title: Diphtheria antitoxin levels in the Netherlands: a population-based study.
abstract: In a population-based study in the Netherlands, diphtheria antitoxin antibodies were measured with a toxin-binding inhibition assay in 9, 134 sera from the general population and religious communities refusing vaccination. The Dutch immunization program appears to induce long-term protection against diphtheria. However, a substantial number of adults born before the program was introduced had no protective diphtheria antibody levels. Although herd immunity seems adequate, long-term population protection cannot be assured. As more than 60% of orthodox reformed persons have antibody levels lower than 0.01 IU/ml, introduction of diphtheria into religious communities refusing vaccination may constitute a danger of spread of the bacterium.
authors.affiliation: National Institute of Public Health and the Environment, Bilthoven, The Netherlands. H.de.Melker@rivm.nl
authors.forename: H E
authors.initials: HE
authors.lastname: de Melker
authors.forename: G A
authors.initials: GA
authors.lastname: Berbers
authors.forename: N J
authors.initials: NJ
authors.lastname: Nagelkerke
authors.forename: M A
authors.initials: MA
authors.lastname: Conyn-van Spaendonck
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D004165:Diphtheria / Q000276:immunology*; D004166:Diphtheria Antitoxin / Q000097:blood* / Q000276:immunology; D004168:Diphtheria Toxoid / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011159:Population Surveillance / Q000379:methods*; D017678:Sex Distribution
chemical_list: D000907:Antibodies, Bacterial; D004166:Diphtheria Antitoxin; D004168:Diphtheria Toxoid