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
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).
Rey M, Patey O, Vincent-Ballereau F. Retour de la diphtérie en Europe. Eurosurveillance 1996; 1: 14–16.
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.
Galazka A M. Immunological basis for immunization/module2: Diphtheria. Geneva (Switzerland): WHO, 1993. Report No.: WHO/EPI/GEN/93.12.
Galazka A, Keja J. Diphtheria: Incidence trends and age-wise changes of immunity. Scand J Infect Dis 1988; 18: 227–233.
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.
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).
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.
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.
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.
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.
Svenson SB, Larsen K. An enzyme-linked immunosorbent assay (ELISA) for the determination of diphtheria toxin antibodies. J Immunol Methods 1977; 17: 249–256.
The control of diphtheria in Europe. Geneva (Switzerland): WHO; April 1990. Report No.: EUR/ICP/EPI 024 5882r.
Maple PAC, George RC, Miller E, Morgan-Capner P, Hayward P. Diphtheria immunity in adults. Lancet 1996; 348: 964.
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.
Calendrier vaccinal 1996–1997. Bull Epidemiol Hebd 1996; (35): 151–152.
Karzon DT, Edwards KM. Diphtheria outbreaks in immunized populations. N Eng J Med 1988; 318: 41–43.
Naumann P, Hagedorn HJ, Paatz R. Diphtherie-Immunität und ihre epidemiologische Bedeutung. Dtsch Med Wochenschr; 1983; 108: 1090–1096.
Christenson B, Böttiger M. Serological immunity to diphtheria in Sweden in 1978 and 1984. Scand J Infect Dis 1986; 18: 227–233.
Crossley K, Irvine P, Warren JB, Lee BK, Mead K. Tetanus and diphtheria immunity in urban Minnesota adults. JAMA 1979; 242: 2298–2300.
Maple PA, Efstratiou A, George RC, Andrews NH, Sesardic D. Diphtheria immunity in UK blood donors. Lancet 1995; 345: 963–965.
Epidémie de diphtérie en Europe de l'Est en 1993. Bull Epidémiol Hebd 1993; (42): 193.
Schneerson R, Robbins JB. Ukraine's diphtheria campaign. Lancet 1996; 348: 1245.
Dittman S. Ukraine's diphtheria campaign. Lancet 1996; 348: 1244.
Doan R, Mercer D, Tsu V, Tyshchenko D, Marievsky V. Ukraine's diphtheria campaign. Lancet 1996; 348: 1244–1245.
Rich V. Diphtheria vaccination fails in Ukraine. Lancet 1996; 347: 1686.
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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