in 1900 in the United States there were 40 death from diphtheria for every 100,000 people. How many diphtheria deaths would be expected in 1900 in a town of 40,000?

Diphtheria once was a major cause of illness and death among children. The United States recorded 206,000 cases of diphtheria in 1921, resulting in 15,520 deaths. Diphtheria death rates range from about 20% for those under age five and over age 40, to 5-10% for those aged 5-40 years. Death rates were likely higher before the 20th century. Diphtheria was the third leading cause of death in children in England and Wales in the 1930s.Since the introduction of effective immunization, starting in the 1920s, diphtheria rates have dropped dramatically in the United States and other countries that vaccinate widely. Between 2004 and 2008, no cases of diphtheria were recorded in the United States. However, the disease continues to play a role globally. "In 2007, (4,190 cases) of diphtheria were reported, which is likely an underestimate of the actual number of cases."