QUESTION 4 Table 3.7 provides the number of reported cases of diphtheria and the number of diphtheria-associated deaths in the United States by decade. Calculate the death-to-case ratio by decade. Describe the data in Table 3.7, including your results. Table 3.7 Number of Cases and Deaths from Diphtheria by Decade - United States, 1940-1999 Decade 1940-1949 1950-1959 1960-1969 1970-1979 1980-1989 1990-1999 Number of New Cases Number of Deaths Death-to-case Ratio (x 100) 143,497 11,228 7.82 23,750 1,710 3,679 390 1,956 90 27 22 3 5 I Data Sources: Centers for Disease Control and Prevention. Summary of notifiable diseases, United States, 2001. MMWR 2001;50(No. 53). Centers for Disease Control and Prevention. Summary of notifiable diseases, United States, 1998. MMWR 1998;47(No. 53). Centers for Disease Control and Prevention. Summary of notifiable diseases, United States, 1989. MMWR 1989;38 (No. 53). The number of new cases and deaths from diphtheria declined dramatically from the 1940s through the 1980s, but remained roughly level at very low levels in the 1990s. The death-to-case ratio was actually higher in the 1980s and 1990s than in 1940s and 1950s. From these data one might conclude that the decline in deaths is a result of the decline in cases, that is, from prevention, rather than from any improvement in the treatment of cases that do occur. Type letter: A. agree, B. disagree