Diphtheria in the first year of life is rare, according to most authorities. Rolleston1 and Deacon2 found an incidence of 0.7 per cent in 2,600 and 31,000 infants, respectively; Baginsky3 reported an incidence of 0.15 per cent in 2,700 infants under 6 months of age. However, McCollum and Place4 give the incidence as 2.75 per cent. This rarity is variously attributed to (1) inherited immunity through placental transmission of antitoxin; (2) lack of exposure; (3) acid secretions in the infant's mouth, and (4) antitoxin transmitted through the mother's milk. Most textbooks merely make general statements concerning the relative immunity that is present in infants under 6 months of age.5 On the other hand, Ribadeau-Dumas, Lacomme and Loiseau 6 claim that diphtheria in the new-born is uncommon only because it is often overlooked.In 2,400 consecutive admissions for diphtheria on the contagious service of the Cincinnati General Hospital, there were forty-nine infants under 1 year of age\p=m-\an incidence of 2.04 per cent. Fourteen of these forty-nine died, a mortality of 28.5 per cent, as contrasted with an aver¬ age mortality at all ages of 8 per cent. The laryngeal type was par¬ ticularly fatal, eleven out of seventeen infants dying. However, Deacon reports a mortality of 62 per cent in laryngeal diphtheria in infants under 1 year. ETIOLOGY Race.-There were forty-six white and three negro infants. This disproportion is interesting, because it is known that negroes are less susceptible to diphtheria than are whites.7
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