International Journal of Epidemiology, Vol 26, 420-427, Copyright © 1997 by International Epidemiological Association
U Sankilampi, R Isoaho, A Bloigu, SL Kivela and M Leinonen
BACKGROUND: Pneumococcal infections are a common cause of morbidity and
mortality among elderly people. Protection against pneumococcal infections
is mediated by serotype-specific antibodies to capsular polysaccharides. To
obtain an estimate of anti-pneumococcal immunity, prevalence and levels of
pneumococcal antibodies were studied in an unvaccinated elderly population.
METHODS: IgG antibodies to pneumococcal serotypes 3, 6A, and B and to cell
wall polysaccharide (C- PS, a common antigen to all pneumococci) were
measured by enzyme immuno- assay in 480 subjects aged 64-97 years (206 men,
274 women) who were a random sample (41%) of elderly inhabitants in a
semirural community in Finland. RESULTS: An average of 10% of the elderly
lacked antibodies to serotypes 3, 6A, and 8, and 62% of the elderly had
them in low titres only. Anti-C-PS antibodies were found in 99% of the
elderly, and in significantly higher titres than anti-capsular antibodies.
Antibody titres to C-PS and to type 6A decreased with age. Elderly women
had significantly lower antibody levels than men. Among the men, current
smokers had higher antibody titres than non-smokers; in the women, this
analysis was not possible because of infrequent history of smoking. The
effect of smoking on antibody titres was reversible after cessation of
smoking. CONCLUSIONS: A considerable proportion of the elderly lacked
protective antibodies to commonly infecting pneumococcal serotypes 3, 6A,
and 8. Smoking increased the prevalence and levels of pneumococcal
antibodies probably as a consequence of numerous respiratory infections.
These observations emphasize the importance of administration of the
pneumococcal vaccine among the elderly.
ARTICLES
Effect of age, sex and smoking habits on pneumococcal antibodies in an elderly population
National Public Health Institute, Department in Oulu, Finland.
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