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Evaluating the Immunity to Tetanus in Adults with the Enzyme-Linked Immunosorbent Assay

Banu Karaca, Nur Yapar, Ayse Yuce

Background: Tetanus is a worldwide preventable disease with vaccination having an incidence of approximately one million, which causes mortality especially in neonates in developing countries and in individuals over 60 years old in developed countries. The disease particularly affects unvaccinated people or those with an incomplete vaccination schedule. It has been reported in literature that immunity to tetanus diminishes with increased age. The aim of this study was to determine the immunity to tetanus and the need for booster immunization in the adult population in Turkey.

Methods and findings: A total of 339 blood samples were collected from patients aged between 20-81 years. Tetanus antitoxin levels were studied with the Enzyme Linked Imumunosorbent Assay (ELISA) method (Genzyme Virotech Germany). Titers <0.1 IU/ml were considered to show insufficient immunity to tetanus.

Of the studied population, 39.5% had insufficient immunity against tetanus. With increasing age, tetanus immunity was seen to decrease. The immunity to tetanus was seen to be higher in patients who had received a booster immunization in the past 5 years compared with the groups with a last booster immunization 5-10 years previously or more than 10 years ago. A higher rate was also determined in the female population with a pregnancy history in the last 5 years compared with the groups with pregnancy 5-10 years previously or more than 10 years ago.

Conclusion: Booster doses for adults are needed. The present vaccination schedule must include boosters every 10 years in order to provide immunity against tetanus for all the population.