1 64
A. SARAGEA ET A L .
a fairly high diphtheria morbidity (only 60% Schick negative reactors) and
a high frequency of toxigenic C. diphtheriae (86%) could still be observed.
Under these conditions two principles were followed to stop the epidemic
spreading. These were
Surveillance and control of antidiphtheria immunity.
Surveillance and control of the organism and its mechanisms of spread.
This epidemiological surveillance work helped the Medical Authorities
of the country to determine the extent of the problem and its place in the
order of priority among other problems related to communicable and noncommunicable diseases and to work out short- and long-term strategies for
its control.
B. Surveillance and control of antidiphtheria immunity
(1) Control was achieved by manufacturing highly immunogenic diphtherial prophylactics and associated vaccines (purified and aluminium
phosphate adsorbed diphtherial toxoid, diphthero-tetanus toxoid and
diphthero-tetanus-pertussis vaccine).
(2) Planning, together with our Health Authorities, a vast programme of
antidiphtheria immunisation incluQing all sensitive age groups up to 18
years of age.
(3) Randomised field control of the application of this programme and
of antidiphtheria acquired immunity by means of Schick conversion
rates (90% Schick negative reactors) and by serum antitoxin titrations in
different age groups of the population.
(4) Active intervention by vaccination when necessary, in order to avoid
gaps in the general immunity level.
T o recognise spreading when it occurred, it was important to have good
bacteriological detection schemes and typing methods.
1. Principles of surveillance
The surveillance and control of the pathogenic agent were carried out by
systematic investigations regarding the incidence and frequency of wild
organisms throughout the country.
T o this end, the Diphtheria Laboratory of the Cantacuzino Institute,
Bucharest, was organised as a National Reference Centre for diphtheria
microbiological, epidemiological and immunological surveys. Close and
permanent relations were established between this centre and all regional
public health laboratory services in the country, and theoretical and
practical advice were given when necessary.
(a) Regarding surveillance of the pathogenic agent, the chief task was to
obtain representative samples from all epidemic situations, from the
A. SARAGEA ET A L .
a fairly high diphtheria morbidity (only 60% Schick negative reactors) and
a high frequency of toxigenic C. diphtheriae (86%) could still be observed.
Under these conditions two principles were followed to stop the epidemic
spreading. These were
Surveillance and control of antidiphtheria immunity.
Surveillance and control of the organism and its mechanisms of spread.
This epidemiological surveillance work helped the Medical Authorities
of the country to determine the extent of the problem and its place in the
order of priority among other problems related to communicable and noncommunicable diseases and to work out short- and long-term strategies for
its control.
B. Surveillance and control of antidiphtheria immunity
(1) Control was achieved by manufacturing highly immunogenic diphtherial prophylactics and associated vaccines (purified and aluminium
phosphate adsorbed diphtherial toxoid, diphthero-tetanus toxoid and
diphthero-tetanus-pertussis vaccine).
(2) Planning, together with our Health Authorities, a vast programme of
antidiphtheria immunisation incluQing all sensitive age groups up to 18
years of age.
(3) Randomised field control of the application of this programme and
of antidiphtheria acquired immunity by means of Schick conversion
rates (90% Schick negative reactors) and by serum antitoxin titrations in
different age groups of the population.
(4) Active intervention by vaccination when necessary, in order to avoid
gaps in the general immunity level.
T o recognise spreading when it occurred, it was important to have good
bacteriological detection schemes and typing methods.
1. Principles of surveillance
The surveillance and control of the pathogenic agent were carried out by
systematic investigations regarding the incidence and frequency of wild
organisms throughout the country.
T o this end, the Diphtheria Laboratory of the Cantacuzino Institute,
Bucharest, was organised as a National Reference Centre for diphtheria
microbiological, epidemiological and immunological surveys. Close and
permanent relations were established between this centre and all regional
public health laboratory services in the country, and theoretical and
practical advice were given when necessary.
(a) Regarding surveillance of the pathogenic agent, the chief task was to
obtain representative samples from all epidemic situations, from the