Immunity to diphtheria in Northern Norway and Northwestern Russia

Jenum, Pål A.; Skogen, Vegard; Danilova, Elena; Eskild, Anne; Sjursen, Haakon

doi:10.1007/bf01690995

Cited by 31 publications

(14 citation statements)

References 11 publications

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“…The situation was quite different regarding diphtheria, as evidently most of the groups studied lacked adequate protection. In agreement with other reports, we also found a high proportion of non-protected adults [5,6,34,40,[48][49][50][51][52]. Indeed, the alarming percentage of non-protected mothers and children is of considerable concern.…”

Section: Discussionsupporting

confidence: 93%

“…Accordingly, three categories of protection have been proposed [31,32] and currently adopted in serological surveys [22,[33][34][35]: fully protective (titers >0.1 IU/mt), partly protective (titer range 0.01-0.1 IU/ml) or non-protective (titers <0.01 IU/ml). Serum IgG anti-T antibody titers in 50 non-vaccinated infants (aged 1-1.4 month) and in infants (aged 3-7.8 months) who received one (n=25), two (n=25) or three (n=55) doses of DTP vaccine, as well as the percentages of protection within each group are shown in Table 1.…”

Section: Tetanus and Diphtheria Antibodiesmentioning

confidence: 99%

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Serum antibodies to diphtheria-tetanus-pertussis vaccine components in Argentine children

et al. 1997

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The Argentine vaccination schedule against diphtheria, tetanus and pertussis (DTP) recommends three doses of DTP vaccine at 2, 4 and 6 months of age, two boosters at 18 months and 6 years, a booster dose of tetanus vaccine every 10 years and two doses during pregnancy. To evaluate the effect of this schedule, antibodies against pertussis toxin (PT) and filamentous hemagglutinin (FHA) and against tetanus and diphtheria toxoids were determined by ELISA in serum samples from children (1 month to 6 years) who received different doses of DPT vaccine: 0 dose (n = 50), 1 dose (n = 25), 2 doses (n = 25), 3 doses (n = 55), first and second booster (n = 25); 25 pregnant women and their offspring, and 45 adults. High antibody levels against PT (> 140 EU/ml) and FHA (> 80 EU/ml) were recorded in mothers and in the newborn. Antibody titers against PT increased with the number of doses given and decreased with time. Full protection against tetanus (titers > 0.1 IU/ml) was observed in the group of adults (0.37 IU/ml), in mothers (4.4 IU/ml) and their newborn offspring (5.5 IU/ml), and in children after receiving the second dose of DTP vaccine (1.86 IU/ml). The immune status for diphtheria was far lower, as most of the groups lacked adequate protection. After the third dose of DTP vaccine, only 78% of the children had antibody titers above the protective level (0.1 IU/ml). Since antibody levels considered to provide full protection were only achieved after the first booster dose of DTP vaccine, the primary three-dose schedule seems to be insufficient to confer adequate immunity in all vaccinees. Because of the high proportion of non-protected adults, a booster dose of Td vaccine should be considered for this group.

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Section: Discussionsupporting

confidence: 93%

Section: Tetanus and Diphtheria Antibodiesmentioning

confidence: 99%

Serum antibodies to diphtheria-tetanus-pertussis vaccine components in Argentine children

et al. 1997

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“…Evidence suggests that a large proportion of the disease among adults may have been transmitted from ill or asymptomatic children and that children played an important role in amplifying the overall epidemic, even in countries where most of the cases were reported among adults. Women had a much higher incidence of diphtheria than did men despite no evidence of lower serologic immunity [36]. In a case-control study in Ukraine, the risk among women was not significantly elevated after adjusting for age, vaccination history, and household size and composition, but having у2 school-age children in the household was associated with a significant increase in risk [37].…”

Section: Reasons For the Reemergence Of Epidemic Diphtheriamentioning

confidence: 93%

Successful Control of Epidemic Diphtheria in the States of the Former Union of Soviet Socialist Republics: Lessons Learned

et al. 2000

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Epidemic diphtheria reemerged in the Russian Federation in 1990 and spread to all Newly Independent States (NIS) and Baltic States by the end of 1994. Factors contributing to the epidemic included increased susceptibility of both children and adults, socioeconomic instability, population movement, deteriorating health infrastructure, initial shortages of vaccine, and delays in implementing control measures. In 1995, aggressive control strategies were implemented, and since then, all affected countries have reported decreases of diphtheria; however, continued efforts by national health authorities and international assistance are still needed. The legacy of this epidemic includes a reexamination of the global diphtheria control strategy, new laboratory techniques for diphtheria diagnosis and analysis, and a model for future public health emergencies in the successful collaboration of multiple international partners. The reemergence of diphtheria warns of an immediate threat of other epidemics in the NIS and Baltic States and a longer-term potential for the reemergence of vaccine-preventable diseases elsewhere. Continued investment in improved vaccines, control strategies, training, and laboratory techniques is needed.

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“…Only small outbreaks and isolated imported cases have been reported, despite the fact that seroepidemiological studies have shown insufficient protection, especially among the adult population (6,11).…”

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confidence: 99%

Antidiphtheria Antibody Responses in Patients and Carriers ofCorynebacterium diphtheriaein the Arkhangelsk Region of Russia

Danilova

Jenum

Skogen

et al. 2006

Clin Vaccine Immunol

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Diphtheria is under control in industrialized countries. However, single cases and outbreaks still occur and the disease is not completely understood. Forty-three individuals suspected of having diphtheria who were referred to the Infectious Disease Hospital of Arkhangelsk from December 1994 to March 1995 were included in this study. Fifteen patients were diagnosed as having diphtheria and received equine hyperimmune antidiphtheria toxin antiserum, and 28 were diagnosed as carriers, 12 with nondiphtherial tonsillitis or pharyngitis and 16 without symptoms. Serum samples were obtained on admission and during the course of the disease or during follow-up of carrier status. Samples were analyzed for antibodies against diphtheria toxin with both an in vitro neutralization test (NT) and a human-specific enzyme immunoassay. All of the cases but one were confirmed by a positive culture. Twelve patients had pharyngeal diphtheria, and three had combined laryngeal and pharyngeal disease. Half of the patients had life-threatening disease, and one died. On admission, the median antibody titers measured with the NT were 0.085 IU/ml for the patients, 5.12 IU/ml for the symptomatic carriers, and 10.24 IU/ml for the healthy carriers. All of the diphtheria patients but one and nine of the carriers (six symptomatic and three healthy) had increased antibody levels during the first 7 to 10 days after admission. No obvious correlation was revealed between the antibody level or its kinetics and the course of the disease. Antibody levels on admission of >1 IU/ml were associated with a low risk of diphtheria.

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Immunity to diphtheria in Northern Norway and Northwestern Russia

Cited by 31 publications

References 11 publications

Serum antibodies to diphtheria-tetanus-pertussis vaccine components in Argentine children

Serum antibodies to diphtheria-tetanus-pertussis vaccine components in Argentine children

Successful Control of Epidemic Diphtheria in the States of the Former Union of Soviet Socialist Republics: Lessons Learned

Antidiphtheria Antibody Responses in Patients and Carriers ofCorynebacterium diphtheriaein the Arkhangelsk Region of Russia

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