Diphtheria Antitoxin Levels in US Blood and Plasma Donors

Gupta, Rajesh K.; Griffin, Paul; Xu, Jin; Rivera, Rachel; Thompson, Claudette M.; Siber, George R.

doi:10.1093/infdis/173.6.1493

Cited by 28 publications

(10 citation statements)

References 13 publications

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“…Patients were classified according to internationally accepted criteria of protective antibody levels (8)(9)(10)(11)(12). Tetanus and diphtheria antibody concentrations lower than 0.01 IU/mL were considered to indicate the absence of protection, between 0.01 and 0.09 IU/mL were considered to indicate basic immunity, and values of 0.1 IU/mL or higher were considered to indicate full protection.…”

Section: Methodsmentioning

confidence: 99%

Effect of a single tetanus-diphtheria vaccine dose on the immunity of elderly people in São Paulo, Brazil

Weckx

Divino-Goes

Lihama

et al. 2006

Braz J Med Biol Res

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Epidemiological data regarding tetanus and diphtheria immunity in elderly people in Brazil are scarce. During the First National Immunization Campaign for the Elderly in Brazil in April 1999, 98 individuals (median age: 84 years) received one tetanus-dyphtheria (Td) vaccine dose (Butantan Institute, lot number 9808079/G). Inclusion criteria were elderly individuals without a history of severe immunosuppressive disease, acute infectious disease or use of immunomodulators. Blood samples were collected immediately before the vaccine and 30 days later. Serum was separated and stored at -20 o C until analysis. Tetanus and diphtheria antibodies were measured by the double-antigen ELISA test. Tetanus and diphtheria antibody concentrations lower than 0.01 IU/mL were considered to indicate the absence of protection, between 0.01 and 0.09 IU/mL were considered to indicate basic immunity, and values of 0.1 IU/mL or higher were considered to indicate full protection. Before vaccination, 18% of the individuals were susceptible to diphtheria and 94% were susceptible to tetanus. After one Td dose, 78% became fully immune to diphtheria, 13% attained basic immunity, and 9% were still susceptible to the disease. In contrast, 79% remained susceptible to tetanus, 4% had basic immunity and 17% were fully immune. Although one Td dose increases immunity to diphtheria in many elderly people who live in Brazil, a complete vaccination series appears to be necessary for the prevention of tetanus.

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Section: Methodsmentioning

confidence: 99%

Effect of a single tetanus-diphtheria vaccine dose on the immunity of elderly people in São Paulo, Brazil

Weckx

Divino-Goes

Lihama

et al. 2006

Braz J Med Biol Res

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“…Although such methods measure antibodies directed against nontoxic epitopes of the toxin molecule, they exhibit a high correlation with results obtained by toxin neutralization assays for samples with antitoxin levels of ≥ 0.1 IU/ml. However, there is a low correlation when the antitoxin titers are < 0.1 IU/ml [2,9]. In that respect, our assay does not differentiate individuals having DAT values of 0.01-0.1 IU/ml (basically protected) from those with titers of < 0.01 IU/ml (susceptible), and it is suggested that all persons with values of < 0.1 IU/ml are not sufficiently protected.…”

Section: Discussionmentioning

confidence: 63%

“…In the developed countries, widespread vaccination of infants and young children began several decades ago and proved to provide high rates of immunity in these agegroups [2]. However, in such regions, it has been shown that diphtheria immunity is waning among adult populations who were given only basic childhood immunization.…”

Section: Introductionmentioning

confidence: 99%

Diphtheria Immunity of Albanian and Other Eastern European Immigrants in Greece Compared with the Local Population - The Risk of Reemergence in Greece

et al. 1999

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A large number of immigrants have come to Greece from diphtheria-endemic countries during the past 8 years. Information on the immune status against diphtheria among immigrants from Albania and the New Independent States (NIS) of the former USSR, as well as the Greek population, is essential in planning public health control measures. The main objective of the study was to determine the risk of the spread of diphtheria if new cases arrived in the country. Diphtheria antitoxin (DAT) in sera from 185 healthy individuals from northern Greece and 227 immigrants from Albania and the NIS was titrated using a quantitative ELISA test. The participants were adults aged 22 to 46 years. Titers were considered as protective when DAT levels were higher or equal to 0.1 IU/ml. Albanian immigrants exhibited the highest rates of protective titers (99 of 167, 59.3%), while lower immunity rates were detected among immigrants from the NIS (20 of 60, 33.3%) (1.5 < OR = 2.9 < 5.4, p = 0.0007) as well as among Greek participants (47 of 185, 25.4%) (2.8 < OR = 4.4 < 7.0, p = 0.00001). Immunity rates did not differ between Greek and NIS participants. DAT levels of persons with protective titers differed between the three population groups (analysis of variance, p = 0.0005), with the highest mean DAT values detected among NIS immigrants (0.613 IU/ml). Lower values were found among protected Albanians (0.482 IU/ml) and Greeks (0.314 IU/ml). There was no significant age- and sex-related difference in immunity rates and DAT levels among the groups. The low immunity rates among Greek adults might suggest that they have had no natural contact with toxigenic strains of corynebacteria. A booster dose of diphtheria toxoid for local adults is recommended, to reduce their risk of acquiring toxigenic strains from individuals who may carry the bacteria without exhibiting clinical disease.

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“…To determine the negative anti-diphtheria antibody titers, by ELISA, the authors [16] utilized the Vero cell neutralization test; when these two tests (ELISA and Vero cell neutralization) were used, the seropositivity rate rose from 64.4% to 90.3%. This suggests that the large fall in anti-diphtheria antibodies observed immediately prior to the booster dose was mainly due to the serological method utilized, since the neutralization test has greater sensitivity for detecting the immunological response for diphtheria when the antibody titer is less than 0.1 IU/ mL and therefore ELISA underestimates the seroprotection rate for this group [17]. The large increase in concentrations of these two antibodies that occurred after the booster dose, in relation to the concentrations found immediately before this dose, was also found in an American study [16].…”

Section: Discussionmentioning

confidence: 99%

Immunogenicity of a combined DTPa-HB vaccine co-administered with Haemophilus influenzae type B conjugate vaccine (PRP-T) for primary and booster vaccinations

et al. 2005

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Objective: To evaluate the immunogenicity of a combined DTPa-HB vaccine co-administered with Haemophilus influenzae type b conjugate vaccine (PRP-T) in Brazilian infants. Material and Methods: A prospective and open clinical study, in which 110 infants were immunized with a threedose primary vaccination regime at two, four and six months of age and with a single booster vaccination. Blood samples were drawn immediately before the first dose, one month after the third dose, at the time of the booster dose and one month after the booster to assess seropositivity and antibody geometric mean titers (GMTs) of antibodies for diphtheria, tetanus, hepatitis B, Haemophilus influenzae type b and for the three pertussis antigens: Pertussis Toxin (PT), Filamentous Hemagglutinin (FHA) and Pertactin (PRN). Results: Among the original 110 infants, 93 completed the study. Seropositivity was 100% for all seven involved antibodies, after the primary vaccination course. At the time of the booster dose, all antibodies (except diphtheria 33.7% and anti-PT 59%) were seropositive for more than 94% of subjects. After the booster, seropositivity increased to 100% for all antibodies. The GMT of these antibodies followed a similar pattern, with a strong increase after the primary course, followed by a second increase after the booster dose. At this time, GMT was2-to 7-fold higher than after the primary course, for all vaccine components. Conclusions: Concomitant administration of DTPa-HB and Hib vaccines elicited strong seroprotection for all the antigenic components. No interference with antibody response was evident. The vaccines provided high immunogenicity, following both the primary vaccinations and the booster dose.

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Diphtheria Antitoxin Levels in US Blood and Plasma Donors

Cited by 28 publications

References 13 publications

Effect of a single tetanus-diphtheria vaccine dose on the immunity of elderly people in São Paulo, Brazil

Effect of a single tetanus-diphtheria vaccine dose on the immunity of elderly people in São Paulo, Brazil

Diphtheria Immunity of Albanian and Other Eastern European Immigrants in Greece Compared with the Local Population - The Risk of Reemergence in Greece

Immunogenicity of a combined DTPa-HB vaccine co-administered with Haemophilus influenzae type B conjugate vaccine (PRP-T) for primary and booster vaccinations

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