title: Diphtheria in Thailand in the 1990s.
abstract: Diphtheria remains endemic in developing countries, but there are limited published data on the subject. Thailand's diphtheria surveillance data are relatively complete and may give a fuller picture of the situation in similar countries. After routine immunization began in 1977, the incidence of reported diphtheria decreased by >98% to <0.1 case per 100,000 persons annually in the 1990s. Despite infant immunization coverage of >90%, diphtheria cases were reported throughout the 1990s, primarily among children <15 years old. Outbreaks were linked to both persistent endemic circulation and to importation of toxigenic Corynebacterium diphtheriae; suboptimal immunization coverage in minority and disadvantaged groups contributed. A serologic survey found 25% of adults 20-39 years old and 14% of adolescents 10-19 years old lacked immunity to diphtheria; these data indicate an accumulation of susceptible adolescents and adults. Diphtheria remains a threat in Thailand; improvements in diphtheria control will depend on improving childhood immunization coverage in Thailand and the surrounding region.
authors.affiliation: Field Epidemiology Training Program, Division of Epidemiology, Ministry of Public Health, Nonthaburi, Thailand. piyanit@health.moph.go.th
authors.forename: P
authors.initials: P
authors.lastname: Tharmaphornpilas
authors.forename: P
authors.initials: P
authors.lastname: Yoocharoan
authors.forename: P
authors.initials: P
authors.lastname: Prempree
authors.forename: S
authors.initials: S
authors.lastname: Youngpairoj
authors.forename: P
authors.initials: P
authors.lastname: Sriprasert
authors.forename: C R
authors.initials: CR
authors.lastname: Vitek
mesh_terms: D000293:Adolescent; D002648:Child; D004165:Diphtheria / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D004168:Diphtheria Toxoid; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D004196:Disease Outbreaks; D005843:Geography; D006801:Humans; D015994:Incidence; D007223:Infant; D013785:Thailand / Q000453:epidemiology
chemical_list: D004168:Diphtheria Toxoid; D015721:Diphtheria-Tetanus-Pertussis Vaccine