IMMUNIZATION AGAINST DIPHTHERIA WITH SPECIAL EMPHASIS ON IMMUNIZATIONOF ADULTS

A massive diphtheria epidemic in Eastern Europe has resulted in increa sed anxiety that this disease could spread to other countries. This fe ar is realistic because there is a gap in the diphtheria immunity in l arge segments of the adult population in many industrialized countries . Experience to date suggests that an immunity gap in adults coupled w ith the presence of large numbers of susceptible children and adolesce nts creates the potential for an extensive epidemic. To prevent epidem ics, countries should consider the immunogenicity and duration of prot ection provided by diphtheria toxoid given to children in the primary series and as booster doses. This paper reviews general issues related to the formulation of diphtheria immunization strategies, especially the need for booster doses in adults and the rationale for use of lowe r-strength diphtheria toxoid for persons older than 6 years of age. Co pyright (C) 1996 Elsevier Science Ltd.