Immunity to diphtheria in Izmir, Turkey

Egemen A., Kurugol Z., Aksit S., Ozacar T., Keskinoglu P., Afsar I.

EUROPEAN JOURNAL OF EPIDEMIOLOGY, vol.16, no.11, pp.1039-1042, 2000 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 16 Issue: 11
  • Publication Date: 2000
  • Doi Number: 10.1023/a:1010853026812
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.1039-1042
  • Keywords: adult vaccination, booster, diphtheria, AGE GROUP, ADULTS, IMMUNIZATION, VACCINATION
  • Dokuz Eylül University Affiliated: No


In order to assess immunity to diphtheria in Izmir, Turkey, a total of 743 persons 1-70 years of age were selected with cluster sampling. The information on socio-demographic characteristics, vaccination status and diphtheria history was gathered for each participant. Diphtheria antitoxin levels were measured qualitatively by using micro-enzyme immune assay. Of studied population, 79.1% had fully protective antitoxin levels (greater than or equal to0.1 IU/ml). Diphtheria protection rates showed a gradual age-related decrease, reaching minimum in the 30-44 age group, in which 40.2% of these subjects had antibody titre below the full protective level. The diphtheria antitoxin geometric mean titer was highest in the 5-9 year age group (1.05 IU/ml). Then, geometric mean titer decreased with increasing age, and reached the minimum level in the 30-44 age group (0.19 IU/ml). These results suggest that in Izmir, Turkey, full serological protection against diphtheria is only detectable in 60% of the adult population. The enhancement of diphtheria immunity by booster vaccinations in adolescents and adults should be considered in Turkey.