Diphtheria in Russia in the 21st Century

Abstract

Objective: evaluate the incidence of diphtheria in Russia from the beginning of mass immunization of children to date and analysis of long-term studies of coverage of vaccination and the state of antitoxic antidiphtheria immunity of the population. Materials and methods. Presents the incidence of diphtheria in 1955 - 2016 and analysis of the condition of antidiphtheria antitoxic immunity of the population of Russia (2010 - 2016) according to seromonitoring of the 83 subjects of the Russian Federation. We examined 367 031 people, of which 65 557 children, 74 033 teenagers and 277 441 adults and examined 13 785 control of blood serum of indicator groups of 52 subjects of the Russian Federation (2 888 children, teenagers and adults 1 639 - 9 258 people) to assess the uality of seromonitoring in the subjects of the Russian Federation and the data associated with the level of previtali of the population. The level of antitoxic antidiphtheria immunity was determined using the reaction of passive hemagglutination antigen of the antigenic. The immunity level was evaluated by the content of medium and high titers of antibodies in serum. The aggregation of data in the work were used the methods of parametric statistics. Results and discussion. Before 1959, in Russia the incidence of iphtheria was very high - 68 0 - 93 0 per 100 thousand population Mass immunization of children was carried out only since 1959 (decree No. 323 «On the elimination of the incidence of diphtheria in the USSR», approved by the USSR health Ministry, 1959 June 23). After the introduction of the Order of the mass immunization of children since 1959, the incidence began to decline sharply - annually by 30 - 40%. In 1968, the incidence rate was 0.89 and in 1975 - 0.03. Total sick 51. However, from 1980 to 1985 marked rise in the incidence (0.2 - 0.9) were mostly ill adults, and since 1990 began a new expansion of morbidity. In 1994, the incidence rate was equal to 26.8 per 100 thousand population. Was 39 703 cases, died 1 104 people, of whom 254 of the child. according to the Ministry of health report the reason for the rise - sereznye deficiencies in the organization and conduct of immunization. After the mass immunization of the entire population in 1993 - 1995 the incidence began to decline after the 2nd booster vaccination in adults (2005) incidence rates were at the level of hundredths per 100 thousand population - 0.06 - -0.01 and in 2011 at the evel of thousandths - 0.006 - 0.001. Since 2009 was not registered fatal cases. The level of immunization of the population of the Russian Federation from 2005 - 2016. was consistently high in children, 96.6 - 97.1% among adolescents of 96.8 - 99.6% in adults in total and by age groups, consistent with the requirements of the who - 97.7 - 98.3%. Information on high levels of vaccination coverage are confirmed by the results of serological monitoring and data control studies of serum. In 2010 - 2015 in children antibody on the protective level was identified 95.2± 0.2% 97.0 ± 0.15% serum in high tension immunity (77.1 ± 0.37% 88.5 ± 0.3%); among teenagers - 97.6 ± 0.13% 98.2 ± 0.12% and 88.1 ± 0.26% - 91.0 ± 0.26%; in adults 91.1 ± 0.17% - 94.5 ± 0.19% and 74.1 ± 0.26% - 84.0 ± 0.18% respectively. By age group adults in Russia on average the condition of antidiphtheria immunity in all years was high at 96.6 ± 0.37% - 97.5% ± 0.17% and somewhat lower in older age groups - 88.0 ± 0.48% - 90.3 ± 0.43% (50 - 59, 60 years old and >). Data control studies of blood serum of children, teenagers and adults: 90.7 ± 0.89% 99.5 ± 0.5%; 92.2 ± 0.6% - 100% и 87.1 ± 1.03% 95.6 ± 0 . 64% respectively. Conclusion: long-time study of the condition of antidiphtheria immunity of the population and control studies of serum of indicator groups, allowed to estimate objectively high level of specific protection of the population against diphtheria. This has contributed to stabilizing the incidence at a sporadic level, with sporadic cases; no deaths and will continue to provide a favorable prognosis for diphtheria in the country