Abstract
Immunity against diphtheria (D) is poorly understood since protection is a complex interaction between host and environment and there are technical problems with existing antitoxin assays. Using a radioimmunoassay, antitoxin was detected in sera from premature infants after 33 weeks of gestation and the maternalcord serum ratio of 18 term infants was 0.8 ±0.3 (1 SD), Following the first DTP (7.5 Lf units D toxoid) significant antitoxin production was not detected. This relatively poor antigenicity was found in the absence as well as presence of maternal antibody. A rise in antibody concentration and affinity was found after the 2nd, 3rd, and 4th injections. More than four injections did not alter concentration and affinity of the antitoxin or the rate of decline in concentration. Correlation with recent epidemiologic studies suggests that a serum contained a protective concentration of antitoxin if it bound more than 150 ng D toxin N/ml of serum. By this criteria only 74% of children who received 3 immunizations and 84% of children who received 4 or more were protected. Among the 188 children studied 34% had appropriate immunizations for age. These observations suggest that the immunologic status of urban children to D is inadequate and an improvement in patient education and immunization practices is needed, (supported by AI-07854)
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Nelson, L., Peri, B., Rieger, C. et al. IMMUNITY TO DIPHTHERIA IN AN URBAN POPULATION. Pediatr Res 11, 438 (1977). https://doi.org/10.1203/00006450-197704000-00412
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DOI: https://doi.org/10.1203/00006450-197704000-00412
