Diphtheria antitoxin levels in the Netherlands: A population-based study

H. E. De Melker, G. A.M. Berbers, N. J.D. Nagelkerke, M. A.E. Conyn-van Spaendonck

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)


In a population-based study in the Netherlands, diphtheria antitoxin antibodies were measured with a toxin-binding inhibition assay in 9,134 sera from the general population and religious communities refusing vaccination. The Dutch immunization program appears to induce long-term protection against diphtheria. However, a substantial number of adults born before the program was introduced had no protective diphtheria antibody levels. Although herd immunity seems adequate, long-term population protection cannot be assured. As more than 60% of orthodox reformed persons have antibody levels lower than 0.01 IU/ml, introduction of diphtheria into religious communities refusing vaccination may constitute a danger of spread of the bacterium.

Original languageEnglish
Pages (from-to)694-700
Number of pages7
JournalEmerging Infectious Diseases
Issue number5
Publication statusPublished - 1999
Externally publishedYes

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases


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