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Test ID: DTABS Diphtheria/Tetanus Antibody Panel, Serum

Useful For

Assessing antibody response to tetanus and diphtheria toxoid vaccines, which should be performed at least 3 weeks after immunization


Aiding in the evaluation of immunodeficiency


This test should not be used to diagnose tetanus infection

Profile Information

Test ID Reporting Name Available Separately Always Performed
DIPGS Diphtheria Toxoid IgG Ab, S Yes Yes
TTIGS Tetanus Toxoid IgG Ab, S Yes Yes

Method Name

Enzyme-Linked Immunosorbent Assay (ELISA)

Reporting Name

Diphtheria/Tetanus Ab Panel, S

Specimen Type


Specimen Required

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions: Centrifuge and aliquot serum into plastic vial.

Specimen Minimum Volume

0.8 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 30 days
  Frozen  30 days

Clinical Information

Diphtheria is an acute, contagious, febrile illness caused by the bacterium Corynebacterium diphtheriae. The disease is classically characterized by a combination of localized inflammation in the upper respiratory tract with the formation of a diphtheric pseudomembrane over the oropharynx, including the tonsils, pharynx, larynx, and posterior nasal passages. C diphtheriae produces a potent diphtheria exotoxin that is absorbed systemically and can lead to cardiac failure and paralysis of the diaphragm.



Tetanus results from contamination of wounds or lacerations with Clostridium tetani spores from the environment. The spores germinate to actively replicating bacterial cells localized within the wound and produce the heat-labile toxin tetanospasmin. Tetanospasmin attaches to peripheral nerve endings and travels to the central nervous system where it blocks inhibitory impulses to motor neurons and leads to severe, spastic muscle contractions, a classic characteristic of tetanus.


Both diseases are preventable by vaccination with diphtheria toxoid, which stimulates antidiphtheria toxoid antibodies, and tetanus toxoid (formaldehyde-treated tetanospasmin), which stimulates development of antitetanus toxoid antibodies. In the United States, these toxoids are administered to children as part of the combined diphtheria, tetanus, and acellular pertussis (TDaP) vaccine.


Two to 3 weeks following vaccination, a patient's immunological response may be assessed by measuring the antidiphtheria toxoid IgG antibody and total antitetanus toxoid IgG antibody levels in serum. An absence of either antibody formation postvaccination may relate to immune deficiency disorders, either congenital or acquired, or iatrogenic due to immunosuppressive drugs.

Reference Values


Vaccinated: Positive (≥0.01 IU/mL)

Unvaccinated: Negative (<0.01 IU/mL)

Reference values apply to all ages.



Vaccinated: Positive (≥0.01 IU/mL)

Unvaccinated: Negative (<0.01 IU/mL)

Reference values apply to all ages.



Results of 0.01 IU/mL or more suggest a vaccine response.


A diphtheria toxoid booster should be considered for patients with antidiphtheria toxoid IgG values between 0.01 and less than 0.1 IU/mL.



Results of 0.01 IU/mL or more suggest a vaccine response.


A tetanus toxoid booster should be strongly considered for patients with antitetanus toxoid IgG values between 0.01 and 0.5 IU/mL.


Some cases of tetanus, usually mild, have occasionally been observed in patients with a measurable serum level of 0.01 to 1.0 IU/mL.

Clinical Reference

1. Bleck TP: Clostridium tetani (tetanus). In: Mandell GL, Bennett JE, Dolin R, eds. Principals and Practice of Infectious Disease. 5th ed. Churchill Livingstone; 2000:2537-2543

2. Gergen PJ, McQuillan GM, Kiely M, Ezzati-Rice TM, Sutter RW, Virella G: A population-based serologic survey of immunity to tetanus in the United States. N Engl J Med. 1995 Mar;332(12):761-766

3. Bjorkholm B, Wahl M, Granstrom M, Hagberg L: Immune status and booster effects of low doses of tetanus toxoid in Swedish medical personnel. Scand J Infect Dis. 1994;26(4):471-475

4. Ramsay ME, Corbel MJ, Redhead K, Ashworth LA, Begg NT: Persistence of antibody after accelerated immunization with diphtheria/tetanus/pertussis vaccine. Br Med J. 1991 Jun;302(6791):1489-1491

5. Centers for Disease Control and Prevention (CDC); National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases. Diphtheria. CDC; Updated September 9, 2022. Accessed October 27, 2022. Available at

6. Truelove SA, Keegan LT, Moss WJ, et al: Clinical and epidemiological aspects of diphtheria: a systematic review and pooled analysis. Clin Infect Dis. 2020 Jun;71(1):89-97

Day(s) Performed

Monday through Friday

Report Available

Same day/1 to 4 days

Test Classification

This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

86317 x 2

LOINC Code Information

Test ID Test Order Name Order LOINC Value
DTABS Diphtheria/Tetanus Ab Panel, S In Process


Result ID Test Result Name Result LOINC Value
TETG Tetanus IgG Ab 33469-8
DIPG Diphtheria IgG Ab 45166-6
DEXDP Diphtheria IgG Value 48654-8
DEXTG Tetanus IgG Value 53935-3


If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.

Mayo Clinic Laboratories | Microbiology and Infectious Disease Catalog Additional Information: