The Association Between Tuberculosis and Diphtheria

28 Pages Posted: 16 Nov 2017

See all articles by Stephen Coleman

Stephen Coleman

Metropolitan State University (retired)

Date Written: November 13, 2017


This research investigates the now-forgotten relationship between diphtheria and tuberculosis. Historical medical reports from the 19th century is reviewed followed by a statistical regression analysis of the relationship between the two diseases in the early 20th century. Historical medical records show a consistent association between diphtheria and tuberculosis that can increase the likelihood and severity of either disease in a coinfection. The statistical analysis uses historical weekly public health data on reported cases in five American cities over a period of several years, finding a modest but statistically significant relationship between the two diseases. No current medical theory explains the association between diphtheria and tuberculosis. Alternative explanations are explored with a focus on how the diseases assimilate iron. In a co-infection, the effectiveness of tuberculosis at assimilating extracellular iron can lead to increased production of diphtheria toxin, worsening that disease, which may in turn exacerbate tuberculosis. Iron-dependent repressor genes connect both diseases.

Keywords: Diphtheria, Tuberculosis, Epidemics, Co-Infection, Statistical Analysis

Suggested Citation

Coleman, Stephen, The Association Between Tuberculosis and Diphtheria (November 13, 2017). Available at SSRN: or

Stephen Coleman (Contact Author)

Metropolitan State University (retired) ( email )

St. Paul, MN 55108
United States


Do you have a job opening that you would like to promote on SSRN?

Paper statistics

Abstract Views
PlumX Metrics