60-738: Edwin Arlington Robinson (December 22, 1869 – April 6, 1935) was an American poet and playwright. Robinson won the Pulitzer Prize for Poetry on three occasions and was nominated for the Nobel Prize in Literature four times. Robinson was born in Head Tide, Maine , on December 22, 1869. His parents were Edward and Mary (née Palmer). They had wanted a girl, and did not name him until he was six months old, when they visited
120-494: A disulfide bond . DT-B is a recognition subunit that gains entry of DT into the host cell by binding to the EGF-like domain of heparin-binding EGF-like growth factor on the cell surface. This signals the cell to internalize the toxin within an endosome via receptor-mediated endocytosis . Inside the endosome, DT is split by a trypsin-like protease into DT-A and DT-B. The acidity of the endosome causes DT-B to create pores in
180-563: A case of diphtheria was diagnosed at Vall d'Hebron University Hospital in Barcelona , Spain . The six-year-old child who died of the illness had not been previously vaccinated due to parental opposition to vaccination . It was the first case of diphtheria in the country since 1986, as reported by the Spanish daily newspaper El Mundo , or from 1998, as reported by the WHO. In March 2016,
240-401: A certain type of bacteriophage . Toxinogenicity is determined by phage conversion (also called lysogenic conversion ); i.e., the ability of the bacterium to make DT changes as a consequence of infection by a particular phage. DT is encoded by the tox gene. Strains of corynephage are either tox (e.g., corynephage β) or tox (e.g., corynephage γ). The tox gene becomes integrated into
300-422: A characteristic swollen neck and throat, or "bull neck." The swollen throat is often accompanied by a serious respiratory condition, characterized by a brassy or "barking" cough, stridor , hoarseness, and difficulty breathing; and historically referred to variously as "diphtheritic croup," "true croup," or sometimes simply as "croup." Diphtheritic croup is extremely rare in countries where diphtheria vaccination
360-562: A copy from his teacher, who happened to be a friend of Robinson. Kermit then recommended it to his father, who, impressed by the poems and aware of Robinson's straits, invited Robinson to join him for dinner at the White House (though Robinson declined due to his lacking "suitable clothes") and in 1905 offered the writer a sinecure at the New York Customs Office. According to Edmund Morris , author of Theodore Rex ,
420-406: A holiday resort—at which point other vacationers decided that he should have a name, and selected the name "Edwin" from a hat containing a random set of boy's names. The man who drew the name was from Arlington, Massachusetts , so "Arlington" was used for his middle name. Throughout his life, he hated not only his given name but also his family's habit of calling him "Win". As an adult, he always used
480-799: A hospital intensive care unit , and given diphtheria antitoxin (consisting of antibodies isolated from the serum of horses that have been challenged with diphtheria toxin). Since antitoxin does not neutralize toxin that is already bound to tissues, delaying its administration increases risk of death. Therefore, the decision to administer diphtheria antitoxin is based on clinical diagnosis, and should not await laboratory confirmation. Antibiotics have not been demonstrated to affect healing of local infection in diphtheria patients treated with antitoxin. Antibiotics are used in patients or carriers to eradicate C. diphtheriae, and prevent its transmission to others. The Centers for Disease Control and Prevention (CDC) recommends either: In cases that progress beyond
540-400: A mild clinical course , but in some outbreaks, the mortality rate approaches 10%. Signs and symptoms may vary from mild to severe, and usually start two to five days after exposure. Symptoms often develop gradually, beginning with a sore throat and fever . In severe cases, a grey or white patch develops in the throat, which can block the airway, and create a barking cough similar to what
600-502: A paper urging timely treatment for diphtheria and adequate doses of antitoxin. In 1906, Clemens Pirquet and Béla Schick described serum sickness in children receiving large quantities of horse-derived antitoxin. Between 1910 and 1911, Béla Schick developed the Schick test to detect pre-existing immunity to diphtheria in an exposed person. Only those who had not been exposed to diphtheria were vaccinated. A massive, five-year campaign
660-474: A second year, but it was to be his last one as a student there. Though short, Robinson's stay in Cambridge included some of his most cherished experiences, and there he made his most lasting friendships. He wrote his friend Harry Smith on June 21, 1893: I suppose this is the last letter I shall ever write you from Harvard. The thought seems a little queer, but it cannot be otherwise. Sometimes I try to imagine
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#1732776827567720-462: A substance produced by C. diphtheriae caused symptoms of diphtheria in animals. In 1890, Shibasaburō Kitasato and Emil von Behring immunized guinea pigs with heat-treated diphtheria toxin. They also immunized goats and horses in the same way, and showed that an " antitoxin " made from serum of immunized animals could cure the disease in non-immunized animals. Behring used this antitoxin (now known to consist of antibodies that neutralize
780-530: A tacit condition of his employment was that, in exchange for his desk and two thousand dollars a year, he should work "with a view to helping American letters", rather than the receipts of the United States Treasury. Robinson remained in the job until Roosevelt left office. In 1913, Robinson lived on Lighthouse Hill, Staten Island . Gradually his literary successes began to mount. He won the Pulitzer Prize three times in 1922, 1925 and 1928, and
840-429: A throat infection, diphtheria toxin spreads through the blood, and can lead to potentially life-threatening complications that affect other organs, such as the heart and kidneys. Damage to the heart caused by the toxin affects the heart's ability to pump blood, or the kidneys' ability to clear wastes. It can also cause nerve damage, eventually leading to paralysis. About 40–50% of those left untreated can die. Diphtheria
900-455: Is customary. As a result, the term " croup " nowadays most often refers to an unrelated viral illness that produces similar but milder respiratory symptoms. Human-to-human transmission of diphtheria typically occurs through the air when an infected individual coughs or sneezes. Breathing in particles released from the infected individual leads to infection. Contact with any lesions on the skin can also lead to transmission of diphtheria, but this
960-501: Is fatal in 5–10% of cases. In children under five years and adults over 40 years, the fatality rate may be as much as 20%. In 2013, it resulted in 3,300 deaths, down from 8,000 deaths in 1990. Better standards of living, mass immunization, improved diagnosis, prompt treatment, and more effective health care have led to a decrease in cases worldwide. In 1613, Spain experienced an epidemic of diphtheria, referred to as El Año de los Garrotillos (The Year of Strangulations). In 1705,
1020-429: Is observed in croup . The neck may also swell, in part due to the enlargement of the facial lymph nodes . Diphtheria can also involve the skin, eyes, or genitals, and can cause complications, including myocarditis (which in itself can result in an abnormal heart rate ), inflammation of nerves (which can result in paralysis ), kidney problems , and bleeding problems due to low levels of platelets . Diphtheria
1080-985: Is still common, children are most affected. It is rare in the developed world due to widespread vaccination , but can re-emerge if vaccination rates decrease. In the United States, 57 cases were reported between 1980 and 2004. Death occurs in 5–10% of those diagnosed. The disease was first described in the 5th century BC by Hippocrates . The bacterium was identified in 1882 by Edwin Klebs . The symptoms of diphtheria usually begin two to seven days after infection. They include fever of 38 °C (100.4 °F) or above; chills; fatigue ; bluish skin coloration ( cyanosis ); sore throat; hoarseness ; cough ; headache; difficulty swallowing; painful swallowing; difficulty breathing ; rapid breathing; foul-smelling and bloodstained nasal discharge; and lymphadenopathy . Within two to three days, diphtheria may destroy healthy tissues in
1140-544: Is the setting of “Richard Cory”, “Mr. Flood’s Party”, and “Luke Havergall”, all of which are included in the Columbia Anthology of the 500 most anthologized poems in the English language. Most of Robinson’s non-Arthurian characters only appear in one poem; however, four residents of Tilbury Town—Calverly, Clavering, Leffingwell, and Lingard—are mentioned in at least three poems each. Robinson never married. During
1200-452: Is uncommon. Indirect infections can occur, as well. If an infected individual touches a surface or object, the bacteria can be left behind and remain viable. Also, some evidence indicates diphtheria has the potential to be zoonotic , but this has yet to be confirmed. Corynebacterium ulcerans has been found in some animals, which would suggest zoonotic potential. Diphtheria toxin (DT) is produced only by C. diphtheriae infected with
1260-418: Is usually spread between people by direct contact, through the air , or through contact with contaminated objects . Asymptomatic transmission and chronic infection are also possible. Different strains of C. diphtheriae are the main cause in the variability of lethality, as the lethality and symptoms themselves are caused by the exotoxin produced by the bacteria. Diagnosis can often be made based on
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#17327768275671320-481: The "Great Race of Mercy" to deliver diphtheria antitoxin is now celebrated by the Iditarod Trail Sled Dog Race . In 1926, Alexander Thomas Glenny increased the effectiveness of diphtheria toxoid (a modified version of the toxin used for vaccination) by treating it with aluminum salts. Vaccination with toxoid was not widely used until the early 1930s. In 1939, Dr. Nora Wattie , who was
1380-465: The Mariana Islands experienced an epidemic of diphtheria and typhus simultaneously, reducing the population to about 5,000 people. In 1735, a diphtheria epidemic swept through New England . Before 1826, diphtheria was known by different names across the world. In England , it was known as "Boulogne sore throat," as the illness had spread from France . In 1826, Pierre Bretonneau gave
1440-583: The Principal Medical Officer (Maternity and Child Welfare) of Glasgow between 1934– 1964, introduced immunisation clinics across Glasgow , and promoted mother and child health education, resulting in virtual eradication of the infection in the city. Widespread vaccination pushed cases in the United States down from 4.4 per 100,000 inhabitants in 1932 to 2.0 in 1937. In Nazi Germany , where authorities preferred treatment and isolation over vaccination (until about 1939–1941), cases rose over
1500-749: The United States ' Centers for Disease Control and Prevention is based on both laboratory and clinical criteria. Empirical treatment should generally be started in a patient in whom suspicion of diphtheria is high. Vaccination against diphtheria is commonly done in infants, and delivered as a combination vaccine, such as a DPT vaccine (diphtheria, pertussis , tetanus ). Pentavalent vaccines , which vaccinate against diphtheria and four other childhood diseases simultaneously, are frequently used in disease prevention programs in developing countries by organizations such as UNICEF . The disease may remain manageable, but in more severe cases, lymph nodes in
1560-562: The World Health Organization included DPT vaccine in their Expanded Programme on Immunization for developing countries . In 1975, an outbreak of cutaneous diphtheria in Seattle, Washington , was reported. After the breakup of the former Soviet Union in 1991, vaccination rates in its constituent countries fell so low that an explosion of diphtheria cases occurred. In 1991, 2,000 cases of diphtheria occurred in
1620-520: The 1920s and several people, all male, have won two. Carl Sandburg won one of the special prizes for his poetry in 1919 and won the Poetry Pulitzer in 1951. Only four women have had multiple nominations: Adrienne Rich with 4, and Louise Glück , Jorie Graham and Diane Seuss with 2 each. Diphtheria Diphtheria is an infection caused by the bacterium Corynebacterium diphtheriae . Most infections are asymptomatic or have
1680-633: The EF-2 protein. Since EF-2 is needed for the moving of tRNA from the A-site to the P-site of the ribosome during protein translation, ADP-ribosylation of EF-2 prevents protein synthesis. ADP-ribosylation of EF-2 is reversed by giving high doses of nicotinamide (a form of vitamin B 3 ), since this is one of the reaction's end products, and high amounts drive the reaction in the opposite direction. The current clinical case definition of diphtheria used by
1740-479: The Night Before , paying 100 dollars for 500 copies. Robinson meant it as a surprise for his mother. Days before the copies arrived, his mother died of diphtheria . His eldest brother, Dean, died of a drug overdose in 1899. Robinson's second volume, Children of The Night , published in 1897, had a somewhat wider circulation. Its readers included President Theodore Roosevelt 's son Kermit , who had received
1800-860: The USSR. Between 1991 and 1998, as many as 200,000 cases were reported in the Commonwealth of Independent States , and resulted in 5,000 deaths. In 1994, the Russian Federation had 39,703 diphtheria cases. By contrast, in 1990, only 1,211 cases were reported. In early May 2010, a case of diphtheria was diagnosed in Port-au-Prince , Haiti , after the devastating 2010 Haiti earthquake . The 15-year-old male patient died while workers searched for antitoxin. In 2013, three children died of diphtheria in Hyderabad, India . In early June 2015,
1860-482: The United States. Park and Biggs described the method for producing serum from horses for use in diphtheria treatment. In 1897, Paul Ehrlich developed a standardized unit of measure for diphtheria antitoxin. This was the first ever standardization of a biological product, and played an important role in future developmental work on sera and vaccines. In 1901, 10 of 11 inoculated St. Louis children died from contaminated diphtheria antitoxin. The horse from which
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1920-592: The antitoxin level in the blood. Diphtheria can be prevented in those exposed, as well as treated with the antibiotics erythromycin or benzylpenicillin . In severe cases a tracheotomy is sometimes needed to open the airway. In 2015, 4,500 cases were officially reported worldwide, down from nearly 100,000 in 1980. About a million cases a year are believed to have occurred before the 1980s. Diphtheria currently occurs most often in sub-Saharan Africa , South Asia , and Indonesia . In 2015, it resulted in 2,100 deaths, down from 8,000 deaths in 1990. In areas where it
1980-661: The antitoxin was derived died of tetanus . This incident, coupled with a tetanus outbreak in Camden, New Jersey , played an important part in initiating federal regulation of biologic products. On 7 January 1904, Ruth Cleveland died of diphtheria at the age of 12 years in Princeton, New Jersey . Ruth was the eldest daughter of former President Grover Cleveland and the former First Lady , Frances Folsom . In 1905, Franklin Royer, from Philadelphia's Municipal Hospital, published
2040-473: The appearance of the throat with confirmation by microbiological culture . Previous infection may not protect against reinfection. A diphtheria vaccine is effective for prevention, and is available in a number of formulations. Three or four doses, given along with tetanus vaccine and pertussis vaccine , are recommended during childhood. Further doses of the diphtheria–tetanus vaccine are recommended every ten years. Protection can be verified by measuring
2100-471: The bacterial genome. The chromosome of C. diphtheriae has two different but functionally equivalent bacterial attachment sites (attB) for integration of β prophage into the chromosome. The diphtheria toxin precursor is a protein of molecular weight 60 kDa . Certain proteases, such as trypsin, selectively cleave DT to generate two peptide chains, amino-terminal fragment A (DT-A) and carboxyl-terminal fragment B (DT-B), which are held together by
2160-399: The bacterium causing diphtheria, and named it Klebs–Loeffler bacterium . The club shape of this bacterium helped Edwin to differentiate it from other bacteria. Over time, it has been called Microsporon diphtheriticum , Bacillus diphtheriae , and Mycobacterium diphtheriae . Current nomenclature is Corynebacterium diphtheriae . In 1884, German bacteriologist Friedrich Loeffler became
2220-509: The disease the name diphthérite (from Greek διφθέρα, diphthera 'leather'), describing the appearance of pseudomembrane in the throat. In 1856, Victor Fourgeaud described an epidemic of diphtheria in California . In 1878, Princess Alice ( Queen Victoria 's second daughter) and her family became infected with diphtheria; Princess Alice and her four-year-old daughter, Princess Marie , both died. In 1883, Edwin Klebs identified
2280-430: The endosome membrane, thereby catalysing the release of DT-A into the cytoplasm . Fragment A inhibits the synthesis of new proteins in the affected cell by catalyzing ADP-ribosylation of elongation factor EF-2 —a protein that is essential to the translation step of protein synthesis. This ADP-ribosylation involves the transfer of an ADP-ribose from NAD+ to a diphthamide (a modified histidine ) residue within
2340-465: The first person to cultivate C. diphtheriae . He used Koch's postulates to prove association between C. diphtheriae and diphtheria. He also showed that the bacillus produces an exotoxin. In 1885, Joseph P. O'Dwyer introduced the O'Dwyer tube for laryngeal intubation in patients with an obstructed larynx. It soon replaced tracheostomy as the emergency diphtheric intubation method. In 1888, Emile Roux and Alexandre Yersin showed that
2400-639: The first time I seem to have something like a favorable opportunity and this winter I shall make a beginning. With his father gone, Robinson became the man of the household. He tried farming and developed a close relationship with his sister-in-law Emma Robinson, who after her husband Herman's death, moved back to Gardiner with her children. She twice rejected marriage proposals from Robinson, after which he permanently left Gardiner. He moved to New York, where he lived as an impoverished poet while cultivating friendships with other writers, artists, and intellectuals. In 1896, he self-published his first book, The Torrent and
2460-535: The last 20 years of his life he became a regular summer resident at the MacDowell Colony in New Hampshire , where several women made him the object of their devoted attention. Robinson and artist Elizabeth Sparhawk-Jones visited MacDowell at the same times over a cumulative total of ten years. They had a romantic relationship in which she was in love with him, devoted to him and understood him, and
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2520-523: The money for the monument from across the country; the Boston architect Henry R. Shepley provided the design, Richards wrote the inscription and Robinson’s biographer, Herman Hagedorn , was the keynote speaker. Robinson's childhood home in Gardiner was designated a National Historic Landmark in 1971. Robinson's grandnephew David S. Nivison , a noted expert on Chinese philosophy and Chinese history ,
2580-447: The neck may swell, and breathing and swallowing are more difficult. People in this stage should seek immediate medical attention, as obstruction in the throat may require intubation or a tracheotomy . Abnormal cardiac rhythms can occur early in the course of the illness or weeks later, and can lead to heart failure . Diphtheria can also cause paralysis in the eye, neck, throat, or respiratory muscles. Patients with severe cases are put in
2640-505: The prize four times and several others won it more than once ( below ). The following individuals received two or more Pulitzer Prizes for Poetry (The 1918 and 1919 Special Prizes are included): The following individuals received two or more nominations: Bolded years are years that the poet won Robert Frost won the Pulitzer Prize for Poetry four times from 1924 to 1943. Edwin Arlington Robinson won three prizes during
2700-419: The respiratory system. The dead tissue forms a thick, gray coating that can build up in the throat or nose. This thick gray coating is called a "pseudomembrane." It can cover tissues in the nose, tonsils, voice box, and throat, making it very hard to breathe and swallow. Symptoms can also include cardiac arrhythmias , myocarditis , and cranial and peripheral nerve palsies . Laryngeal diphtheria can lead to
2760-789: The same period from 6.1 to 9.6 per 100,000 inhabitants. Between June 1942 and February 1943, 714 cases of diphtheria were recorded at Sham Shui Po Barracks , resulting in 112 deaths because the Imperial Japanese Army did not release supplies of anti-diphtheria serum. In 1943, diphtheria outbreaks accompanied war and disruption in Europe . The 1 million cases in Europe resulted in 50,000 deaths. During 1948 in Kyoto , 68 of 606 children died after diphtheria immunization due to improper manufacture of aluminum phosphate toxoid. In 1974,
2820-439: The signature "E. A." Robinson's family moved to Gardiner, Maine , in 1870. He later described his childhood as "stark and unhappy". Robinson first studied at Mrs. Morrell's School in Gardiner and later attended public schools, graduating from Gardiner High School . Robinson's early struggles led many of his poems to have a dark pessimism and his stories to deal with "an American dream gone awry." His eldest brother, Dean,
2880-431: The state my mind would be in had I never come here, but I cannot. I feel that I have got comparatively little from my two years, but still, more than I could get in Gardiner if I lived a century. By mid-1893, Robinson had returned to Gardiner, where he made plans to start writing seriously. In October he wrote his friend Gledhill: Writing has been my dream ever since I was old enough to lay a plan for an air castle. Now for
2940-649: The tests of the New York State Health Department . The manufacturer of the antitoxin, the Mulford Company of Philadelphia , paid damages in every case. During the 1920s, an annual estimate of 100,000 to 200,000 diphtheria cases and 13,000 to 15,000 deaths occurred in the United States. Children represented a large majority of these cases and fatalities. One of the most infamous outbreaks of diphtheria occurred in 1925, in Nome, Alaska ;
3000-453: The toxin produced by C. diphtheriae ) for human trials in 1891, but they were unsuccessful. Successful treatment of human patients with horse-derived antitoxin began in 1894, after production and quantification of antitoxin had been optimized. In 1901, Von Behring won the first Nobel Prize in medicine for his work on diphtheria. In 1895, H. K. Mulford Company of Philadelphia started production and testing of diphtheria antitoxin in
3060-551: The winner. Before the establishment of the award, the 1918 and 1919 Pulitzer cycles included three Pulitzer Prize Special Citations and Awards (called at the time the Columbia University Poetry Prize) for poetry books funded by "a special grant from The Poetry Society ." See Special Pulitzers for Letters . In its first 92 years to 2013, the Pulitzer Prize for Poetry was awarded 92 times. Two were given in 2008, none in 1946. Robert Frost won
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#17327768275673120-500: Was a doctor and had become addicted to laudanum while self-medicating for neuralgia . The middle brother, Herman, a handsome and charismatic man, married the woman Edwin loved, Emma Löehen Shepherd. Emma thought highly of Edwin and encouraged his poetry, but he was deemed too young to be in realistic competition for her hand, which didn't keep him from being agitated deeply by witnessing what he considered her being deceived by Herman's charm and choosing shallowness over depth. The marriage
3180-565: Was a great blow to Edwin's pride, and during the wedding ceremony, on February 12, 1890, the despondent poet stayed home and wrote a poem of protest, "Cortège", the title of which refers to the train that took the newly married couple out of town to their new life in St. Louis, Missouri . Herman suffered multiple business failures, becoming an alcoholic, and ended up estranged from his wife and children. Herman died impoverished in 1909 of tuberculosis at Boston City Hospital . Robinson's poem Richard Cory
3240-435: Was a trustee of Robinson's estate. Pulitzer Prize for Poetry The Pulitzer Prize for Poetry is one of the seven American Pulitzer Prizes awarded annually for Letters, Drama, and Music. It was first presented in 1922, and is given for a distinguished volume of original verse by an American author, published during the preceding calendar year. Finalists have been announced since 1980, ordinarily two others beside
3300-523: Was buried at Oak Grove Cemetery in Gardiner, Maine . When Robinson died, Sparhawk-Jones attended his vigil and later painted several works in his memory. The same month, a memorial ceremony was held at Gardiner High School, Robinson's old school. In October of the same year, a monument was erected in Gardiner Common through the efforts of Robinson's friend and mentor Laura E. Richards , who raised
3360-578: Was coordinated by Dr. Schick. As a part of the campaign, 85 million pieces of literature were distributed by the Metropolitan Life Insurance Company , with an appeal to parents to "Save your child from diphtheria." A vaccine was developed in the next decade, and deaths began declining significantly in 1924. In 1919, in Dallas, Texas , 10 children were killed and 60 others made seriously ill by toxic antitoxin which had passed
3420-482: Was elected a member of the American Academy of Arts and Letters in 1927. He was later described by the poet Michael Schmidt as "more artful than Hardy and more coy than Frost and a brilliant sonneteer". Tilbury Town is a fictional American town which is the location for many works by Robinson. The small New England village was modeled after Gardiner, Maine , where Robinson grew up. Tilbury Town
3480-626: Was relaxed in her approach with him; he called her Sparhawk and was courteous towards her. They had a relationship that the poet D. H. Tracy described as "courtly, quiet, and intense". She described him as a charming, sensitive, and emotionally grounded man with high moral values. Robinson died of cancer on April 6, 1935, in the New York Hospital (now the Weill Cornell Medical Center) in New York City; he
3540-433: Was thought by his sister-in-law Emma to refer to her husband. In 1891, at the age of 21, Robinson entered Harvard University as a special student where he took classes in English, French, and Shakespeare ; as well as one on Anglo-Saxon that he later dropped. He did not aim to get all A's; as he wrote his friend Harry Smith, "B, and in that vicinity, is a very comfortable and safe place to hang." Robinson's real desire
3600-470: Was to get published in one of the Harvard literary journals. Within the first fortnight of being there, The Harvard Advocate published Robinson's "Ballade of a Ship." He was even invited to meet with the editors, but when he returned, he complained to his friend Mowry Saben , "I sat there among them, unable to say a word." Robinson's father died after his first year at Harvard. He returned to Harvard for
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