title: Diphtheria in Lithuania, 1986-1996.
abstract: Diphtheria reappeared in Lithuania in 1986 and rose to epidemic levels by 1992. Between 1991 and 1996, 110 cases of diphtheria were registered, with an incidence of 0.03-1.15/100,000 population. Most cases (84%) and all 17 deaths occurred among persons >/=15 years, most of whom had never been vaccinated. Persons 40-49 years old had the highest average annual age-specific morbidity (1.70/100,000) and mortality (0.53/100,000) rates. Low levels of immunity among individuals 40-49 years old and migration to epidemic areas in Russia and Belarus contributed to the epidemic's occurrence. Between 1991 and 1995, toxigenic Corynebacterium diphtheriae strains were isolated from 84 of all registered patients (76%), and nontoxigenic strains were isolated from 13 (12%). By 1996, two mass vaccination campaigns, which provided one dose of vaccine to individuals 25-30 years old and three doses of vaccine to persons 31-60 years old, helped reduce the number of cases. The first campaign achieved 69% coverage; the second achieved 48% coverage.
authors.affiliation: Center of Pediatrics, Vilnius University, LT 2009 Vilnius, Lithuania (Lietuva). usonis@ktl.mii.lt
authors.forename: V
authors.initials: V
authors.lastname: Usonis
authors.forename: V
authors.initials: V
authors.lastname: Bakasenas
authors.forename: B
authors.initials: B
authors.lastname: Morkunas
authors.forename: R
authors.initials: R
authors.lastname: Valentelis
authors.forename: P
authors.initials: P
authors.lastname: Ching
authors.forename: J
authors.initials: J
authors.lastname: Kreysler
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D003353:Corynebacterium diphtheriae / Q000276:immunology / Q000302:isolation & purification; D004165:Diphtheria / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality / Q000517:prevention & control*; D004168:Diphtheria Toxoid / Q000008:administration & dosage; D022422:Diphtheria-Tetanus Vaccine; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage; D018563:Disease Notification / Q000706:statistics & numerical data; D004196:Disease Outbreaks / Q000517:prevention & control; D006801:Humans; D017589:Immunization Programs; D007115:Immunization Schedule; D015994:Incidence; D007223:Infant; D008097:Lithuania / Q000453:epidemiology; D008875:Middle Aged; D009313:National Health Programs; D013745:Tetanus Toxoid / Q000008:administration & dosage; D017778:Vaccines, Combined / Q000008:administration & dosage
chemical_list: D004168:Diphtheria Toxoid; D022422:Diphtheria-Tetanus Vaccine; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D013745:Tetanus Toxoid; D017778:Vaccines, Combined