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A multicentre serosurvey on diphtheria immunity in a French population of 1004 subjects

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Abstract

Diphtheria immunity was determined in serum specimens obtained in 1994 from 1004 subjects seen in emergency departments of three distant French cities. An enzyme immunoassay was used to measure serum diphtheria antitoxin concentrations according to the following criteria: (a) antitoxin < 0.01 IU/ml: susceptibility, (b) 0.01–0.09 IU/ml: basic protection, (c) ≥ 0.10 IU/ml: full protection. Among these patients, 20.3% were fully susceptible to diphtheria, 30.3% had basic but doubtful protection and only 49.4% were fully protected. Protection was different by age-groups: 73.5% of the subjects under 40 years of age, 46% between 40 and 65 and 33% over 65 were fully protected. Protection decreased with increasing age (p < 0.001)and was greater for men than women after 40 years of age (p < 0.001). The results of this exploratory study indicate that the enhancement of diphtheria immunity by boosters in adult population should be reconsidered in France as well as in many industrialized countries.

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References

  1. Dittman S, Roure C. Plan of action for the prevention and control of diphtheria in the European region (1994–1995). Copenhagen (Denmark): WHO, 1994. Report No.: ICP/EPI 038 (A).

    Google Scholar 

  2. Rey M, Patey O, Vincent-Ballereau F. Retour de la diphtérie en Europe. Eurosurveillance 1996; 1: 14–16.

    PubMed  Google Scholar 

  3. Rey M, Vincent-Ballereau F, Patey O. Le retour de la diphtérie en Europe. La population française est-elle protégée? Bull Acad Nat Med 1997; 181: 93–102.

    PubMed  Google Scholar 

  4. Galazka A M. Immunological basis for immunization/module2: Diphtheria. Geneva (Switzerland): WHO, 1993. Report No.: WHO/EPI/GEN/93.12.

    Google Scholar 

  5. Galazka A, Keja J. Diphtheria: Incidence trends and age-wise changes of immunity. Scand J Infect Dis 1988; 18: 227–233.

    Google Scholar 

  6. Cellesi C, Zanchi A, Michelangeli C, Giovannoni F, Sansoni A, Rossolini GM. Immunity to diphtheria in a sample of adult population from central Italy. Vaccine 1989; 7: 417–420.

    Article  PubMed  Google Scholar 

  7. Borcic B, Milosevic TS, Mlinaric AD, Dobrovsak-Sourek V, Ljubicic M, Gotovac P. Imunost hrvatskog pucanstva na difteriju 1994. Godine. Lijec Vjesn 1996; 118: 227–229. (In Croat).

    Google Scholar 

  8. Comodo N, Bonanni P, Lo Nostro A, Tiscione E, Mannelli F, Tomei A. Low prevalence of diphtheria immunity in the population of Florence, Italy. Eur J Epidemiol 1996; 12: 251–255.

    PubMed  Google Scholar 

  9. Yuan L, Lau W, Thipphawong J, Kasenda M, Xie F, Bevilacqua J. Diphtheria and tetanus immunity among blood donors in Toronto. Can Med Assoc J 1997; 156: 985–990.

    Google Scholar 

  10. Melville-Smith M, Balfour A. Estimation of Corynebacterium diphtheriae antitoxin in human sera: A comparison of an enzyme-linked immunosorbent assay with the toxin neutralization test. J Med Microbiol 1988; 25: 279–283.

    PubMed  Google Scholar 

  11. Lau RC, Bettelheim KA, Patel AC. The 1985 national immunisation survey: Diphtheria, tetanus and pertussis (whooping cough). N Z Med J 1988; 101: 797–800.

    PubMed  Google Scholar 

  12. Svenson SB, Larsen K. An enzyme-linked immunosorbent assay (ELISA) for the determination of diphtheria toxin antibodies. J Immunol Methods 1977; 17: 249–256.

    Article  PubMed  Google Scholar 

  13. The control of diphtheria in Europe. Geneva (Switzerland): WHO; April 1990. Report No.: EUR/ICP/EPI 024 5882r.

  14. Maple PAC, George RC, Miller E, Morgan-Capner P, Hayward P. Diphtheria immunity in adults. Lancet 1996; 348: 964.

    Google Scholar 

  15. Simonsen O, Kristiansen M, Aggerbeck H, Hau C, Heron I. Fall-off in immunity following diphtheria revaccination — an 8 year follow-up study. APMIS 1996; 104: 921–925.

    PubMed  Google Scholar 

  16. Calendrier vaccinal 1996–1997. Bull Epidemiol Hebd 1996; (35): 151–152.

  17. Karzon DT, Edwards KM. Diphtheria outbreaks in immunized populations. N Eng J Med 1988; 318: 41–43.

    Google Scholar 

  18. Naumann P, Hagedorn HJ, Paatz R. Diphtherie-Immunität und ihre epidemiologische Bedeutung. Dtsch Med Wochenschr; 1983; 108: 1090–1096.

    PubMed  Google Scholar 

  19. Christenson B, Böttiger M. Serological immunity to diphtheria in Sweden in 1978 and 1984. Scand J Infect Dis 1986; 18: 227–233.

    PubMed  Google Scholar 

  20. Crossley K, Irvine P, Warren JB, Lee BK, Mead K. Tetanus and diphtheria immunity in urban Minnesota adults. JAMA 1979; 242: 2298–2300.

    PubMed  Google Scholar 

  21. Maple PA, Efstratiou A, George RC, Andrews NH, Sesardic D. Diphtheria immunity in UK blood donors. Lancet 1995; 345: 963–965.

    Article  PubMed  Google Scholar 

  22. Epidémie de diphtérie en Europe de l'Est en 1993. Bull Epidémiol Hebd 1993; (42): 193.

  23. Schneerson R, Robbins JB. Ukraine's diphtheria campaign. Lancet 1996; 348: 1245.

    Article  Google Scholar 

  24. Dittman S. Ukraine's diphtheria campaign. Lancet 1996; 348: 1244.

    Google Scholar 

  25. Doan R, Mercer D, Tsu V, Tyshchenko D, Marievsky V. Ukraine's diphtheria campaign. Lancet 1996; 348: 1244–1245.

    Google Scholar 

  26. Rich V. Diphtheria vaccination fails in Ukraine. Lancet 1996; 347: 1686.

    Article  PubMed  Google Scholar 

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Ballereau, F., Schrive, I., Fisch, A. et al. A multicentre serosurvey on diphtheria immunity in a French population of 1004 subjects. Eur J Epidemiol 14, 499–503 (1998). https://doi.org/10.1023/A:1007433032718

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  • DOI: https://doi.org/10.1023/A:1007433032718

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