Full text loading...
Chapter 11 : Epidemic Diphtheria in the Newly Independent States of the Former Soviet Union
In spite of decades of good control, in the newly independent states of the former Soviet Union epidemic diphtheria has reemerged. During the late 1980s, childhood immunization coverage levels were low in some regions of the Soviet Union. One of the factors contributing to lack of ontime vaccination of children was a long list of contraindications for vaccination. In the central Asian republics and Caucasian countries there were vaccine shortages due to disruption of the supply in 1992 and 1993, following the dissolution of the Soviet Union. Before the dissolution of the Soviet Union, Russian-manufactured diphtheria toxoid vaccine was used throughout the Soviet Union. Although morbidity data from the armed forces are not available to civilian public health authorities in the former Soviet Union, outbreaks of diphtheria among soldiers have been reported. High coverage among children (95% coverage with four doses of diphtheria toxoid in all districts) and administration of a single dose of diphtheria toxoid to each inhabitant were essential to achieve high population immunity. The risk of emergence of epidemic diphtheria in other countries is difficult to estimate, but clearly clinical and public health expertise in diagnosis and management of diphtheria cases must be maintained. Although previously a disease of children, diphtheria has emerged as an epidemic disease among adolescents and adults in the newly independent states of the former Soviet Union decades after the implementation of an effective childhood vaccination program.
Key Concept Ranking
- Clinical and Public Health