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Active immunization by vaccination with diphtheria tox-oid is the key in preventing diphtheria. Vaccines consist of microorganisms or cellular components that act as antigens. Administration of the vaccine stimulates the production of antibodies with specific protective properties. Serum antitoxin concentration of 0.01 IU/mL is usually accepted as the minimum protective level, and 0.1 IU/mL provides a definitely protective level.
· Vaccination is important, especially for high-risk groups (such as children, elderly individuals, and immigrants from areas of continued endemic infections).
· Active immunization by vaccination increases resistance to C. diphtheriae infection. Vaccines consist of microorganismsor cellular components that act as antigens.
Passive immunization is carried out by antidiphtheric serum (ADS). This consists of administration of 500–1000 U of ADS given subcutaneously, and ADS is usually recom-mended as emergency measure for treatment of susceptible persons. It is most effective in reducing the fatality rate. The long half-life of specific antitoxin in the circulation is an important factor in ensuring effective neutralization of diph-theria toxin. However, to be effective, the antitoxin must react with the toxin before it becomes internalized into the cell.
Combined immunization is carried out by simultaneous administration of ADS and diphtheria toxoid. The ADS is given in one arm, while the toxoid is given in the other arm, followed by a complete schedule of vaccination with toxoid.
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