Naumann P, Hagedorn H J, Paatz R
Dtsch Med Wochenschr. 1983 Jul 15;108(28-29):1090-6. doi: 10.1055/s-2008-1069698.
Indirect haemagglutination test for antitoxic diphtheria antibodies was performed on 3503 sera of persons of all age groups. The results demonstrate that a high percentage of juveniles and adults with less than 0.01 IU/ml has either no (48.9% for juveniles, 35.6% for adults) or at 0.01-0.09 IU/ml only insufficient immunological protection (30% and 41%, respectively) against diphtheria and its toxic effects. But even among children up to 14 years of age, 28.5% are completely without and 20.5% without reliably protective antitoxic immunity, despite a high rate of immunization. There is thus a dangerously high epidemic potential of susceptible persons in the population of the Federal Republic of Germany. To erect a barrier of immunity against epidemic spread requires not only immunization of all children, but also re-immunization every five to six years, plus immunization of juveniles and young adults among a selected group with, at present, highest risk of infection. For this purpose there is a diphtheria toxoid of Behringwerke for adults with only 5 IU toxoid/0.5 ml, which, however, after single application produced an antitoxic immunity (greater than or equal to 0.1 IU/ml) in previously sensitized subjects (17 of 49). Of 32 primary seronegative persons 14 reacted to two injections, while a further 18 (36.7%) had no immune response within six weeks even after second injection.
对3503份各年龄组人群的血清进行了抗毒性白喉抗体间接血凝试验。结果表明，大量青少年和成年人抗毒性白喉抗体水平低于0.01 IU/ml，其中一部分人（青少年为48.9%，成年人为35.6%）没有免疫保护，另一部分人（分别为30%和41%）在抗体水平为0.01 - 0.09 IU/ml时，对白喉及其毒性作用的免疫保护不足。即便在14岁以下儿童中，尽管免疫接种率很高，但仍有28.5%的儿童完全没有免疫保护，20.5%的儿童没有可靠的保护性抗毒性免疫。因此，在德意志联邦共和国的人群中，易感人群的流行潜力高到危险程度。要建立一道免疫屏障以防止疫情传播，不仅需要对所有儿童进行免疫接种，还需要每五到六年进行一次重新接种，此外还要对选定的、目前感染风险最高的青少年和年轻成年人进行免疫接种。为此，拜耳公司生产了一种成人用白喉类毒素，每0.5 ml含5 IU类毒素，然而，在先前致敏的受试者（49人中有17人）单次接种后产生了抗毒性免疫（大于或等于0.1 IU/ml）。在32名初次血清阴性的受试者中，14人在接种两次后产生了反应，而另外18人（36.7%）即使在第二次接种后六周内也没有免疫反应。
