Comparative seroepidemiology of diphtheria in six European countries and Israel

P. Di Giovine, G. Kafatos, A. Nardone, N. Andrews, R. M. Olander, G. Alfarone, K. Broughton, D. Cohen, B. Kriz, I. Mikova, D. O'Flanagan, F. Schneider, I. Selga, L. Valinsky, I. Velicko, I. Karacs, R. Pebody, C. Von Hunolstein

Research output: Contribution to journalArticlepeer-review

Abstract

SUMMARY Serological surveys for diphtheria were conducted in six European countries including Czech Republic, Hungary, Ireland, Latvia, Luxembourg, Slovakia and one country outside Europe, Israel. For each country, a nationally representative population sample was collected across the entire age range and was tested for antibodies to diphtheria toxin. Although each national laboratory used its preferred assay, the results were all standardized to those of the in vitro neutralization test and expressed in international units (IU) which allowed comparative analyses to be performed. The results showed that increasing age is related to a gradual increase in seronegative subjects (<0·01' IU/ml of diphtheria antitoxin antibodies). This may reflect waning immunity following childhood vaccination without repeated booster vaccinations in adults. Differences in seronegativity were also found according to gender. In subjects aged 1-19' years, geometric mean titres of antitoxin are clearly related to the different vaccination schedules used in the participating countries. Although clinical disease remains rare, the susceptibility to diphtheria observed in these serosurveys highlights the importance of strengthened surveillance.

Original languageEnglish
Pages (from-to)132-142
Number of pages11
JournalEpidemiology and Infection
Volume141
Issue number1
DOIs
StatePublished - Jan 2013

Keywords

  • Diphtheria
  • Immunoepidemiology
  • Serology

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