Low prevalence of diphtheria immunity in the population of Florence, Italy

Comodo, Nicola; Bonanni, Paolo; Nostro, Antonella Lo; Tiscione, Emilia; Mannelli, Francesco; Tomei, Alexander

doi:10.1007/bf00145414

Cited by 18 publications

(9 citation statements)

References 10 publications

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“…The results of the present analyses are also in accord with those of several other studies [2–5,12–14,19,21] with respect to the typical age trend in diphtheria immunity. In individuals who were born before diphtheria vaccination became mandatory, immunity is related to natural infection.…”

Section: Discussionsupporting

confidence: 92%

Susceptibility to diphtheria in adults: prevalence and relationship to gender and social variables

Völzke

Kloker

Krämer

et al. 2006

Clinical Microbiology and Infection

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Recent outbreaks of diphtheria have drawn attention to the re-emergence of this disease. This study investigated susceptibility to diphtheria in north-east Germany and its relationship to gender and social factors. A study population of 4275 individuals recruited for the population-based Study of Health in Pomerania (SHIP) was available for analysis. IgG antibodies against diphtheria toxin were determined by ELISA and were used to define susceptibility to diphtheria (i.e., IgG titres < 0.1 IU/mL). The prevalence of susceptibility to diphtheria was 32.4%. Multivariate analysis revealed 45% increased odds of women being susceptible to diphtheria. Women who had not received diphtheria toxoid vaccination during the previous 10 years had four-fold increased odds of being susceptible to diphtheria toxin compared with unvaccinated men. None of the social factors investigated was associated with susceptibility status. It was concluded that a high proportion of middle-aged adults was susceptible to diphtheria. Women lacked seroprotection more often than men, which might be explained, in part, by gender-specific immune responses following vaccination. There is a need for information campaigns to improve public awareness of these problems.

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Section: Discussionsupporting

confidence: 92%

Susceptibility to diphtheria in adults: prevalence and relationship to gender and social variables

Völzke

Kloker

Krämer

et al. 2006

Clinical Microbiology and Infection

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show abstract

“…A shortened vaccination schedule (3, 5, 12 months) was introduced in Sweden in 1979 and recent studies attest to the fact that the majority of the Swedish population have only low immunity to diphtheria and the rate of protection for 10 year olds did not exceed 52 % [31,32]. A number of earlier studies from Poland, England and elsewhere also showed inadequate protection rates in adults of 20-50 years [10,33] and 30-60 years [11,27,[34][35][36][37].…”

Section: Discussionmentioning

confidence: 99%

The prevalence of diphtheria immunity in healthy population in Poland

2001

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The degree of seroprotection against diphtheria in Poland was evaluated by determination of IgG antibodies to Corymebacterium diphtheriae toxin (IgG-DTAb). The study population consisted of 4,829 healthy subjects aged from 1 day to 85 years from 7 regions of Poland. Serum samples collected between 1996 and 1998 were assayed for IgG-DTAb antibodies using a toxoid enzyme immunoassay. Neutralization of toxin in Vero cells was performed as a reference method with the WHO standard for human diphtheria antitoxin. The study revealed a lack of seroprotection (IgG-DTAb < 0.1 IU/ml) in 23% of individuals, basic seroprotection (0.1-1.0 IU/ml) in 64%, and effective seroprotection (> 1.0 IU/ml) in 13%. The non-protected group consisted of non-vaccinated children below 2 months of age (10%), individuals between 2 months and 18 years old (20%) and greater than 19 years old (70%). Of the adults, 32% were seronegative, 63% had basic seroprotection and only 5% were fully protected; 43% of adults between 30 and 64 years, who had not been vaccinated at least during the previous 10 years were not protected against diphtheria. The geometric mean titre (GMT) of IgG-DTAb was 0.25 IU/ml in the total population. Age-related GMTs differed significantly from each other and were higher (0.44 IU/ml) in individuals from 2 months to 18 years old, compared with 014 IU/ml and 0.17 lU/ml in children under 2 months and adults, respectively. No significant difference was found in the GMTs of men and women in all age groups. We conclude that the currently used vaccination programme in Poland is highly effective and assures protection against diphtheria in the majority of the population in the 10-year period following the last booster. However, a significant proportion of adults between 30 and 64 years lack protection and this indicates a need for booster immunization for this group.

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“…This has been shown by various recent studies in Italy [8][9][10][11], France [12], Spain [13][14][15][16], Germany [17,18] and the United Kingdom [19]. Although the major epidemic in East European countries has been in remission since 1996 [20], more than 7000 cases were reported in 1997 and more than 2500 in 1998 [2].…”

Section: Introductionmentioning

confidence: 88%

Immunogenicity and reactogenicity of the adult tetanus–diphtheria vaccine. How many doses are necessary?

et al. 2001

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The immunogenicity and reactogenicity of the tetanus-diphtheria adult type vaccine was compared in two groups: group I (n = 201, 18-30 years old, presumably vaccinated with the DTP vaccine) and group II (n = 147, > or = 45 years old, without vaccination antecedents). Before vaccination, the seroprotection levels for tetanus were 90.5% (group I) and 30.6% (group II). These rose to 99.5% and 81.7%, respectively, after administration of one vaccine dose. For diphtheria, prevaccination seroprotection levels were 38.3% (group I) and 19.0% (group II). These rose to 85.8% and 65.7%, respectively, after vaccination. The logistic regression analysis showed an association between antibody titre and age. In group II, 3 doses of Td vaccine were needed to reach titres similar to those achieved in group I with a single dose. Stated reactogenicity was greater in: young subjects, women, those with higher titres of tetanus antibodies and those receiving other vaccines simultaneously. These results confirm the need for vaccination schedules adapted to the characteristics of each population age-group.

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Low prevalence of diphtheria immunity in the population of Florence, Italy

Cited by 18 publications

References 10 publications

Susceptibility to diphtheria in adults: prevalence and relationship to gender and social variables

Susceptibility to diphtheria in adults: prevalence and relationship to gender and social variables

The prevalence of diphtheria immunity in healthy population in Poland

Immunogenicity and reactogenicity of the adult tetanus–diphtheria vaccine. How many doses are necessary?

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