[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-289641-105":59,"doc-detail-289641-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","diphtheria-anti-toxin-dat-supply-issues-brief-review-and-proposition","Diphtheria anti-toxin (DAT) supply issues - brief review and proposition","","Brief review and proposal on diphtheria anti-toxin (DAT) supply challenges. DAT, once the primary therapy before widespread vaccination, is now unavailable routinely as manufacturers declined and routine production ceased. Small stockpiles are often depleted or extended after re-testing, while rapid identification and shipment may arrive too late for effective treatment. The document surveys manufacturing capacity, outlines potential demand for 4,000–8,000 courses, discusses equine DAT dosing and diagnostics, and evaluates alternatives and stockpile strategy for UN procurement.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/diphtheria-anti-toxin-dat-supply-issues-brief-review-and-proposition/289641/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/diphtheria-anti-toxin-dat-supply-issues-brief-review-and-proposition/289641.png","ImageObject",300,407,{"name":92,"@type":93},"Caleb Sterling","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-09-17",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is DAT supply currently constrained?","Question",{"text":112,"@type":113},"DAT production declined after vaccine adoption and reduced diphtheria incidence, leaving no routine manufacturer. Only a few producers retain procedures and horse flocks needed to supply the product.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What problem can occur even when DAT stockpiles exist?",{"text":117,"@type":113},"Many stockpiles are small, depleted, or have expiry dates extended through re-testing. For suspected or confirmed cases without an available stockpile, delays identifying a current supplier and arranging shipment can make treatment arrive too late.",{"name":119,"@type":110,"acceptedAnswer":120},"What alternatives to equine-derived DAT are discussed?",{"text":121,"@type":113},"Human polyclonal DAT is available for diagnostics but not for therapeutic use. Convalescent-patient plasma has been studied but is not a commercial product, while monoclonal DAT preparations are in development and not yet available.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},289641,1790115298,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":39},962084925290,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Diphtheria anti-toxin (DAT) supply issues: brief review and proposition  \nDiphtheria anti-toxin (DAT) was the first immunotherapeutic ever used. It was developed in the late 19th century, and until the development and use of diphtheria vaccine, DAT was the primary intervention for diphtheria, reducing case fatality rates from 25-50% in untreated patients to 3% inpatients treated earlyi. It is obtained by immunizing horses with inactivated diphtheria toxin, and purifying the immunoglobulins.  \nDuring the first half of the 20th century many countries produced DAT for national use, however with the increasing use of vaccine and declining incidence of the disease the market for DAT collapsed, and with it the number of manufacturers. As a result there is no manufacturer producing DAT on a routine basis, and only a few manufacturers have retained the procedures and necessary horse flocks to be able to provide this product (see below) .  \nA few countries have been maintaining stockpiles, however these stockpiles are small and most have either expired or have had the expiry dates extended through re-testing by an independent laboratory to confirm activity of the product. In Europe 60% of member states have reported obtaining DAT supplies even for diagnostics highlighting risksii. Other countries such as South Africa facing small outbreaks, have made requests to manufacturers for supply of a few vials. Effective treatment of cases requires rapid access to and administration of DAT. In the event of a suspected or confirmed case in the absence of a stockpile the time taken to identify a manufacturer with remaining supply within expiry date (if at all available), and the time to arrange for shipment, may mean the supply arrives too late to save the lives of the patients. Regional stockpiles that can be readily accessed may be a preferable solution.  \nAlternatives to equine-derived DAT:  \nHuman polyclonal DAT is available for diagnostic purposes. While a DAT prepared from blood donations was developed in Australia in the 1970s iiithere is currently no supply for therapeutic use. Studies during the outbreak in Russia in the 1990s showed that plasma from selected donors amongst convalescent patients could be used iv however this is not a commercial product.  \nSeveral groups are developing monoclonal DAT preparationsv including MassBio (USA) which has demonstrated efficacy of their monoclonal in preclinical models. A monoclonal DAT preparation could have significant advantages over equine DAT in that the quality and safety issues associated with equine preparations would be avoided, and in theory supplies could be assured. It will however require several years of clinical development and several million dollars of public-sector funds to bring this product to approval, and the production costs are unlikely to be less than for the equine product. While this may become a useful product in the future it is not currently available.  \nManufacturing capacity for equine DAT:  \nThe manufacturers known (through written confirmation) to have current DAT manufacturing capacity (but not necessarily maintaining supplies) are:  \nIndia: VINS Bioproducts Ltd.  \nPremium serums & vaccines Ltd. (which has acquired the SIIL process) . Brazil: Butantan Institute.  \nManufacturers thought to have DAT manufacturing capacity (no reply to written enquiry to date): Russia: Microgen  \nJapan: Kaketsuken  \nIran: Razi Institute  \nPotential Needs  \nThe number of reported cases each year and by region are as follows:  \nThis suggests that an annual supply of 4000-8000 treatment courses would be required to enable access for all patients. DAT is administered intravenously in a saline drip over 2-4 hours. Testing for sensitivity to DAT through a scratch test or an ID test must be performed prior to administering DAT. Treatment therefore requires access to appropriate health care infrastructure as well as appropriate diagnostic capacity.  \nDAT is usually provided as lyophilised i","cbCaig4bXQOVaDVH","https://ap.wps.com/l/cbCaig4bXQOVaDVH","pdf",204585,"English","# Diphtheria anti-toxin (DAT) supply issues\n## Background and current market situation\n## Stockpiles and access risks\n## Alternatives to equine-derived DAT\n## Manufacturing capacity for equine DAT\n## Potential needs and dosing assumptions\n## Conclusion and procurement considerations","[{\"question\":\"Why is DAT supply currently constrained?\",\"answer\":\"DAT production declined after vaccine adoption and reduced diphtheria incidence, leaving no routine manufacturer. Only a few producers retain procedures and horse flocks needed to supply the product.\"},{\"question\":\"What problem can occur even when DAT stockpiles exist?\",\"answer\":\"Many stockpiles are small, depleted, or have expiry dates extended through re-testing. For suspected or confirmed cases without an available stockpile, delays identifying a current supplier and arranging shipment can make treatment arrive too late.\"},{\"question\":\"What alternatives to equine-derived DAT are discussed?\",\"answer\":\"Human polyclonal DAT is available for diagnostics but not for therapeutic use. Convalescent-patient plasma has been studied but is not a commercial product, while monoclonal DAT preparations are in development and not yet available.\"}]","Diphtheria anti-toxin (DAT) supply issues - brief review and proposition | PDF",1789636136]