title: Neonatal tetanus despite protective serum antitoxin concentration.
abstract: Using the ELISA technique to estimate serum antibodies against tetanus toxin, seven neonates with clinical tetanus were found to have antibody levels 4-13 times higher than the presumed minimum protective level of 0.01 IU/ml. All but one of their mothers had been vaccinated with tetanus toxoid in pregnancy. In two other neonates, whose mothers had received multiple booster doses of toxoid during pregnancy, the anti-toxin concentrations were 100- and 400-times the presumed protective level. Therefore the toxin dose may overwhelm the pre-existing anti-toxin level and produce disease. Furthermore, multiple booster injections of tetanus toxoid may not only enhance serum anti-toxin titres, but could also lead to an ineffective immune response.
authors.affiliation: Department of Microbiology and Immunology, Muhimbili Medical Centre, Tanzania.
authors.forename: S Y
authors.initials: SY
authors.lastname: Maselle
authors.forename: R
authors.initials: R
authors.lastname: Matre
authors.forename: R
authors.initials: R
authors.lastname: Mbise
authors.forename: T
authors.initials: T
authors.lastname: Hofstad
mesh_terms: D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007112:Immunity, Maternally-Acquired / Q000276:immunology; D007231:Infant, Newborn; D011247:Pregnancy; D013636:Tanzania; D013742:Tetanus / Q000276:immunology* / Q000517:prevention & control; D013743:Tetanus Antitoxin / Q000097:blood*; D013744:Tetanus Toxin / Q000633:toxicity*; D013745:Tetanus Toxoid; D014611:Vaccination
chemical_list: D013743:Tetanus Antitoxin; D013744:Tetanus Toxin; D013745:Tetanus Toxoid