Immunisation of adults during an outbreak of diphtheria.
In an outbreak of infection due to Corynebacterium diphtheriae in a hospital for mentally subnormal adults sera from 211 members of staff were screened for diphtheria antitoxin titres. Of these, 79 (37%) required immunisation, and a low dose preparation (1 LfU of diphtheria and 10 LfU tetanus toxoids) was offered. Of the 64 subjects who accepted a single immunisation and were subsequently retested, seroconversion to diphtheria toxoid occurred in 45 (70%), the rate being highest in younger adults. Seroconversion to tetanus toxoid occurred in 59% of subjects. Local reactions to the single dose were reported by 29 (43%) subjects, and nine (13%) experienced moderately severe local reactions and systemic symptoms. We conclude that adults should not be vaccinated without previous screening for susceptibility to diphtheria; that neither previous immunisation nor age is reliable in predicting the need for vaccination; and that though a single booster dose of diphtheria toxoid is probably effective in adults under 45, two doses should be given to those in the older age group.
D000328:Adult; D003428:Cross Infection / Q000517:prevention & control*; D004165:Diphtheria / Q000517:prevention & control*; D004166:Diphtheria Antitoxin / Q000032:analysis; D004168:Diphtheria Toxoid / Q000008:administration & dosage / Q000009:adverse effects; D004196:Disease Outbreaks / Q000517:prevention & control*; D004334:Drug Administration Schedule; D005260:Female; D006782:Hospitals, Special; D006801:Humans; D007114:Immunization; D008607:Intellectual Disability; D008297:Male; D008875:Middle Aged; D013745:Tetanus Toxoid / Q000008:administration & dosage
D004166:Diphtheria Antitoxin; D004168:Diphtheria Toxoid; D013745:Tetanus Toxoid