[Clinical, laboratorial and radiographic predictors of Bordetella pertussis infection]

Epidemiology incidence and geographical distribution of Pertussis using GIS and its incidence prediction in Iran in 2021

Background: Pertussis is a respiratory tract infection caused by Bordetella pertussis, which causes inflammation of the lungs and respiratory tract. The purpose of this study was to investigate the incidence and geographical distribution of pertussis using the geographic information system (GIS) and to predict its incidence in Iran in 2021.

Methods: This was a descriptive analytical study. Information on pertussis was obtained from the Center for Communicable Diseases Control during 2009-2015. In the next step, the ArcGIS 9.3 was used to prepare geographic maps of the disease incidence and frequency. Therefore, the disease prediction map was drawn. using the Raster Calculator tool.

Results: The results showed that the highest incidence of pertussis during 2009-2015 was in Zanjan, Qom, Mazandaran, and Qazvin provinces. The incidence of pertussis in Iran increased from 0.74 in 2009 to 1.53 in 2015. Based on the modeling results for Iran, Qom, Mazandaran, Tehran, Qazvin, and Zanjan provinces, with 76.76%, 73.69%, 66.32%, 30.94% and 24.18% of their areas (Km2), are at high risk for pertussis in the coming years, respectively.

Conclusion: The incidence of the disease has been increasing in recent years, indicating the emergence of the disease in Iran. The modeling maps show that the Iranian provinces of Qom, Tehran, Zanjan, and Qazvin are at risk of the disease incidence in the coming years, indicating the need for planning, appropriate interventions and more precise implementation of the vaccination program against the disease.

Epidemiology of pertussis among adolescents, adults, and older adults in selected countries of Latin American: a systematic review

We aimed to describe the impact of pertussis on adolescents, adults, and older adults over 2007–2018 in selected Latin American countries by reviewing the literature. We searched the Medline, Embase, Scopus, LILACS, Scielo, Google Scholar, CAPES Journals Web-portal, and Cochrane databases for observational epidemiological studies, clinical trials, and systematic reviews of primary studies. Data were extracted and analyzed for all individuals aged ≥10 years. Of 6,891 studies identified only 25 were eligible. Studies were conducted in Brazil (14), Argentina (4), Colombia (4), Mexico (2) and Chile (1). Epidemiological data among target population were limited. No studies clearly assessed the status of asymptomatic or oligosymptomatic B. pertussis carriers in these age groups. Among all pertussis cases identified, the percentage of patients ≥10 years-old ranged between 2.1% and 66.7% depending on country and sample characteristics. The definition of cases, diagnostic methods, and age groups were not consistent across studies.

SEVERE PERTUSSIS IN CHILDHOOD: UPDATE AND CONTROVERSY - SYSTEMATIC REVIEW

Objective:

Through a systematic review, this essay aimed at revising the concepts of severe pertussis, updating the epidemiology, pathophysiology, clinical presentation, antibiotic therapy and auxiliary therapeutic options for symptomatology and complications.

Data sources:

This review considered publications from the last 30years in the databases US National Library of Medicine (PubMed), Scientific Electronic Library Online (SciELO), Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS), Cochrane, Google Scholar, as well as protocols of the Ministry of Health and recommendations of the Centers for Disease Control and Prevention, related to childhood pertussis (whooping cough), with emphasis on its severe form. This research was based on keywords derived from the terms “pertussis”, “azithromycin”, “antitussives”, “leukocyte reduction” in Portuguese and English. Duplicate studies and those with unavailable full-text were excluded.

Data synthesis:

Among 556 records found, 54 were selected for analysis. Pertussis, as a reemerging disease, has affected all age groups, evidencing the transient immunity conferred by infection and vaccination. Severe cases occur in neonates and infants, with secondary viral and bacterial complications and malignant pertussis, a longside hyperleukocytosis, respiratory failure and shock. Macrolides continue to be the chosen antibiotics, while antitussives for coughing remain without efficacy. The prompt treatment in Intensive Care Units improved the prognostic in severe cases, and transfusion was promising among procedures for leukoreduction.

Conclusions:

Approaching severe pertussis in childhood remains a challenge for diagnostic and therapy, as the available therapeutic options are still unsatisfactory. Strategies of prevention are expected to reduce the occurrence of severe cases, while new studies should confirm the role of auxiliary therapies.

Factors Associated with Time to Appropriate Treatment in Pertussis Cases in Georgia, 2009 to 2013

Pertussis is endemic in the United States, with periodic epidemics that continue to highlight its importance as a public health issue. The clinical presentation of pertussis can vary by age and vaccination status. However, little is known about the factors that affect time to antibiotic treatment of pertussis cases. We analyzed 5 years of data from the Georgia Department of Public Health to understand how factors such as age, symptoms, and vaccination status can alter the clinical picture of pertussis and affect time to treatment. We used multivariable linear regression to assess the impact of each variable on time to antibiotic treatment. There was little consistency across age groups for symptom and demographic predictors of time to antibiotic treatment. Overall, the multivariate linear regression showed that among patients ≤18 years old, none of the variables had an impact on time to antibiotic treatment greater than -0.25 to 1.47 days. Among patients >18 years old, most variables had little impact on time to treatment, though two (paroxysmal cough in >18- to 40-year-olds and hospitalization in individuals over 40) were associated with an additional 5 days in time to treatment from cough onset. This study highlights how the difficulties in pertussis diagnosis, particularly among adults, can affect time to antibiotic treatment; adults may not begin antibiotic treatment until there is an accumulation of symptoms. Health care providers need to recognize the variety of symptoms that pertussis can present with and consider confirmatory testing early.

Comparing Seasonal Pattern of Laboratory Confirmed Cases of Pertussis with Clinically Suspected Cases

Objectives

During recent decades, there has been limited attention on the seasonal pattern of pertussis within a high vaccine coverage population. This study aimed to compare the seasonal patterns of clinical suspected pertussis cases with those of laboratory confirmed cases in Iran.

Methods

The current study was conducted using time series methods. Time variables included months and seasons during 2011–2013. The effects of seasons and months on the incidence of pertussis were estimated using analysis of variance or Kruskal–Wallis.

Results

The maximum average incidence of clinically confirmed pertussis was 23.3 in July (p = 0.04), but the maximum incidence of clinical suspected pertussis was 115.7 in May (p = 0.6). The maximum seasonal incidences of confirmed and clinical pertussis cases were reported in summer (average: 12, p = 0.004), and winter (average: 108.1; p = 0.4), respectively.

Conclusion

The present study showed that the seasonal pattern of laboratory confirmed pertussis cases is highly definite and different from the pattern of clinical suspected cases.

Problem of immunoglobulin M co-detection in serological response to bacterial and viral respiratory pathogens among children suspected of legionellosis

The objective of this research was an analysis of the serological response to respiratory bacterial and viral pathogens, in 156 children admitted to hospital in Warsaw with a suspicion of legionellosis. Levels of immunoglobulin (Ig) M to Bordetella pertussis, Mycoplasma pneumoniae, respiratory syncytial virus (RSV), adenoviruses, human parainfluenza virus (HPIV) t. 1-4 and influenza t. A + B viruses were determined retrospectively by ELISAs. In the prospective examinations (only Legionella pneumophila sg1), a positive level of IgM was found in 35 patients, but in 59 children together with retrospective tests. There were positive results for B. pertussis (21 children), followed by HPIV (10 children), M. pneumoniae (5 patients), RSV (4 persons), adenoviruses (3 children), and influenza A + B virus (3 persons). Positive results for > 1 agent were found in 16 children. The most often co-detected IgM were to L. pneumophila sg1 and B. pertussis (9 children) and L. pneumophila sg1 and M. pneumoniae (5 patients). The distribution of IgM to L. pneumophila sg1, B. pertussis and HPIV among children ≤ 4 years differed significantly from IgM specific to other pathogens. A high number of HPIV infections, mainly single, was found among infants. Positive results of IgM to L. pneumophila sg1 were mainly found in children aged 4-5 years. and the oldest children (over 10 years.). However, among the oldest children, anti-L. pneumophila sg1 antibodies were often found together with IgM to B. pertussis. Infections due to more than 2 pathogens were only observed among patients with pneumonia, especially due to L. pneumophila sg1 and/or B. pertussis. Conversely, co-detection of IgM ELISA for L. pneumophila and M. pneumoniae were mainly detected among patients hospitalized without pneumonia.