Sutter R W, Hardy I R, Kozlova I A, Tchoudnaia L M, Gluskevich T G, Marievsky V, Deforest A, Wharton M
Child Vaccine Preventable Disease Branch, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
J Infect Dis. 2000 Feb;181 Suppl 1:S197-202. doi: 10.1086/315557.
After 30 years of control, epidemic diphtheria returned to the Soviet Union in 1990. To develop control strategies, the immunogenicity of the tetanus and diphtheria toxoids (Td) vaccine was assessed. Workers who were 18-67 years old received two Td immunizations separated by 30 days. A neutralization assay determined diphtheria antitoxin (DAT) on enrollment and on days 7, 30, 60, and 425. On enrollment, 43.0% of 488 workers had DAT <0.1 IU/mL. After one dose, 88.5% had DAT >/=0.1 IU/mL, after two doses, 92.2% had >/=0.1 IU/mL and >90% of participants <30 or >/=50 years of age attained >/=1.0 IU/mL; however, only 78.4% of those who were 30-39 years old and 51.8% of those who were 40-49 years old achieved >/=1.0 IU/mL after two doses. To control the epidemic in Ukraine, one Td dose should be administered to virtually the entire population (persons 30-49 years old require three doses of Td for optimal individual protection and to maximize population immunity).
经过30年的控制，流行性白喉于1990年在苏联再度出现。为制定控制策略，对白喉破伤风类毒素（Td）疫苗的免疫原性进行了评估。18至67岁的工人接受了两次Td免疫接种，间隔30天。采用中和试验在入组时以及第7、30、60和425天测定白喉抗毒素（DAT）。入组时，488名工人中有43.0%的DAT<0.1 IU/mL。一剂接种后，88.5%的人DAT≥0.1 IU/mL，两剂接种后，92.2%的人DAT≥0.1 IU/mL，年龄<30岁或≥50岁的参与者中超过90%达到DAT≥1.0 IU/mL；然而，30至39岁的人群中只有78.4%、40至49岁的人群中只有51.8%在两剂接种后达到DAT≥1.0 IU/mL。为控制乌克兰的疫情，几乎应给全体人口接种一剂Td（30至49岁的人需要接种三剂Td以获得最佳的个体保护并使群体免疫力最大化）。
