Abstract
Despite effective vaccines, diphtheria (D) resurged recently in the former socialistic block, and tetanus (T) still occurs in less privileged countries. We studied the antibody persistence for D and T in Indian pre-school children who had received four doses of DTP vaccine and subsequently, the response to a booster dose. Anti-D and anti-T IgG antibodies prior to and one month after a DT vaccine were measured by ELISA in 223 healthy children of 4-6 years who had previously received four doses of the triple vaccine. Adverse reactions were monitored for one month. While 30% and 14% of subjects were susceptible to D and T, respectively, 98% and 100% of them attained seroprotection post-vaccination. Both responses were significant. Local, but not systemic reactions except fever were rather common. A high proportion of the Indian pre-school population is susceptible to D and T, despite of receiving four doses. The current policy of giving the fifth dose at this age is appropriate.
Highlights
Recent epidemics of diphtheria in successor countries of the former Soviet Union have drawn attention to this once forgotten disease [1,2]
We studied the antibody persistence for D and T in Indian pre-school children who had received four doses of diphtheria-tetanus-pertussis vaccine (DTP) vaccine and subsequently, the response to a booster dose
Anti-D and anti-T IgG antibodies prior to and one month after a DT vaccine were measured by enzyme-linked immunosorbent assay (ELISA) in 223 healthy children of 4-6 years who had previously received four doses of the triple vaccine
Summary
Recent epidemics of diphtheria in successor countries of the former Soviet Union have drawn attention to this once forgotten disease [1,2]. Reports from developing countries suggest changes in the epidemiology of this disease, as diphtheria occurs in outbreaks with high case fatality rates and complications [3]. A teaching hospital in Assam reported 101 cases of diphtheria in a 5-year period of 1997-2002 [5]. In a tertiary care hospital in north India [6], diphtheria has reappeared. Globally there were 7088 cases of diphtheria in 2008 [7], out of which 6081 cases were in India (86%) [8]. 22% of the total tetanuscases in the world in 2008 were from India (3714 out of 16628 cases) [7,8]
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