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Clinical and Vaccine Immunology, June 2006, p. 627-632, Vol. 13, No. 6
1071-412X/06/$08.00+0     doi:10.1128/CVI.00026-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Antidiphtheria Antibody Responses in Patients and Carriers of Corynebacterium diphtheriae in the Arkhangelsk Region of Russia

Elena Danilova,1,2,{dagger} Pål A. Jenum,3* Vegard Skogen,4 Valentin F. Pilnikov,5 and Haakon Sjursen1

Institute of Medicine,1 Center for International Health, University of Bergen, Bergen,2 Department of Bacteriology, Norwegian Institute of Public Health, Oslo,3 Department of Medicine, University Hospital of North Norway and Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway,4 Hospital of Infectious Diseases, Arkhangelsk, Russia5

Received 24 January 2006/ Returned for modification 14 February 2006/ Accepted 4 April 2006

Diphtheria is under control in industrialized countries. However, single cases and outbreaks still occur and the disease is not completely understood. Forty-three individuals suspected of having diphtheria who were referred to the Infectious Disease Hospital of Arkhangelsk from December 1994 to March 1995 were included in this study. Fifteen patients were diagnosed as having diphtheria and received equine hyperimmune antidiphtheria toxin antiserum, and 28 were diagnosed as carriers, 12 with nondiphtherial tonsillitis or pharyngitis and 16 without symptoms. Serum samples were obtained on admission and during the course of the disease or during follow-up of carrier status. Samples were analyzed for antibodies against diphtheria toxin with both an in vitro neutralization test (NT) and a human-specific enzyme immunoassay. All of the cases but one were confirmed by a positive culture. Twelve patients had pharyngeal diphtheria, and three had combined laryngeal and pharyngeal disease. Half of the patients had life-threatening disease, and one died. On admission, the median antibody titers measured with the NT were 0.085 IU/ml for the patients, 5.12 IU/ml for the symptomatic carriers, and 10.24 IU/ml for the healthy carriers. All of the diphtheria patients but one and nine of the carriers (six symptomatic and three healthy) had increased antibody levels during the first 7 to 10 days after admission. No obvious correlation was revealed between the antibody level or its kinetics and the course of the disease. Antibody levels on admission of >1 IU/ml were associated with a low risk of diphtheria.

* Corresponding author. Present address: Department of Microbiology, Central Laboratory, Hospital of Asker and Bærum, P.O. Box 83, 1309 Rud, Norway. Phone: (47) 67809708. Fax: (47) 67809705. E-mail: pajenum{at}c2i.net.

{dagger} Present address: Unit of Innovation, Central Research Laboratory, Northern State Medical University, 163000 Arkhangelsk, Russia.

Clinical and Vaccine Immunology, June 2006, p. 627-632, Vol. 13, No. 6
1071-412X/06/$08.00+0     doi:10.1128/CVI.00026-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.





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