus leads to death in about 1 in 10 cases.”

Microscopic view of the tetanus bacilli
Source: Sanofi Pasteur, “Tetanus Bacilli (Clostrium Tetani),”, Aug. 7, 2013

Records from the fifth century first describe tetanus (lockjaw). Giorgio Rattone and Antonio Carle, Italian scientists, first produced tetanus in animals by injecting them with pus from a human case in 1884, the same year Arthur Nicolaier, a German internist, produced tetanus in animals by injecting them with soil samples. In 1889, Kitasato Shibasaburo isolated the tetanus toxin from a human and proved that the toxin can be neutralized by antibodies. In 1897, Edmond Nocard, a French microbiologist and veterinarian, demonstrated passive immunization. Gaston Ramon inactivated the tetanus toxoid with formaldehyde in the early 1920s. In 1924, P. Descombey produced the tetanus toxoid that was used in the US military during World War II.


Pertussis (whooping cough), according to the CDC, “is a highly contagious respiratory tract infection. Although it initially resembles an ordinary cold, whooping cough may eventually turn more serious, especially in infants.”

Microscopic view of the pertussis (whooping cough) bacteria
Source: Sanofi Pasteur, “Pertussis Bacteria (Bordetella Pertussis),”, Aug. 7, 2013

In 1900 Jules Bordet and Octave Gengou, Belgian scientists, first observed Bordetella pertussis and then isolated the pertussis bacterium in 1906, it was called Bordet-Gengou bacillus. In 1925 Thorvald Madsen, a Danish physician, tested the pertussis vaccine; the 1925 report suggested the vaccine was a success but a 1933 report stated that two children may have died from the vaccine. In 1939, the pertussis vaccine was shown to be effective by Pearl Kendrick and Grace Elderding American scientists.

In 1948, the DTaP (diphtheria, tetanus, and pertussis) combination vaccine was developed.

The CDC recommends that children receive the first dose of the DTaP vaccination at 2 months of age.


CDC, “Diphtheria: Causes and Transmission,”, May 13, 2013

CDC, “Diphtheria Vaccination,”, May 10, 2013

CDC, “Pertussis (Whooping Cough) Vaccination,”, July 29, 2014

CDC, “Reported Cases and Deaths from Vaccine Preventable Diseases, United States, 1950-2013,”, Sep. 2014

CDC, “Tetanus: Epidemiology and Prevention of Vaccine-Preventable Diseases, The Pink Book: Course Textbook – 12th Edition Second Printing (May 2012),”, July 7, 2014

CDC, “Tetanus (Lockjaw) Vaccination,”, Feb. 7, 2013

CDC, “U.S. Vaccination Coverage Reported via NIS,”, Mar. 11, 2014

College of Physicians of Philadelphia, “The History of Vaccines: Timelines, Diseases and Vaccines,” (accessed June 25, 2014)