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Leber AL, Salamon DP, Prince HE. Pertussis Diagnosis in the 21st Century: Progress and Pitfalls, Part II. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.clinmicnews.2011.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Huang LM, Chang LY, Tang H, Bock HL, Lu CY, Huang FY, Lin TY, Lee CY. Immunogenicity and reactogenicity of a reduced-antigen-content diphtheria-tetanus-acellular pertussis vaccine in healthy Taiwanese children and adolescents. J Adolesc Health 2005; 37:517. [PMID: 16310132 DOI: 10.1016/j.jadohealth.2005.08.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2005] [Revised: 08/02/2005] [Accepted: 08/10/2005] [Indexed: 11/30/2022]
Abstract
PURPOSE Disease caused by Bordetella pertussis is increasingly being identified among older children and adults in immunized populations, indicating a waning of the vaccine-induced immunity. These findings suggest the need for booster immunization of older children and adults. Modern acellular reduced-antigen-content vaccines have been developed, which can be given as a booster in individuals more than 4 years of age. This study was to assess the immunogenicity and reactogenicity of Boostrix, GlaxoSmithKline Biologicals' reduced-antigen-content diphtheria-tetanus acellular pertussis (dTpa) vaccine, when administered as a booster in healthy subjects previously primed with DTP vaccine. METHODS Healthy Taiwanese children and adolescents aged 6-8 years and 15-20 years, previously primed with DTP vaccine, were enrolled. All received one dose of Boostrix. Two blood samples were taken from each of them, one before vaccination and one at 1 month after vaccination. Serum antibodies to diphtheria and tetanus toxoids and immunoglobulin G (IgG) antibodies against the pertussis components PT, FHA and PRN were measured by enzyme-linked immunosorbent assay (ELISA) technique. Adverse reactions following vaccination were recorded. RESULTS A total of 180 subjects were recruited. The vaccine response rates to the pertussis antigens ranged between 89.0-100%. There were no serious adverse events reported during the study period. CONCLUSIONS The results of this study suggest that Boostrix may be safely and effectively administered as a booster dose to children previously primed with DTP vaccine.
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Affiliation(s)
- Li-Min Huang
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
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McIntyre PB, Turnbull FM, Egan AM, Burgess MA, Wolter JM, Schuerman LM. High levels of antibody in adults three years after vaccination with a reduced antigen content diphtheria-tetanus-acellular pertussis vaccine. Vaccine 2005; 23:380-5. [PMID: 15530684 DOI: 10.1016/j.vaccine.2004.05.030] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2002] [Revised: 05/14/2004] [Accepted: 05/24/2004] [Indexed: 10/26/2022]
Abstract
There is increasing interest in prevention of pertussis in adults by vaccination, but little is known about the duration of the antibody response to pertussis, diphtheria or tetanus in reduced antigen content vaccines formulated for adult use. Follow-up of a clinical trial including 550 adults comparing responses to reduced antigen content diphtheria-tetanus-acellular pertussis (dTpa) vaccine, or a licensed Td vaccine, provided the opportunity to evaluate this. Blood samples were collected at 0, 1, 12, 24 and 36 months following vaccination; of the original cohort of 550, 387 subjects (dTpa group N=310, Td+pa group N=77) were tested at month 36. Following a decrease in antibody levels against all vaccine antigens between one and 24 months following vaccination, levels stabilized during the third year, remaining higher at 36 months than pre-vaccination for all vaccine antigens. In particular, more than 90% of subjects remained seropositive for pertussis toxin and pertactin antibodies at 36 months after vaccination, suggesting ongoing protection against pertussis. Adult-formulated dTpa vaccines could replace Td for routine booster vaccination of older individuals.
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Affiliation(s)
- Peter B McIntyre
- Centre for Immunisation Research, University of Sydney and the Royal Alexandra Hospital for Children, Locked Bag 4001, Westmead, NSW 2145, Australia.
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Cherry JD, Grimprel E, Guiso N, Heininger U, Mertsola J. Defining pertussis epidemiology: clinical, microbiologic and serologic perspectives. Pediatr Infect Dis J 2005; 24:S25-34. [PMID: 15876920 DOI: 10.1097/01.inf.0000160926.89577.3b] [Citation(s) in RCA: 134] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In the past decade, numerous sources have noted an increase in reported pertussis in highly immunized populations. This has been accompanied by a perceived change in disease epidemiology, characterized by a significant increase in reported pertussis incidence among adolescents and adults. In populations where children are routinely immunized, adolescents and adults now constitute the main source of infection in infants. However, a range of factors makes delineation of these epidemiologic trends difficult. Reported cases of pertussis represent only a fraction of the actual number of Bordetella pertussis symptomatic infections, because underconsulting, underrecognition and underdiagnosis are widespread and are a particular problem in adolescents and adults. Possible explanations for failure to diagnose pertussis include the heterogeneity in pertussis disease expression and low physician awareness and index of suspicion. Consequently defining pertussis from a clinical perspective is difficult, and this is reflected by a lack of consistency between case definitions. Although case definitions for specific circumstances have been established by the World Health Organization and the United States Centers for Disease Control, these are not universally useful, making intercountry comparisons and global evaluation difficult. Less-than-optimal and poorly performed laboratory tests, or their lack of availability, also make confirmation of B. pertussis infection difficult. To overcome these problems, clinical case definitions should be standardized for outbreak and endemic situations. Rapid, easy-to-use and inexpensive laboratory diagnostic techniques also must be made available and be widely implemented. In particular, polymerase chain reaction and single serum serology are 2 techniques that should be more widely adopted.
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Affiliation(s)
- James D Cherry
- David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
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Mattoo S, Cherry JD. Molecular pathogenesis, epidemiology, and clinical manifestations of respiratory infections due to Bordetella pertussis and other Bordetella subspecies. Clin Microbiol Rev 2005; 18:326-82. [PMID: 15831828 PMCID: PMC1082800 DOI: 10.1128/cmr.18.2.326-382.2005] [Citation(s) in RCA: 778] [Impact Index Per Article: 40.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Bordetella respiratory infections are common in people (B. pertussis) and in animals (B. bronchiseptica). During the last two decades, much has been learned about the virulence determinants, pathogenesis, and immunity of Bordetella. Clinically, the full spectrum of disease due to B. pertussis infection is now understood, and infections in adolescents and adults are recognized as the reservoir for cyclic outbreaks of disease. DTaP vaccines, which are less reactogenic than DTP vaccines, are now in general use in many developed countries, and it is expected that the expansion of their use to adolescents and adults will have a significant impact on reducing pertussis and perhaps decrease the circulation of B. pertussis. Future studies should seek to determine the cause of the unique cough which is associated with Bordetella respiratory infections. It is also hoped that data gathered from molecular Bordetella research will lead to a new generation of DTaP vaccines which provide greater efficacy than is provided by today's vaccines.
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Affiliation(s)
- Seema Mattoo
- Department of Microbiology, Immunology, and Molecular Genetics, David Geffen School of Medicine, University of California, Los Angeles, California 90095-1752, USA
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Fiszer U, Tomik B, Grzesiowski P, Krygowska-Wajs A, Walory J, Michałowska M, Palasik W. The antibodies against Bordetella pertussis in sera of patients with Parkinson's disease and other non-neurological diseases. Acta Neurol Scand 2004; 110:113-7. [PMID: 15242419 DOI: 10.1111/j.1600-0404.2004.00285.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES It has been reported that the prevalance of parkinsonism might be associated with exposure to whooping cough. METHODS Examination of levels of antibodies against Bordetella pertussis in serum using enzyme-linked immunosorbent assay (ELISA) tests [presence of IgG antibodies against filamentous hemagglutinin and pertussis toxin (PT)] were performed in 81 persons (including 45 patients with controls) (age-matched groups). RESULTS Positive results were found in patients with Parkinson's disease (PD), patients with other non-inflammatory diseases, and controls (about 40-45% in each group). A detailed examination of separate responses (IgG and IgA antibodies against PT, and a whole cell immune response) and of the serum level of immunoglobulins IgG, IgA and IgM was also performed. CONCLUSION Our results demonstrate numerous cases of whooping cough serum antibodies among the adult population (also among PD patients). The results of our research, i.e. a common occurrence of Bordetella pertussis infection do not provide evidence of relationship between PD and the above-mentioned infection.
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Affiliation(s)
- U Fiszer
- Department of Neurology and Epileptology, Medical Center for Postgraduate Education, Warsaw, Poland.
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Tilley PA, Kanchana MV, Knight I, Blondeau J, Antonishyn N, Deneer H. Detection of Bordetella pertussis in a clinical laboratory by culture, polymerase chain reaction, and direct fluorescent antibody staining; accuracy, and cost. Diagn Microbiol Infect Dis 2000; 37:17-23. [PMID: 10794935 DOI: 10.1016/s0732-8893(00)00117-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Control of Bordetella pertussis in the community is hampered by slow and insensitive diagnostic tests. We therefore examined the accuracy and cost of culture, direct fluorescent antibody (DFA) staining, and PCR in a routine clinical laboratory. Six hundred thirty seven nasopharyngeal swabs and aspirates in casamino acids transport medium were cultured, stained with polyclonal (Difco), and monoclonal (BL-5 and Accu-Mab) anti-B. pertussis reagents, and amplified by an IS481-specific PCR. PCR products were detected by a hybridization-enzyme immunoassay kit (Gen-eti-k DEIA, DiaSorin), with confirmation by a second PCR in a separate laboratory. Sensitivities and specificities of culture, polyclonal DFA, monoclonal DFA, and PCR were 36 and 100%, 11.4 and 94.6%, 8.3 and 98. 4%, and 95.0 and 99.3%, respectively, with a prevalence of 15.7%. The DFA tests were the most economical, and the PCR cost was 31% higher than culture. This study suggests that with minor improvements in economy, pertussis PCR can be implemented in a clinical laboratory with marked improvement in diagnostic accuracy.
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Affiliation(s)
- P A Tilley
- Dept of Microbiology and Immunology, University of Saskatchewan, Saskatoon, SK, Canada.
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Van der Wielen M, Van Damme P, Joossens E, François G, Meurice F, Ramalho A. A randomised controlled trial with a diphtheria-tetanus-acellular pertussis (dTpa) vaccine in adults. Vaccine 2000; 18:2075-82. [PMID: 10715521 DOI: 10.1016/s0264-410x(99)00568-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of this assessor-blinded trial was to compare the immunogenicity and reactogenicity of a candidate diphtheria, tetanus toxoids and acellular pertussis vaccine with reduced antigen content for diphtheria and pertussis (dTpa) with a licensed reduced adult-type diphtheria-tetanus vaccine Td (reduced diphtheria content) and with an experimental candidate monovalent acellular pertussis vaccine with reduced antigen content (pa). The dTpa and pa vaccines had identical pertussis antigen content. A total of 299 healthy adults (> or =18 years, mean age: 30.1 years+/-10.7) were randomised into 3 groups to receive a single dose of one of the study vaccines. In all groups, clinically significant reactions (severe) were infrequent (0-6%) and no serious adverse events were reported during the study. The incidence of local and systemic reactions following the administration of dTpa was comparable to the Td vaccine group. Of the total study group, prior to vaccination 52. 3 and 93.2% of the subjects had anti-diphtheria and anti-tetanus antibody levels > or = 0.1 IU/ml, respectively; and 73.1, 98.2 and 74.5% of the subjects were seropositive for pertussis toxin (PT), filamentous hemagglutinin (FHA) and pertactin (PRN) antibodies, respectively. One month after vaccination, a similar percentage of subjects in the dTpa and Td groups had anti-diphtheria (88.4% vs 90. 1%) and anti-tetanus (100% vs 98.9%) antibody levels > or =0.1 IU/ml. Similar anti-FHA (100%) and anti-PRN (98.9%) vaccine response rates were seen in the dTpa and pa groups, while the anti-PT vaccine response rates were 96.8 and 100.0%, respectively. The dTpa vaccine is as well tolerated and immunogenic as the licensed Td vaccine, and additionally, can also boost antibodies against pertussis.
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Affiliation(s)
- M Van der Wielen
- Centre for the Evaluation of Vaccination, Epidemiology and Community Medicine, University of Antwerp, Antwerp, Belgium
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Nygren M, Reizenstein E, Ronaghi M, Lundeberg J. Polymorphism in the pertussis toxin promoter region affecting the DNA-based diagnosis of Bordetella infection. J Clin Microbiol 2000; 38:55-60. [PMID: 10618063 PMCID: PMC86018 DOI: 10.1128/jcm.38.1.55-60.2000] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The pertussis toxin (PT) promoter region is a frequently used target for DNA-based diagnosis of pertussis and parapertussis infections. The reported polymorphism in this region has also allowed discrimination of species in mixtures with several Bordetella species by their specific PCR amplicon restriction patterns. In the present study, we investigated the degree of polymorphism in order to confirm the reliability of the assay. Five different sequence types of the amplified 239- or 249-bp region were found among the 33 Bordetella pertussis, B. parapertussis, and B. bronchiseptica American Type Culture Collection reference strains and patient isolates analyzed. According to the sequences that were obtained and according to the PT promoter sequences already available in the databases, restriction enzyme analysis with TaqI, BglI, and HaeII, which gave four different patterns, can be performed to reliably identify B. pertussis, B. parapertussis, and B. bronchiseptica.
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Affiliation(s)
- M Nygren
- Department of Biotechnology, KTH, Royal Institute of Technology, Sweden
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Affiliation(s)
- J E Hoppe
- University Children's Hospital, Tübingen, Germany
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Weber DJ, Rutala WA. Pertussis: An Underappreciated Risk for Nosocomial Outbreaks. Infect Control Hosp Epidemiol 1998. [DOI: 10.2307/30141559] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Hoppe JE. State of art in antibacterial susceptibility of Bordetella pertussis and antibiotic treatment of pertussis. Infection 1998; 26:242-6. [PMID: 9717684 DOI: 10.1007/bf02962373] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- J E Hoppe
- Universitätskinderklinik, Tübingen, Germany
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Hoppe JE, Paulus T. Comparison of three media for agar dilution susceptibility testing of Bordetella pertussis using six antibiotics. Eur J Clin Microbiol Infect Dis 1998; 17:391-3. [PMID: 9758277 DOI: 10.1007/bf01691567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Since antimicrobial susceptibility testing of the fastidious species Bordetella pertussis is not standardized, the most suitable medium for agar dilution testing of this species has not yet been determined. In the present study, Mueller-Hinton, Bordet-Gengou, and Oxoid charcoal agars (each supplemented with 5% horse blood) were evaluated for agar dilution susceptibility testing of Bordetella pertussis against ampicillin, chloramphenicol, ciprofloxacin, doxycycline, erythromycin, and trimethoprim-sulfamethoxazole. Mueller-Hinton agar was the most suitable medium.
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Affiliation(s)
- J E Hoppe
- Section of Bacteriology, University Children's Hospital, Tübingen, Germany
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Müller FM, Hoppe JE, Wirsing von König CH. Laboratory diagnosis of pertussis: state of the art in 1997. J Clin Microbiol 1997; 35:2435-43. [PMID: 9316885 PMCID: PMC229988 DOI: 10.1128/jcm.35.10.2435-2443.1997] [Citation(s) in RCA: 128] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- F M Müller
- University Children's Hospital, Aachen, Germany.
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Hoppe JE, Tschirner T. Comparison of Etest and agar dilution for testing the activity of three macrolides against Bordetella parapertussis. Diagn Microbiol Infect Dis 1997; 28:49-51. [PMID: 9218920 DOI: 10.1016/s0732-8893(97)89160-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Agar dilution and Etest using Mueller-Hinton II agar supplemented with 5% whole defibrinated horse blood were compared for testing the activities of azithromycin, clarithromycin, and erythromycin against 34 clinical isolates of the fastidious species Bordetella parapertussis. There was good overall agreement (100.0% within +/- 1 log2 dilution step) between both methods. The Etest offers an excellent and convenient alternative to agar dilution for testing the activities of macrolides against B. parapertussis.
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Affiliation(s)
- J E Hoppe
- Section of Bacteriology, University Children's Hospital, Tübingen, Germany
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