Author/Editor		Ribič, Helena; Kraigher, Alenka; Hočevar-Grom, Ada; Zrimšek, Romana; Radšel-Medvešček, Alenka
Title		Ogroženost zaradi davice v Sloveniji
Translated title		Risk of diphtheria in Slovenia
Type		članek
Source		Zdrav Vars
Vol. and No.		Letnik 36, št. 3-4
Publication year		1997
Volume		str. 82-4
Language		slo
Abstract		More than fifty years have passed since the introduction of immunisation against diphtheria. A detailed analysis of the situation in Europe and elsewhere globally shows that this disease still presents an important problem for public health. Reasons for epidemics in the states of former Soviet Union are: low immunisation coverage of target population, insufficient surveillance of immunisation from the side of health services, a gap in immunity of adults, and frequent migration of population. The last case of diphtheria in Slvoenia was registered in the year 1967. The import of this disease has not been diagnosed yet in spite of constant contacts with states where there is an epidemics of diphtheria. For a further decision-making regarding the protection against diphtheria, a seroepidemiologic research on population risk due to this disease was performed. In two and a half years 6128 clinical samples were examined. Non-toxicogenic strains of Chorynebacterium diphtheriae were isolated from 11 samples, taken from 10 persons while there were no toxicogenic strains. Incidence rate of non-toxigenic diphtheria bacillus is 0,1 - 0,25 in 1000.000 inhabitants per year and is low, like as in same other European countries. Examining of sera for fiphtheria antitoxin has shown that the antitoxin level in children and youth up to 20 years of age is high, therefore the protection against diphtheria is good. Immunity is highest in the first years following the last immunisation and decreases with the years from the last dose of vaccine. The lowest average antitoxin level was found in the age group above 55 years. Results of the investigation have shown that it is important to continue the systemic immunsation of children against diphtheria, to vaccinate before travelling to the areas with diphtheria and to introduce a booster dose against diphtheria for the elder people above 55 years of age.
Summary		Več kot petdeset let je že minilo od uvedbe cepljenja proti davici. Podrobnejša analiza stanja v Evropi in drugod po svetu kaže, da je bolezen še vedno pomemben javnozdravstveni problem. Vzroki za epidemijo v državah nekdanje SZ so: nizka precepljenost ciljne populacije, pomanjkljivo nadzorovanje cepljenja s strani zdravstvene službe, vrzel v imunosti pri odraslih in pogosta migracija prebivalstva. V Sloveniji je bil zadnji primer davice zabeležen leta 1967. Zaenkrat, kljub stalnim stikom z državami, kjer je epidemija davice, vnos bolezni k nam še ni bil ugotovljen. Za nadalnjnje odločanje o varovanju pred davico je bila pri nas izvedena seroepidemiološka raziskava o ogroženosti prebivalstva zaradi te bolezni. V dveh letih in pol je bilo pregledanih 6128 kliničnih vzorcev. Netoksigeni sevi so bili izolirani iz 11 vzorcev, vzetih 10 osebam, toksigenih sevov bacila davice ni bilo. Incidenca pojavljanja netoksigenega bacila davice je 0,1 - 0,25 na 100.000 prebivalcev na leto in je nizka, podobno kot v nekaterih drugih evropskih državah. Preiskovanje serumov na davični antitoksin je pokazalo, da je raven antitoksina pri otrocih in mladini do 20. leta visoka in s tem zaščitenost proti davici dobra. Imunost je najvišja v prvih letih po zadnjem cepljenju in se nato z leti od zadnega odmerka cepiva zmanjšuje. Najnižja povprečna raven antitoksina je bila ugotovljena v starostni skupini nad 55 let. Rezultati raziskave so pokazali, da je pomembno, da nadaljujemo s sistematičnim cepljenjem otrok proti davici, da cepimo pred potovanjem na območja, kjer je davica in da uvedemo osvežilno cepljenje proti davici za starejše nad 55 let.
Descriptors		DIPHTHERIA SLOVENIA INFANT, NEWBORN ADOLESCENCE ADULT MIDDLE AGE CHILD AGED