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Iusitini L, Pacheco G, Schober T. Assessing the impact of the COVID-19 pandemic on childhood vaccine uptake with administrative data. SSM Popul Health 2024; 26:101657. [PMID: 38596363 PMCID: PMC11002846 DOI: 10.1016/j.ssmph.2024.101657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/29/2024] [Accepted: 03/14/2024] [Indexed: 04/11/2024] Open
Abstract
This study examines the impact of the COVID-19 pandemic on childhood vaccination coverage in New Zealand using population-wide administrative data. For each immunisation event from ages 6 weeks to 4 years, we compare vaccine uptake of children who became eligible for immunisation during the pandemic to earlier-born cohorts whose immunisations were due before the pandemic. We find that the initial phase of the pandemic had, on average, small or nil effects on timely immunisation at the four infancy events, but a large effect at the 4-year event of -15 percentage points. Nine months after eligibility, catch-up among the pandemic-affected cohorts was largely achieved for the infancy immunisations, but 4-year coverage remained 6 percentage points below pre-pandemic levels. Vaccine uptake at 4 years initially dropped most among children of European ethnicity and of non-beneficiary parents but catch-up quickly surpassed their Māori, Pacific, and beneficiary counterparts for whom sizeable gaps in coverage below pre-pandemic levels remained at the end of our observation period. The pandemic thus widened pre-existing inequalities in immunisation coverage.
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Affiliation(s)
- Leon Iusitini
- New Zealand Policy Research Institute, Auckland University of Technology, New Zealand
| | - Gail Pacheco
- New Zealand Policy Research Institute, Auckland University of Technology, New Zealand
| | - Thomas Schober
- New Zealand Policy Research Institute, Auckland University of Technology, New Zealand
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2
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Patiño P, Gallego C, Martínez N, Iregui C, Rey A. Effect of carbohydrates on the adhesion of Bordetella bronchiseptica to the respiratory epithelium in rabbits. Vet Res Commun 2024; 48:1481-1495. [PMID: 38336962 PMCID: PMC11147920 DOI: 10.1007/s11259-024-10307-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 01/10/2024] [Indexed: 02/12/2024]
Abstract
This study proposes an ecological approach for preventing respiratory tract infections caused by Bordetella bronchiseptica in mammals using a mixture of carbohydrates. In an in vivo study, 51-day-old New Zealand rabbits were treated with a solution containing 1 × 107 CFUs of B. bronchiseptica and 250 μg of one of the following carbohydrates: N acetylglucosamine (GlcNAc), N acetylgalactosamine (GalNAc), alpha methyl mannose (AmeMan), alpha methyl glucose (AmeGlc) and sialic acid (Neu5AC). Positive (B. bronchiseptica) and negative (Physiological Saline Solution (PSS)) controls were included. Animals treated with GlcNAc or AmeGlc showed no clinical signs of infection and exhibited a significant reduction (p < 0.05) in the severity of microscopic lesions evaluated in the nasal cavity and lung compared with the positive controls. Additionally, the presence of bacteria was not detected through microbiological isolation or PCR in the lungs of animals treated with these sugars. Use of a mixture of GlcNAc and AmeGlc resulted in greater inhibition of microscopic lesions, with a significant reduction (p < 0.05) in the severity of these lesions compared to the results obtained using individual sugars. Furthermore, the bacterium was not detected through microbiological isolation, Polymerase Chain Reaction (PCR) or indirect immunoperoxidase (IIP) in this group.
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Affiliation(s)
- Pilar Patiño
- Pathobiology Group, Laboratory of Veterinary Pathology, Faculty of Veterinary Medicine and Zootechnics, Universidad Nacional de Colombia (UN), Bogotá D.C., Colombia
| | - Carolina Gallego
- Laboratory of Veterinary Pathology, Universidad de Ciencias Aplicadas y Ambientales, Bogotá D.C., Colombia
| | - Nhora Martínez
- Pathobiology Group, Laboratory of Veterinary Pathology, Faculty of Veterinary Medicine and Zootechnics, Universidad Nacional de Colombia (UN), Bogotá D.C., Colombia
| | - Carlos Iregui
- Pathobiology Group, Laboratory of Veterinary Pathology, Faculty of Veterinary Medicine and Zootechnics, Universidad Nacional de Colombia (UN), Bogotá D.C., Colombia
| | - Alba Rey
- Pathobiology Group, Laboratory of Veterinary Pathology, Faculty of Veterinary Medicine and Zootechnics, Universidad Nacional de Colombia (UN), Bogotá D.C., Colombia.
- Faculty of Agricultural Sciences, Veterinary Medicine Program, Fundación Universitaria Agraria de Colombia, Bogotá D.C., Colombia.
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Chen J, Shin JY, Kim H, Kim JH, Choi A, Cheong HJ, Oh YM, Guignard A, Shantakumar S. Incidence and Healthcare Burden of Pertussis among Older Adults with and without Pre-Existing Chronic Obstructive Pulmonary Disease or Asthma in South Korea. COPD 2023; 20:126-134. [PMID: 37093711 DOI: 10.1080/15412555.2023.2169120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
A retrospective cohort study was conducted to examine trends in the incidence and burden of pertussis among adults ≥50 years in South Korea, with/without pre-existing chronic obstructive pulmonary disease (COPD) or asthma. The nationwide Health Insurance Review and Assessment Service (HIRA) database was used to identify patients ≥50 years diagnosed with pertussis (2009-2018). Mean annual incidence of pertussis per 100 000 persons and overall mean incidence rate ratios (IRR) were calculated for patients with pre-existing COPD or asthma versus those with neither. Incremental healthcare costs (all-cause and pertussis-related) and healthcare utilisation (number of outpatient visits, emergency room visits, and number and length of hospitalisations) up to 12 months after, compared to 3 months before pertussis diagnosis, were also measured for each group (matched on sex, age, and Charlson Comorbidity Index). Of 1011 pertussis cases, 175 had asthma, 96 had COPD (not mutually exclusive), and 796 had neither. Overall mean pertussis incidence was 2.5, 3.4, and 0.5 for adults with pre-existing COPD, asthma, and those with neither. IRR (95% confidence interval) of pertussis for adults with pre-existing COPD and asthma was 4.9 (4.0-6.1) and 6.7 (5.7-7.9). Both COPD-pertussis and asthma-pertussis groups had higher mean incremental all-cause costs and length of hospitalisations than the general-pertussis group 3 months following pertussis diagnosis. In conclusion, individuals ≥50 years in South Korea with pre-existing COPD or asthma were at an increased risk of being diagnosed with pertussis and had higher healthcare resource utilisation than those without these conditions.
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Affiliation(s)
| | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea
| | | | - Ju Hwan Kim
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
| | - Ahhyung Choi
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
| | - Hee Jin Cheong
- Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Yeon-Mok Oh
- Department of Pulmonology and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
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Versteeg JW, Jamet N, Redekop K. Cost of illness due to pertussis in adults ≥50 years of age in the United Kingdom. Vaccine 2023; 41:6991-6998. [PMID: 37839946 DOI: 10.1016/j.vaccine.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 10/04/2023] [Accepted: 10/04/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Pertussis is an endemic respiratory tract infection caused by Bordetella pertussis that may affect all individuals from infants to older adults. Pertussis incidence in adults is often underreported and in various countries, including the United Kingdom (UK), there are evidence gaps on pertussis-associated economic burden in the older adult population. We aimed to quantify the economic burden of pertussis in adults aged ≥50 years in the UK. METHODS A cost-of-illness study was conducted to estimate the cost of pertussis from a societal perspective. We utilized a sum diagnosis cost approach in which costs related to infection with pertussis were included. Medical, patient, and indirect costs were calculated individually and combined to calculate total costs. A framework was developed to assess costs for consecutive age groups from 50-54 years of age to ≥85 years of age. Sensitivity and scenario analyses were used to assess analysis uncertainty. RESULTS The base-case analysis estimated the total annual economic burden of pertussis to be approximately £238 million (M). This comprised approximately £159 M in indirect costs, £66 M in medical costs, and £13 M in patient costs. Costs for the age group 55-59 years had the highest impact on the economic burden, with approximately £79 M in total annual costs. Visits to general practitioners and nurses were the largest contributors to medical costs (∼£37 M) followed by inpatient visits (∼£21 M). Transportation costs (∼£10 M) were the major patient costs. Productivity loss (∼£71 M) and leisure time loss (∼£72 M) had comparable contributions to annual indirect costs. Sensitivity and scenario analyses suggested that incidence rates, indirect costs, and underreporting estimates had the highest impact on outcomes. CONCLUSION Total cost of pertussis in the UK among adults ≥50 years of age is substantial and highest for adults 55-59 years of age. Indirect costs were the main contributors to the economic burden.
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Affiliation(s)
| | | | - Ken Redekop
- Erasmus School of Health Policy & Management, Rotterdam, the Netherlands
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Mercogliano M, Fiorilla C, Esposito F, Sorrentino M, Mirizzi PD, Parisi A, Tajani A, Buonocore G, Triassi M, Palladino R. Knowledge and attitude factors associated with the prevalence of Tdap (tetanus, diphtheria, and acellular pertussis) booster vaccination in healthcare workers in a large academic hospital in Southern Italy in 2022: a cross-sectional study. Front Public Health 2023; 11:1173482. [PMID: 37522000 PMCID: PMC10374026 DOI: 10.3389/fpubh.2023.1173482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/13/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction In Europe, there is still suboptimal tetanus, diphtheria, and acellular pertussis (Tdap) booster coverage. This study aimed to assess coverage status, knowledge, and attitude on Tdap vaccination in healthcare workers (HcWs) of the University Hospital "Federico II" in Naples, Southern Italy, in 2022, to improve current vaccination strategies. Methods A cross-sectional study was conducted using a validated anonymous questionnaire. Knowledge and attitude were measured as scores. Multivariable logistic and linear regression models were employed to identify correlates of Tdap booster and knowledge and attitude toward the vaccination, as appropriate. Models were controlled for age, sex, profession, department, and job seniority. Results A total of 206 questionnaires were administered among HcWs, and 143 (69.4%) were medical doctors. In total, 71 (34.47%) HcWs received the Tdap booster. Those who have worked 5-9 years at the hospital had a 78% lower likelihood of being vaccinated with the Tdap booster (5-9 years-OR: 0.22, CI: 0.06 | 0.85) as compared with newly hired HcWs. No differences in the average knowledge score were found. Other healthcare workers had a lower attitude as compared to medical doctors (Other-Coef. -2.15; CI: -4.14 | -0.15) and, as compared with those who worked in a clinical department, those who worked in a diagnostic-therapeutic department or medical management had 3.1 and 2.0 lower attitude scores, on average, respectively (diagnostic-therapeutic-Coef. -3.12, CI: -5.13 | -1.12; public health-Coef. -1.98, CI: -3.41 | -0.56). Discussion The study findings support the necessity to implement public health strategies and improve knowledge and attitude toward vaccinations and specifically highlight the importance of Tdap booster every 10 years as a prevention tool to protect high-risk populations.
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Affiliation(s)
| | - Claudio Fiorilla
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | - Federica Esposito
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | - Michele Sorrentino
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | | | - Antonio Parisi
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | - Andrea Tajani
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | - Gaetano Buonocore
- Clinical Directorate, University Hospital “Federico II” of Naples, Naples, Italy
| | - Maria Triassi
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), Naples, Italy
| | - Raffaele Palladino
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), Naples, Italy
- Department of Primary Care and Public Health, School of Public Health, Imperial College, London, United Kingdom
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Kim H, Shin JY, Chen J, Kim JH, Noh Y, Cheong HJ, Oh YM, Guignard A, Shantakumar S. Risk Factors of Pertussis Among Older Adults in South Korea: A Nationwide Health Data-Based Case-Control Study. Infect Dis Ther 2023; 12:545-561. [PMID: 36588139 PMCID: PMC9925654 DOI: 10.1007/s40121-022-00747-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 12/12/2022] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION To better understand the conditions associated with pertussis diagnosis among older adults in South Korea, a matched case-control study was conducted of individuals ≥ 50 years diagnosed with pertussis between 2009 and 2018. METHODS Pertussis cases were identified using the nationwide Health Insurance Review and Assessment service (HIRA) database. Each case was then matched to up to 10 controls identified using the National Health Insurance Service-National Sample Cohort (NHIS-NSC) by age, sex, and geographic region at index date. In the 12 months and 30 days prior to index date, the presence of clinical characteristics previously reported to be related to pertussis and pertussis-like conditions were assessed, respectively. A conditional multivariate logistic regression model was then used to calculate odds ratios (ORs) of pertussis diagnosis, adjusted for each of the characteristics. RESULTS Pertussis cases (n = 1004) generally demonstrated a higher prevalence of comorbidities compared to controls (n = 9710). Pre-existing asthma and chronic obstructive pulmonary disease (COPD) within 12 months of index date were associated with a two-fold increased risk of pertussis with adjusted ORs (95% confidence interval) of 2.08 (1.68-2.58) and 2.32 (1.59-3.39), respectively. Gastroesophageal reflux disease [GERD; 2.67 (2.23-3.19)], cancer [1.68 (1.23-2.31)], cardiovascular disease [1.62 (1.31-2.00)], renal disease [1.56 (1.12-2.16)], autoimmune disease [1.50 (1.25-1.79)], and hyperlipidemia [1.43 (1.16-1.77)] were also associated with pertussis diagnosis. Finally, acute respiratory events within 30 days prior to index date, such as pneumonia, acute bronchitis, and upper respiratory tract infection (URTI), were highly associated with increased odds of pertussis diagnosis [adjusted ORs of 8.28 (5.10-13.44), 4.86 (3.84-6.14), and 2.90 (2.30-3.67), respectively]. CONCLUSIONS This study's findings complement and expand upon previous studies on the adult pertussis population, generating real-world data to describe underlying clinical characteristics of those diagnosed with pertussis in South Korea.
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Affiliation(s)
| | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, Seobu-ro 2066, Jangan-gu, Suwon, Gyeonggi-do, 440-746, South Korea.
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea.
| | | | - Ju Hwan Kim
- School of Pharmacy, Sungkyunkwan University, Seobu-ro 2066, Jangan-gu, Suwon, Gyeonggi-do, 440-746, South Korea
| | - Yunha Noh
- School of Pharmacy, Sungkyunkwan University, Seobu-ro 2066, Jangan-gu, Suwon, Gyeonggi-do, 440-746, South Korea
| | - Hee Jin Cheong
- Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Yeon-Mok Oh
- Department of Pulmonology and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Ray S, Puente A, Steinmetz NF, Pokorski JK. Recent advancements in single dose slow-release devices for prophylactic vaccines. WILEY INTERDISCIPLINARY REVIEWS. NANOMEDICINE AND NANOBIOTECHNOLOGY 2023; 15:e1832. [PMID: 35850120 PMCID: PMC9840709 DOI: 10.1002/wnan.1832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/31/2022] [Indexed: 01/31/2023]
Abstract
Single dose slow-release vaccines herald a new era in vaccine administration. An ideal device for slow-release vaccine delivery would be minimally invasive and self-administered, making these approaches an attractive alternative for mass vaccination programs, particularly during the time of a pandemic. In this review article, we discuss the latest advances in this field, specifically for prophylactic vaccines able to prevent infectious diseases. Recent studies have found that slow-release vaccines elicit better immune responses and often do not require cold chain transportation and storage, thus drastically reducing the cost, streamlining distribution, and improving efficacy. This promise has attracted significant attention, especially when poor patient compliance of the standard multidose vaccine regimes is considered. Single dose slow-release vaccines are the next generation of vaccine tools that could overcome most of the shortcomings of present vaccination programs and be the next platform technology to combat future pandemics. This article is categorized under: Therapeutic Approaches and Drug Discovery > Emerging Technologies Implantable Materials and Surgical Technologies > Nanomaterials and Implants Biology-Inspired Nanomaterials > Protein and Virus-Based Structures.
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Affiliation(s)
- Sayoni Ray
- Department of NanoEngineering, University of California-San Diego, La Jolla, California, USA,Center for Nano-ImmunoEngineering, University of California-San Diego, La Jolla, California, USA
| | - Armando Puente
- Department of NanoEngineering, University of California-San Diego, La Jolla, California, USA,Center for Nano-ImmunoEngineering, University of California-San Diego, La Jolla, California, USA
| | - Nicole F. Steinmetz
- Department of NanoEngineering, University of California-San Diego, La Jolla, California, USA,Center for Nano-ImmunoEngineering, University of California-San Diego, La Jolla, California, USA,Institute for Materials Discovery and Design, University of California-San Diego, La Jolla, California, USA,Department of Bioengineering, University of California-San Diego, La Jolla, California, USA,Department of Radiology, University of California-San Diego, La Jolla, California, USA,Moores Cancer Center, University of California-San Diego, La Jolla, California, USA
| | - Jonathan K. Pokorski
- Department of NanoEngineering, University of California-San Diego, La Jolla, California, USA,Center for Nano-ImmunoEngineering, University of California-San Diego, La Jolla, California, USA,Institute for Materials Discovery and Design, University of California-San Diego, La Jolla, California, USA
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Chen Q, Wang W, Shi X, Xu Y, Zhu Y, Wu Y, Wang Z, Sun H, Sun X. Seroepidemiology of pertussis in the east of China: Estimates of incidence of infection in adolescents and adults pre- and post-COVID-19. Front Public Health 2022; 10:1054617. [PMID: 36530663 PMCID: PMC9754053 DOI: 10.3389/fpubh.2022.1054617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/11/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction The dramatic decrease in the number of reported cases of pertussis during COVID-19 pandemic has been underestimated. The objective was to compare the estimated incidence rate of pertussis in populations pre- and post-COVID-19 pandemic by analyzing the anti-pertussis toxin (anti-PT) IgG and anti-filamentous hemagglutininant (anti-FHA) IgG antibodies in healthy Chinese population from 2018 to 2021. Methods All serum samples (N = 1,000) were collected from healthy population (aged ≥ 15 years) who attended an annual monitoring project of antibody levels in Jiangsu province in 2018-2021 were measured by ELISA. Results The positive rates of anti-PT IgG and anti-FHA IgG antibodies were 11.4% (114/1,000) and 20.2% (202/1,000) (≥40 IU/ml), the GMC were 17.25 (95% CI: 15.49-19.03) IU/mL and 24.94 (95% CI: 22.73-27.16) IU/mL in the study population, respectively. The percentage of participants with anti-PT IgG antibodies higher than 40 IU/mL was 5.20% (11/212) in 2018, 5.5% (19/348) in 2019, 21.2% (46/217) in 2020 and 17.0% (38/223) in 2021, respectively. The non-detectable rate (<5 IU/mL) of anti-PT IgG antibodies was 16.9, 17.7, 28.1, and 37.3% in 2018, 2019, 2020, and 2021, respectively. We assumed that the infection occurred within 58.6 days, and based on the overall proportion (2.9%) of individuals with anti-PT IgG antibody ≥100 IU/ml, the incidence rate (/100) was estimated by the formula to be 18.08 (95% CI: 12.40-26.11). In addition, the estimated incidence of Post-COVID-19 was higher than that of Pre-COVID-19 (36.33/100 vs. 12.84/100), and the difference was statistically significant (p < 0.05). Conclusions Our results suggest a high rate of under-reporting of pertussis in Jiangsu Province both pre- and post-COVID-19 pandemic, and there are a large number of adults of childbearing age who are susceptible to pertussis. It seems imperative that vaccination of adolescents and adults should be considered for inclusion in vaccination programs.
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Affiliation(s)
- Qiang Chen
- Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Wen Wang
- Department of Rheumatology and Immunology, The Affiliated Suqian First People's Hospital of Nanjing Medical University, Suqian, China
| | - Xiuyun Shi
- Expanded Program on Immunization, Siyang Center for Disease Control and Prevention, Suqian, China
| | - Yan Xu
- Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yanhong Zhu
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Yun Wu
- Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Zhiguo Wang
- Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Hui Sun
- Medical Department, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, China
| | - Xiang Sun
- Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
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Zhang C, Hu W, Wang R, Wang Y, Li Y, Lv Y, Li W, Si Y, Zhang S. Seroepidemiology of pertussis and diphtheria among healthy adults in Shaanxi Province, northwest China: A large - scale cross-sectional study. Hum Vaccin Immunother 2022; 18:2133913. [PMID: 36255248 DOI: 10.1080/21645515.2022.2133913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
To determine the estimated pertussis incidence in adults and the need for a booster dose by detecting pertussis and diphtheria antibody levels in adults in Shaanxi province, China. Blood samples were collected from healthy individuals aged 18-59 years in Shaanxi province in 2017. Serum immunoglobulin G (IgG) antibodies against pertussis toxin (PT) and diphtheria toxin (DT) were determined using enzyme-linked immunosorbent assay. The data on reported pertussis cases in Shaanxi province were collected from the China Information System for Disease Control and Prevention and compared with the results of this study. A total of 4307 subjects were enrolled. The mean concentration of anti-PT IgG was 19.6 IU/mL (95% CI = 18.9-20.3), and the positive rate (≥40 IU/mL) was 11.0% (474/4307), of which recent infections (≥100 IU/mL) accounted for 1.2% (53/4307). Only one adult case of pertussis was reported in 2017, which is much lower than the results of this study. The mean concentration of anti-DT IgG was 0.04 IU/mL (95% CI = 0.04-0.05), and the positive rate (≥0.01 IU/mL) was 82.3% (3543/4307). The mean concentration of anti-DT IgG decreased from 0.07 IU/mL in the 18-29 year-old group to 0.03 IU/mL in the 50-59 year-old-group, and the positivity rate decreased from 86.7% to 78.7%. Our study suggests that pertussis is not uncommon among adults. The existing surveillance system might have underestimated the true incidence of pertussis. The diphtheria antibody levels decreased with age. Booster vaccination against pertussis should be considered for adolescents and young adults.
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Affiliation(s)
- Chao Zhang
- Department of Immunization Program, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi, China
| | - Weijun Hu
- Department of Immunization Program, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi, China
| | - Ruize Wang
- Department of Immunization Program, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi, China
| | - Yinan Wang
- Department of Immunization Program, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi, China
| | - Yajun Li
- Department of Immunization Program, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi, China
| | - Yake Lv
- Department of Immunization Program, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi, China
| | - Weixuan Li
- Department of Immunization Program, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi, China
| | - Yuan Si
- Department of Immunization Program, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi, China
| | - Shaobai Zhang
- Department of Immunization Program, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi, China
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10
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Biselli R, Nisini R, Lista F, Autore A, Lastilla M, De Lorenzo G, Peragallo MS, Stroffolini T, D’Amelio R. A Historical Review of Military Medical Strategies for Fighting Infectious Diseases: From Battlefields to Global Health. Biomedicines 2022; 10:2050. [PMID: 36009598 PMCID: PMC9405556 DOI: 10.3390/biomedicines10082050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/12/2022] [Accepted: 08/13/2022] [Indexed: 11/17/2022] Open
Abstract
The environmental conditions generated by war and characterized by poverty, undernutrition, stress, difficult access to safe water and food as well as lack of environmental and personal hygiene favor the spread of many infectious diseases. Epidemic typhus, plague, malaria, cholera, typhoid fever, hepatitis, tetanus, and smallpox have nearly constantly accompanied wars, frequently deeply conditioning the outcome of battles/wars more than weapons and military strategy. At the end of the nineteenth century, with the birth of bacteriology, military medical researchers in Germany, the United Kingdom, and France were active in discovering the etiological agents of some diseases and in developing preventive vaccines. Emil von Behring, Ronald Ross and Charles Laveran, who were or served as military physicians, won the first, the second, and the seventh Nobel Prize for Physiology or Medicine for discovering passive anti-diphtheria/tetanus immunotherapy and for identifying mosquito Anopheline as a malaria vector and plasmodium as its etiological agent, respectively. Meanwhile, Major Walter Reed in the United States of America discovered the mosquito vector of yellow fever, thus paving the way for its prevention by vector control. In this work, the military relevance of some vaccine-preventable and non-vaccine-preventable infectious diseases, as well as of biological weapons, and the military contributions to their control will be described. Currently, the civil-military medical collaboration is getting closer and becoming interdependent, from research and development for the prevention of infectious diseases to disasters and emergencies management, as recently demonstrated in Ebola and Zika outbreaks and the COVID-19 pandemic, even with the high biocontainment aeromedical evacuation, in a sort of global health diplomacy.
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Affiliation(s)
- Roberto Biselli
- Ispettorato Generale della Sanità Militare, Stato Maggiore della Difesa, Via S. Stefano Rotondo 4, 00184 Roma, Italy
| | - Roberto Nisini
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy
| | - Florigio Lista
- Dipartimento Scientifico, Policlinico Militare, Comando Logistico dell’Esercito, Via S. Stefano Rotondo 4, 00184 Roma, Italy
| | - Alberto Autore
- Osservatorio Epidemiologico della Difesa, Ispettorato Generale della Sanità Militare, Stato Maggiore della Difesa, Via S. Stefano Rotondo 4, 00184 Roma, Italy
| | - Marco Lastilla
- Istituto di Medicina Aerospaziale, Comando Logistico dell’Aeronautica Militare, Viale Piero Gobetti 2, 00185 Roma, Italy
| | - Giuseppe De Lorenzo
- Comando Generale dell’Arma dei Carabinieri, Dipartimento per l’Organizzazione Sanitaria e Veterinaria, Viale Romania 45, 00197 Roma, Italy
| | - Mario Stefano Peragallo
- Centro Studi e Ricerche di Sanità e Veterinaria, Comando Logistico dell’Esercito, Via S. Stefano Rotondo 4, 00184 Roma, Italy
| | - Tommaso Stroffolini
- Dipartimento di Malattie Infettive e Tropicali, Policlinico Umberto I, 00161 Roma, Italy
| | - Raffaele D’Amelio
- Dipartimento di Medicina Clinica e Molecolare, Sapienza Università di Roma, Via di Grottarossa 1035-1039, 00189 Roma, Italy
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11
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Bahar E, Shamarina D, Sergerie Y, Mukherjee P. Descriptive Overview of Pertussis Epidemiology Among Older Adults in Europe During 2010–2020. Infect Dis Ther 2022; 11:1821-1838. [PMID: 35793057 PMCID: PMC9257120 DOI: 10.1007/s40121-022-00668-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/16/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Following the introduction of pertussis vaccination during infancy, the age-related demographics of pertussis epidemiology have changed. Methods To better understand the pertussis burden (defined here as number of cases and/or incidence rate [IR]) among older adults (OA; at least 50 years of age) in Europe, we collected data on the reported number of cases and IR in this population in Denmark, England and Scotland, Finland, Germany, the Netherlands, Norway and Sweden from 2010 to 2020. Additionally, we collected contextual epidemiological information on surveillance systems, case definitions, laboratory diagnostics and vaccination approaches. Results We observed large heterogeneity in the burden among OA between countries: annual IRs ranged from 0.4 (England, 2010) to 54.5 (Norway, 2011) per 100,000 population; 9% (Denmark, 2010) to 45% (England, 2017) of all reported cases occurred in OA. No clear impact of changes in contextual epidemiological information or common trends between countries could be observed, highlighting the need for standardised pertussis surveillance programmes across Europe. The epidemiological trends observed in OA were similar to those observed in 0–4-year-olds. Conclusion This analysis showed that B. pertussis continues to circulate among OA in Europe, suggesting that current vaccination strategies are insufficient to decrease the disease burden in all age groups. This may indicate that improved monitoring of pertussis in OA and booster vaccination throughout adulthood are necessary to control the total pertussis burden. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-022-00668-y. Whooping cough is an infectious, vaccine-preventable disease that is primarily serious in unvaccinated infants but can also affect adults (at least 50 years old). While vaccination is well established in children, many countries do not routinely vaccinate older adults. Moreover, whooping cough infections in older adults can be difficult to identify for healthcare professionals because of the atypical and mild nature of symptoms. Consequently, the extent of whooping cough occurrence in this population is underestimated. To better understand the extent of disease occurrence, we studied whooping cough infections in Denmark, England and Scotland, Finland, Germany, the Netherlands, Norway and Sweden from 2010 to 2020. Our study was based on the number of laboratory-confirmed cases reported to relevant institutions. We also assessed whether we could identify links between disease occurrence among older adults and contextual epidemiological information, such as disease monitoring systems, methods used for laboratory confirmation, vaccination schedules and vaccination coverage rates. Our study confirmed that whooping cough affects older adults and disease occurrence follows similar trends to those in 0- to 4-year-old children. Because the contextual epidemiological information differed over time and between countries, we could not establish links with disease occurrence in older adults. These data may provide further evidence to authorities that whooping cough among older adults would be better controlled and its burden more accurately estimated with a reinforced comprehensive approach around vaccination and monitoring. Because adults can also infect children who are not yet fully vaccinated, such an approach might help further control the disease in children.
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Affiliation(s)
- Enas Bahar
- Modis C/O GSK, Avenue Fleming 20, 1300 Wavre, Belgium
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12
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Hattabi H, Bouchez C, Dubos F, Martinot A, Faure K, Dessein R, Bartolo S, Subtil D. [Should French pregnant women be vaccinated against pertussis during pregnancy?]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2022; 50:486-493. [PMID: 35483610 DOI: 10.1016/j.gofs.2022.02.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 02/03/2022] [Accepted: 02/20/2022] [Indexed: 06/14/2023]
Abstract
Many countries with a high perinatal level have started a policy of vaccination of pregnant women against pertussis. To date, France has not chosen this policy. The objective was to review knowledge on pertussis mortality in infants. Compare the strategies available to protect the infant before his first vaccination, scheduled for two months of age. We proceeded to a litterature analysis, from January 1998 to 2021. Search by the following keywords used ; "Whooping cough, vaccination, pregnancy, strategy, cocooning", on the scientific basis of "Pubmed", as well as French and foreign vaccination recommendations. Currently 90% of whooping cough deaths are concerning infants under six months of age and this mortality represents 2% of mortality in the first year of life. Vaccination at birth is not effective. The cocooning strategy, which consists of vaccinating those around the child, is expensive and difficult to implement. A systematic vaccination policy for pregnant women is effective and reasonably expensive when compared to the cocooning strategy. In England, it was recently accompanied by a 78% reduction in confirmed cases of pertussis in infants under six months of age. In conclusion, compared to cocooning strategy, pertussis vaccination of pregnant women appears more effective and cost-effective, and this with each pregnancy.
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Affiliation(s)
- H Hattabi
- University Lille, CHU Lille, pôle femme mère nouveau-né, hôpital Jeanne de Flandre, 59000 Lille, France.
| | - C Bouchez
- University Lille, CHU Lille, pôle femme mère nouveau-né, hôpital Jeanne de Flandre, 59000 Lille, France
| | - F Dubos
- University Lille, CHU Lille, pôle enfant, hôpital Jeanne de Flandre, 59000 Lille, France; University Lille, EA 2694, METRICS, Evaluation des technologies de santé et des pratiques médicales. CHU Lille, hôpital Jeanne de Flandre, 59000 Lille, France
| | - A Martinot
- University Lille, CHU Lille, pôle enfant, hôpital Jeanne de Flandre, 59000 Lille, France; University Lille, EA 2694, METRICS, Evaluation des technologies de santé et des pratiques médicales. CHU Lille, hôpital Jeanne de Flandre, 59000 Lille, France
| | - K Faure
- University Lille, CHU Lille, service de maladies infectieuses, rue Michel Polonowski, 59000 Lille, France; University Lille, EA7366, recherche translationnelle relation hôte-pathogènes, faculté de médecine pôle recherche, 59045 Lille, France
| | - R Dessein
- University Lille, EA7366, recherche translationnelle relation hôte-pathogènes, faculté de médecine pôle recherche, 59045 Lille, France
| | - S Bartolo
- University Lille, CHU Lille, pôle femme mère nouveau-né, hôpital Jeanne de Flandre, 59000 Lille, France; University Lille, EA 2694, METRICS, Evaluation des technologies de santé et des pratiques médicales. CHU Lille, hôpital Jeanne de Flandre, 59000 Lille, France
| | - D Subtil
- University Lille, CHU Lille, pôle femme mère nouveau-né, hôpital Jeanne de Flandre, 59000 Lille, France; University Lille, EA 2694, METRICS, Evaluation des technologies de santé et des pratiques médicales. CHU Lille, hôpital Jeanne de Flandre, 59000 Lille, France
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13
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Evolution of Bordetella pertussis in the acellular vaccine era in Norway, 1996 to 2019. Eur J Clin Microbiol Infect Dis 2022; 41:913-924. [PMID: 35543837 PMCID: PMC9135841 DOI: 10.1007/s10096-022-04453-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 04/28/2022] [Indexed: 01/16/2023]
Abstract
We described the population structure of Bordetella pertussis (B. pertussis) in Norway from 1996 to 2019 and determined if there were evolutionary shifts and whether these correlated with changes in the childhood immunization program. We selected 180 B. pertussis isolates, 22 from the whole cell vaccine (WCV) era (1996–1997) and 158 from the acellular vaccine (ACV) era (1998–2019). We conducted whole genome sequencing and determined the distribution and frequency of allelic variants and temporal changes of ACV genes. Norwegian B. pertussis isolates were evenly distributed across a phylogenetic tree that included global strains. We identified seven different allelic profiles of ACV genes (A–F), in which profiles A1, A2, and B dominated (89%), all having pertussis toxin (ptxA) allele 1, pertussis toxin promoter (ptxP) allele 3, and pertactin (prn) allele 2 present. Isolates with ptxP1 and prn1 were not detected after 2007, whereas the prn2 allele likely emerged prior to 1972, and ptxP3 before the early 1980s. Allele conversions of ACV genes all occurred prior to the introduction of ACV. Sixteen percent of our isolates showed mutations within the prn gene. ACV and its booster doses (implemented for children in 2007 and adolescents in 2013) might have contributed to evolvement of a more uniform B. pertussis population, with recent circulating strains having ptxA1, ptxP3, and prn2 present, and an increasing number of prn mutations. These strains clearly deviate from ACV strains (ptxA1, ptxP1, prn1), and this could have implications for vaccine efficiency and, therefore, prevention and control of pertussis.
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14
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Guarnieri V, Giovannini M, Lodi L, Astorino V, Pisano L, Di Cicco E, Canessa C, Citera F, Peroni D, Azzari C, Ricci S. Severe pertussis disease in a paediatric population: The role of age, vaccination status and prematurity. Acta Paediatr 2022; 111:1781-1787. [PMID: 35638439 DOI: 10.1111/apa.16436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 03/10/2022] [Accepted: 05/24/2022] [Indexed: 11/27/2022]
Abstract
AIM To estimate hospitalisation rate and investigate the role of age, prematurity and vaccination status in severe pertussis cases. METHODS We retrospectively evaluated 200 children aged 0-14 years, admitted to the emergency rooms of Meyer Hospital of Florence and Pisa Hospital with a diagnosis of pertussis from 1 October 2010 to 31 January 2020. RESULTS Children younger than 12 months were 63.0%. Preterm infants were 6.5%. The rate of hospitalisation was 49.0%. Among hospitalised cases, 80.6% were younger than 5 months. Overall, 62.0% were unvaccinated; this percentage increased among hospitalised (73.5%) and preterm subsamples (76.9%). Delays in pertussis vaccination were found in 57.7% of term infants and in 80.0% of preterms. Multivariable analysis confirmed the age under 2 months as the variable at higher risk for hospitalisation (OR 4.49, 95% CI 1.85-10.96, p < 0.001). Being fully vaccinated represented a significant protective factor (OR 0.12, 95% CI 0.04-0.35, p < 0.001). CONCLUSION Older classes of age and a complete vaccination, in time with the recommended schedule, are both protective factors for hospitalisation in severe pertussis disease. The widespread vaccination delay frequently observed in preterm children may be the cause for their higher rate of hospitalisation.
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Affiliation(s)
- Valentina Guarnieri
- Department of Pediatrics, Department of Health Sciences University of Florence Florence Italy
| | - Mattia Giovannini
- Department of Pediatrics, Department of Health Sciences University of Florence Florence Italy
- Allergy Unit, Department of Pediatrics Meyer Children's University Hospital Florence Italy
| | - Lorenzo Lodi
- Department of Pediatrics, Department of Health Sciences University of Florence Florence Italy
| | - Valeria Astorino
- Department of Pediatrics, Department of Health Sciences University of Florence Florence Italy
- Immunology and Molecular Microbiology Unit Meyer Children's Hospital Florence Italy
| | - Laura Pisano
- Department of Pediatrics, Department of Health Sciences University of Florence Florence Italy
- Immunology and Molecular Microbiology Unit Meyer Children's Hospital Florence Italy
| | - Elisa Di Cicco
- Pediatric Clinic, Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Clementina Canessa
- Department of Pediatrics, Department of Health Sciences University of Florence Florence Italy
- Immunology and Molecular Microbiology Unit Meyer Children's Hospital Florence Italy
| | - Francesco Citera
- Department of Pediatrics, Department of Health Sciences University of Florence Florence Italy
- Immunology and Molecular Microbiology Unit Meyer Children's Hospital Florence Italy
| | - Diego Peroni
- Pediatric Clinic, Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Chiara Azzari
- Department of Pediatrics, Department of Health Sciences University of Florence Florence Italy
- Immunology and Molecular Microbiology Unit Meyer Children's Hospital Florence Italy
| | - Silvia Ricci
- Department of Pediatrics, Department of Health Sciences University of Florence Florence Italy
- Immunology and Molecular Microbiology Unit Meyer Children's Hospital Florence Italy
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15
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Dassarma B, Tripathy S, Chabalala M, Matsabisa MG. Challenges in Establishing Vaccine Induced Herd Immunity through Age Specific Community Vaccinations. Aging Dis 2022; 13:29-36. [PMID: 35111360 PMCID: PMC8782562 DOI: 10.14336/ad.2021.0611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 06/11/2021] [Indexed: 12/24/2022] Open
Abstract
Presently, the second wave of COVID-19 pandemic is driving the world towards a devastating total failure of the healthcare system. The purpose of the review is to search for the studies reporting on the implication of herd immunity into a naïve population through age specific mass vaccination. This review is based on selected publications on the effect herd immunity to COVID 19 in communities. We searched published scientific articles, review articles, reports, published in 2020 as well as read some basic, cult publications related to establishment of indirect immunity to a population. We have focused on use of application of vaccine induced herd immunity into community to confer indirect immunity against COVID-19 and searched on electronic databases, including PubMed (http://www.pubmed.com), Scopus (http://www.scopus.com), Google Scholar (http://www.scholar.google.com), Web of Science (www.webofscience.com) and Science Direct by using key words such as Herd immunity, indirect or passive immunization, Coronavirus disease 2019 (COVID-19), severe acute respiratory syndrome, coronavirus 2 (SARS-CoV-2), and immune-technique. This review proposes the implication of mass vaccination-induced herd immunity in a population to curb the infection, and to every individual in a given population irrespective of their age.
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Affiliation(s)
- Barsha Dassarma
- Department of Pharmacology, School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein9300, SA
| | - Satyajit Tripathy
- Department of Pharmacology, School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein9300, SA
| | - Matimbha Chabalala
- Department of Pharmacology, School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein9300, SA
| | - Motlalepula Gilbert Matsabisa
- Department of Pharmacology, School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein9300, SA
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16
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Jog P, Memon IA, Thisyakorn U, Hozbor D, Heininger U, von König CHW, Tan T. Pertussis in Asia: Recent country-specific data and recommendations. Vaccine 2022; 40:1170-1179. [PMID: 35074239 DOI: 10.1016/j.vaccine.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 10/30/2021] [Accepted: 12/02/2021] [Indexed: 11/24/2022]
Abstract
The Global Pertussis Initiative (GPI) Roundtable Meeting held in 2019, which preceded the COVID-19 pandemic, focused on the incidence, surveillance, and immunization practices for pertussis in the Asian region. Participants from China, India, Indonesia, Malaysia, Pakistan, Philippines, South Korea, Taiwan, and Thailand presented country-specific information on pertussis prevalence, diagnosis, surveillance, vaccine administration and schedules, maternal and neonatal disease rates, and policies and practice of vaccination during pregnancy. In recent years, many Asian countries have seen an increase in pertussis cases, although underreporting of the disease is a concern. Currently, most Asian countries have only passive surveillance for pertussis in place. There is a need for improved surveillance to determine the disease burden and justify vaccination policies and recommendations, such as essential vaccination, boosters, and vaccination during pregnancy. Better awareness of the disease in adolescents and adults is necessary, and infant and childhood vaccination schedules need to be improved in many countries. Differences between private versus public sector vaccination schedules and between whole-cell and acellular pertussis vaccines should continue to be examined. It can be anticipated that unmet needs in the prevention and management of pertussis will continue as the COVID-19 pandemic evolves and that key recommendations highlighted in this meeting report will be of ongoing importance.
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Affiliation(s)
| | | | - Usa Thisyakorn
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand.
| | - Daniela Hozbor
- Instituto de Biotecnología y Biología Molecular, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, La Plata, Argentina
| | - Ulrich Heininger
- Department of Infectious Diseases and Vaccinology, University of Basel Children's Hospital, Basel, Switzerland
| | | | - Tina Tan
- Feinberg School of Medicine of Northwestern University, Chicago, IL, USA
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17
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Prygiel M, Mosiej E, Wdowiak K, Górska P, Polak M, Lis K, Krysztopa-Grzybowska K, Zasada AA. Effectiveness of experimental and commercial pertussis vaccines in the elimination of Bordetella pertussis isolates with different genetic profiles in murine model. Med Microbiol Immunol 2021; 210:251-262. [PMID: 34338880 PMCID: PMC8326312 DOI: 10.1007/s00430-021-00718-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/07/2021] [Indexed: 12/19/2022]
Abstract
The aim of this study was to compare the elimination of Bordetella pertussis clinical isolates, representing different genotypes in relation to alleles encoding virulence factors (MLST-multi-locus antigen sequence typing), MLVA type (multi-locus variable-number tandem repeat analysis) and PFGE group (pulsed-field gel electrophoresis) from the lungs of naive mice or mice were immunised with the commercial whole-cell pertussis vaccine, the acellular pertussis vaccine and the experimental whole-cell pertussis vaccine. Molecular data indicate that the resurgence of pertussis in populations with high vaccine coverage is associated with genomic adaptation of B. pertussis, to vaccine selection pressure. Pertactin-negative B. pertussis isolates were suspected to contribute to the reduced vaccine effectiveness. It was shown that one of the isolates used is PRN deficient. The mice were intranasally challenged with bacterial suspension containing approximately 5 × 10 7 CFU/ml B. pertussis. The immunogenicity of the tested vaccines against PT (pertussis toxin), PRN (pertactin), FHA (filamentous haemagglutinin) and FIM (fimbriae types 2 and 3) was examined. The commercial whole-cell and acellular pertussis vaccines induced an immunity effective at eliminating the genetically different B. pertussis isolates from the lungs. However, the elimination of the PRN-deficient isolate from the lungs of mice vaccinated with commercial vaccines was delayed as compared to the PRN ( +) isolate, suggesting phenotypic differences with the circulating isolates and vaccine strains. The most effective vaccine was the experimental vaccine with the composition identical to that of the strains used for infection.
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Affiliation(s)
- Marta Prygiel
- Department of Vaccines and Sera Evaluation, National Institute of Public Health, National Institute of Hygiene, Warsaw, Poland.
| | - Ewa Mosiej
- Department of Vaccines and Sera Evaluation, National Institute of Public Health, National Institute of Hygiene, Warsaw, Poland
| | - Karol Wdowiak
- Department of Vaccines and Sera Evaluation, National Institute of Public Health, National Institute of Hygiene, Warsaw, Poland
| | - Paulina Górska
- Department of Vaccines and Sera Evaluation, National Institute of Public Health, National Institute of Hygiene, Warsaw, Poland
| | - Maciej Polak
- Department of Vaccines and Sera Evaluation, National Institute of Public Health, National Institute of Hygiene, Warsaw, Poland
| | - Klaudia Lis
- Department of Vaccines and Sera Evaluation, National Institute of Public Health, National Institute of Hygiene, Warsaw, Poland
| | - Katarzyna Krysztopa-Grzybowska
- Department of Vaccines and Sera Evaluation, National Institute of Public Health, National Institute of Hygiene, Warsaw, Poland
| | - Aleksandra Anna Zasada
- Department of Vaccines and Sera Evaluation, National Institute of Public Health, National Institute of Hygiene, Warsaw, Poland
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18
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Bordetella pertussis in School-Age Children, Adolescents and Adults: A Systematic Review of Epidemiology and Mortality in Europe. Infect Dis Ther 2021; 10:2071-2118. [PMID: 34435338 PMCID: PMC8387212 DOI: 10.1007/s40121-021-00520-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 07/30/2021] [Indexed: 11/16/2022] Open
Abstract
Pertussis (whooping cough) epidemics persist globally despite high vaccine coverage among infants and young children. The resurgence of pertussis in high-income countries is partly due to waning vaccine immunity, resulting in a pool of unprotected adolescents and adults. However, pertussis is generally less severe in adolescents and adults, and this difference in presentation means it can often be unrecognised by healthcare professionals, meaning that it is largely under-diagnosed in older populations. A systematic search of MEDLINE, EMBASE and BIOSIS was undertaken to identify studies published between 1 January 1990 and 17 June 2019, with information on pertussis epidemiology and mortality in school-aged children, adolescents and adults in Europe. A formal statistical comparison (e.g. using meta-analyses) was not possible because of the mix of methodologies reported. There were 69 epidemiological studies and 19 mortality studies identified for review. Over the past decade, the reported incidence of notified pertussis cases varied widely between European countries, which is likely associated with differences in surveillance systems, diagnostic techniques and reporting regulations. However, several studies show that pertussis is circulating among adolescents and adults in Europe, and although pertussis-related morbidity and mortality are highest in infants, there is evidence that adults aged > 50 years are at increased risk. For example, in a hospital-based surveillance study in Portugal, between 2000 and 2015, 94% of hospitalised pertussis cases were infants aged < 1 year, with a case fatality rate (CFR) of 0.8%; however, among hospitalised adult cases of pertussis, the CFRs were 11.5% (aged 18–64 years) and 17.4% (aged > 65 years). Very few European countries currently include pertussis boosters for adults in the national immunisation strategy. In addition to increasing pertussis vaccination coverage in adolescents and adults, mitigation strategies in European countries should include improved diagnosis and treatment in these populations.
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19
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Saleem SM, Bhattacharya S. Reducing the infectious diseases burden through "life course approach vaccination" in India-a perspective. AIMS Public Health 2021; 8:553-562. [PMID: 34395705 PMCID: PMC8334644 DOI: 10.3934/publichealth.2021045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/01/2021] [Indexed: 11/29/2022] Open
Abstract
The burden of vaccine-preventable diseases is increasing day by day across all age groups. However as per the universal immunization programme, we vaccinate only under-fives and antenatal mothers, a large portion of the vulnerable population remain unvaccinated and the concept of “life course approach” regarding vaccination is missing. It increases the overall burden to the already constrained Indian health care system. As India, now has become the largest manufacturer of multiple vaccines, we have continuous chain healthcare points (primary-tertiary level), with dedicated manpower in the public health sector that is why in this paper we are proposing to expand the horizon of the vaccination process using a “life course approach”. It will not only directly benefit the vulnerable populations (individual level), but also it can benefit the nation, indirectly. Although we may face challenges at multiple phases (conception to implementation), they can be overcome by multisectoral and multipronged innovations.
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20
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Garlasco J, Bordino V, Marengo N, Rainero E, Scacchi A, Ditommaso S, Giacomuzzi M, Bert F, Zotti CM. Pertussis immunisation during pregnancy: Antibody levels and the impact of booster vaccine. Vaccine 2021; 39:4957-4963. [PMID: 34330557 DOI: 10.1016/j.vaccine.2021.07.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/28/2021] [Accepted: 07/19/2021] [Indexed: 11/28/2022]
Abstract
Pertussis (whooping cough) is a highly infectious disease caused by Bordetella pertussis. Mothers lacking adequate immunity and contracting the disease represent the biggest risk of transmission to new-borns, for which the disease is often a threat. The aim of the study was to estimate the frequency of pertussis susceptibility among pregnant women, in order to point out the need for a vaccine recall during pregnancy, and to evaluate the antibody response in already vaccinated women. A cross-sectional observational study was conducted in the blood test centre of "St. Anna" Obstetrics and Gynaecology Hospital in Turin (Piedmont, Italy). Eligibility criteria included pregnant women coming to the centre for any blood test, aged 18 or above and with gestational age between 33 and 37 weeks at the moment of the blood draw. The data collection was carried out from May 2019 to January 2020 and the concentration of anti-Pertussis Toxin (anti-PT) IgG was measured through the Enzyme-Linked Immunosorbent Assay (ELISA) technique. Two-hundred women (median age 35) were enrolled: 132 (66%) had received at least one dose of pertussis vaccine, 82 of which during pregnancy. Recently vaccinated women had significantly higher antibody titres (even 12-15 times as high) compared to those vaccinated more than 5 years before or never vaccinated at all (p < 0.0001). Moreover, 95.1% of recently vaccinated women had anti-PT IgG levels above 10 IU/ml, and 85.4% above 20 IU/ml, while the same proportions were as low as 37% and 21% (respectively) in the group of women not vaccinated in pregnancy. This study confirmed that the vaccination is greatly effective in ensuring high antibody titres in the first months after the booster vaccine, with considerable differences in anti-PT IgG compared to women vaccinated earlier or never vaccinated at all, and therefore vaccinating pregnant women against pertussis still represents a valuable strategy.
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Affiliation(s)
- Jacopo Garlasco
- Department of Public Health Sciences and Paediatrics, University of Turin, 5/bis, Via Santena, I-10126 Turin, Italy.
| | - Valerio Bordino
- Department of Public Health Sciences and Paediatrics, University of Turin, 5/bis, Via Santena, I-10126 Turin, Italy.
| | - Noemi Marengo
- Department of Public Health Sciences and Paediatrics, University of Turin, 5/bis, Via Santena, I-10126 Turin, Italy.
| | - Erika Rainero
- Department of Public Health Sciences and Paediatrics, University of Turin, 5/bis, Via Santena, I-10126 Turin, Italy.
| | - Alessandro Scacchi
- Department of Public Health Sciences and Paediatrics, University of Turin, 5/bis, Via Santena, I-10126 Turin, Italy.
| | - Savina Ditommaso
- Department of Public Health Sciences and Paediatrics, University of Turin, 5/bis, Via Santena, I-10126 Turin, Italy.
| | - Monica Giacomuzzi
- Department of Public Health Sciences and Paediatrics, University of Turin, 5/bis, Via Santena, I-10126 Turin, Italy.
| | - Fabrizio Bert
- Department of Public Health Sciences and Paediatrics, University of Turin, 5/bis, Via Santena, I-10126 Turin, Italy.
| | - Carla Maria Zotti
- Department of Public Health Sciences and Paediatrics, University of Turin, 5/bis, Via Santena, I-10126 Turin, Italy.
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Macina D, Evans KE. Bordetella pertussis in School-Age Children, Adolescents, and Adults: A Systematic Review of Epidemiology, Burden, and Mortality in Asia. Infect Dis Ther 2021; 10:1115-1140. [PMID: 33928533 PMCID: PMC8322225 DOI: 10.1007/s40121-021-00439-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/24/2021] [Indexed: 11/26/2022] Open
Abstract
Cyclic epidemics of pertussis (whooping cough) have been observed globally over the past twenty years despite high infant vaccine coverage. The resurgence of pertussis in high-income countries is partly due to waning vaccine immunity in older children and adults, as well as better surveillance and diagnostics. Moreover, in adolescents and adults, pertussis symptoms are mild and similar to common cough syndromes, meaning that it is under-diagnosed in older populations. A systematic search of MEDLINE, EMBASE, and BIOSIS was undertaken to identify studies published between 1 January 1990 and 17 June 2019, with information on pertussis epidemiology, burden of illness, and mortality in school-aged children, adolescents, and adults in Asia. Studies identified for inclusion were reviewed narratively because a statistical comparison was not possible due to the mix of methodologies used. The results showed that in East Asia, including Japan, South Korea, China, and Taiwan, pertussis is circulating in older children and adults. Diphtheria-tetanus-pertussis (DTP4) coverage is high in East Asia, yet outbreaks observed in Japan and South Korea suggest that vaccine-acquired immunity had waned in adolescents and adults. Several school outbreaks in China show that pertussis is circulating in young children, with continued circulation in adolescents and adults. There was a lack of information from Southeast/South Asian countries, although pan-Asian serosurveys showed that recent pertussis infection was common in adolescents and in adults with persistent cough. To conclude, the circulation of pertussis in Asian countries with high DTP4 coverage supports the expansion of routine vaccination to include booster doses for children at school entry and adolescents. However, surveillance is weak or absent in many countries, meaning that the true burden of pertussis, particularly among older populations, is unknown.
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Affiliation(s)
- Denis Macina
- Global Medical, Sanofi Pasteur, 14 Espace Henry Vallée, 69007, Lyon, France.
| | - Keith E Evans
- InScience Communications, Chowley Oak Business Park, Chowley Oak Lane, Tattenhall, Cheshire, UK
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ERRATA CORRIGE. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E249-E260. [PMID: 34322644 PMCID: PMC8283635 DOI: 10.15167/2421-4248/jpmh2021.62.1.1832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
[This corrects the article on p. E530-E541 in vol. 61, PMID: 33628957.].
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Macina D, Evans KE. Bordetella pertussis in School-Age Children, Adolescents, and Adults: A Systematic Review of Epidemiology, Burden, and Mortality in the Middle East. Infect Dis Ther 2021; 10:719-738. [PMID: 33905101 PMCID: PMC8116454 DOI: 10.1007/s40121-021-00440-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/24/2021] [Indexed: 10/13/2023] Open
Abstract
Despite modern diphtheria-tetanus-pertussis (DTP) vaccines and high vaccine coverage, a resurgence of pertussis (whooping cough) has been observed globally. In North America and Europe, high vaccine coverage in children has led to a shift in the age-specific peak incidence of infection away from infants and towards older children and adolescents. However, much less is known about the prevalence of pertussis in older children and adults in the Middle East. A systematic search of MEDLINE, EMBASE, and BIOSIS was undertaken to identify studies published between 1 January 1990 and 17 June 2019, with information on pertussis epidemiology, burden of illness, and mortality in school-aged children, adolescents, and adults in the Middle East. Studies identified for inclusion were reviewed narratively because a statistical comparison was not possible because of the mix of methodologies used. The results showed that surveillance data are weak or missing in most Middle Eastern countries, and among 24 epidemiological studies identified, most were from Iran (14), Israel (4), and Turkey (3), with single studies from the United Arab Emirates and Iraq. Despite various surveillance periods, clinical definitions, and antibody cut-off values used across the studies, the reported seroprevalence of pertussis antibodies suggested that adolescents and adults are commonly exposed to pertussis in the community and that vaccine-acquired immunity from childhood wanes. Few countries in the Middle East include a diphtheria-tetanus-acellular pertussis (Tdap) booster for adolescents on the national schedule. Israel was the only country with epidemiological data in a population that received Tdap, and the study showed that after the introduction of the adolescent booster dose, there was decrease in pertussis among children aged 5–14 years. To conclude, results from the Middle East suggest that in common with other regions, pertussis is widely circulating and that it might be shifting towards older age groups.
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Affiliation(s)
- Denis Macina
- Global Medical, Sanofi Pasteur, 14 Espace Henry Vallée, 69007, Lyon, France.
| | - Keith E Evans
- inScience Communications, Chowley Oak Business Park, Chowley Oak Lane, Tattenhall, Cheshire, UK
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Circulation of Bordetella pertussis in vaccinated Cambodian children: A transversal serological study. Int J Infect Dis 2021; 106:134-139. [PMID: 33766688 DOI: 10.1016/j.ijid.2021.03.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND The Cambodia pertussis immunization schedule includes three doses given at age 6, 10 and 14 weeks using a whole-pertussis vaccine. No booster doses are included. Pertussis biological diagnosis is unavailable in Cambodia and its burden remains unclear. This study aimed to provide accurate data on pertussis serological status of Cambodian children and adolescents, and to evaluate vaccination timeliness. METHODS Fully vaccinated children aged 3-15 years were recruited at the Rabies Prevention Center, Institut Pasteur in Cambodia, Phnom Penh. Capillary blood samples and information on pertussis vaccination history were collected. Anti-pertussis toxin (PT) IgG titers were quantified by ELISA. RESULTS Compliance with the national immunization schedule was 95.1%. Initiation of vaccination after 8 weeks of age was observed for 29.0% of the children, but was less frequent in the youngest children (13.0%) compared with the oldest ones (46.4%). Rate of children exhibiting anti-PT IgG varied across age groups, and increased from 35.7% to 55.0% in 3-5 and 12-15 years age groups, respectively. CONCLUSION Pertussis circulates among vaccinated Cambodian children and adolescents. These data support the need for public health authorities to strengthen pertussis surveillance and use local epidemiological data to make evidence-based decision for the establishment of an optimal vaccination strategy.
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The impact of publicly funded rotavirus immunization programs on Canadian children. ACTA ACUST UNITED AC 2021; 47:97-104. [PMID: 33746618 DOI: 10.14745/ccdr.v47i02a02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Background In 2008, the National Advisory Committee on Immunization recommended routine rotavirus immunizations in healthy Canadian infants. Over the following seven years, eight provinces and two territories introduced the rotavirus vaccine into their publicly funded immunization programs. Objective Assess the burden of rotavirus infections before and after implementation of publicly funded immunization programs. Methods We analyzed laboratory-confirmed community cases of rotavirus reported to the National Enteric Surveillance Program and hospitalizations of children younger than three years old from 2007 to 2017 with rotavirus diagnosis-specific ICD-10 codes. Rates of illness were calculated for each province for the two years prior to and after implementation of public funding of the vaccine. The year of implementation was not included to accommodate the uptake period of the vaccine. Age-specific rates were assessed in jurisdictions where five years of data were available the year after the vaccine was publicly funded. The pre-post and difference-in-difference (DID) methodologies were applied to hospital discharge data to evaluate changes between the funding and non-funding jurisdictions. Results Community cases of laboratory-confirmed rotavirus infection reported to the National Enteric Surveillance Program declined by 54% between 2010 and 2017. Rates of hospital discharges decreased significantly among children in six provinces after the adoption of the rotavirus vaccine. Hospital discharge rates in Alberta, Manitoba, Ontario and Prince Edward Island dropped between 53% and 71%, and by 75% for British Columbia and Saskatchewan. Conclusion Public funding of the rotavirus vaccine appeared to lead to significant reductions in laboratory-confirmed rotavirus cases reported to the National Enteric Surveillance Program and in the rates of rotavirus gastroenteritis-related hospital discharges.
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Tessier E, Campbell H, Ribeiro S, Andrews N, Stowe J, Nicholls M, Morgan J, Litt D, Fry NK, Amirthalingam G. Investigation of a pertussis outbreak and comparison of two acellular booster pertussis vaccines in a junior school in South East England, 2019. Euro Surveill 2021; 26:2000244. [PMID: 33769247 PMCID: PMC7995557 DOI: 10.2807/1560-7917.es.2021.26.12.2000244] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 09/03/2020] [Indexed: 11/20/2022] Open
Abstract
In March 2019, a pertussis outbreak occurred in children in a junior school (7-11 years) in England who had been offered pertussis-containing booster vaccine at 40 months of age. In a case-control investigation, we assessed the extent of transmission and any difference in protection afforded to those who had previously received a booster 3- or 5-component acellular pertussis vaccine (aP). We took oral fluid specimens from the students to determine IgG antibodies against pertussis toxin (anti-PT). Parents of students attending the school were sent a questionnaire on pertussis symptoms and vaccination status was retrieved from general practitioner records for all students. Of 381 students, 134 (35.2%) were classified as pertussis cases, 133 by demonstration of significant anti-PT IgG titres and one clinically. There was no significant difference in the risk of pertussis between students receiving 3-component (33.7%) or 5-component (32.3%) aP boosters. However, pertussis infection differed significantly in school year 4, with 22.9%, 50.0%, 23.7% and 38.1% pertussis cases in years 3, 4, 5 and 6, respectively. The proportion of students with incomplete vaccinations recorded was higher than the proportion of those not covered according to the national reported coverage, possibly contributing to sustained transmission within the school.
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Affiliation(s)
- Elise Tessier
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, United Kingdom
| | - Helen Campbell
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, United Kingdom
| | - Sonia Ribeiro
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, United Kingdom
| | - Nick Andrews
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, United Kingdom
| | - Julia Stowe
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, United Kingdom
| | - Margot Nicholls
- Surrey and Sussex Health Protection Team (South East), Public Health England, Surrey, United Kingdom
| | - Jaime Morgan
- Surrey and Sussex Health Protection Team (South East), Public Health England, Surrey, United Kingdom
| | - David Litt
- Vaccine Preventable Bacteria Section, National Infection Service, Public Health England, London, United Kingdom
| | - Norman K Fry
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, United Kingdom
- Vaccine Preventable Bacteria Section, National Infection Service, Public Health England, London, United Kingdom
| | - Gayatri Amirthalingam
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, United Kingdom
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Pham NTH, Le NDT, Le NK, Nguyen KD, Larsson M, Olson L, Tran DM. Pertussis epidemiology and effect of vaccination among diagnosed children at Vietnam, 2015-2018. Acta Paediatr 2020; 109:2685-2691. [PMID: 32181924 DOI: 10.1111/apa.15259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 03/05/2020] [Accepted: 03/13/2020] [Indexed: 11/28/2022]
Abstract
AIM To evaluate effect and costs of pertussis vaccination at Vietnam National Children's Hospital. METHODS Pertussis cases were defined by positive laboratory tests of children under 5 years January 2015-June 2018, and data on patient characteristics, clinical data and hospitalisation costs were collected through patient records. RESULTS Of 909 inpatients, 400 (44%) were <2 months, the age for first DPT vaccination, and mechanical ventilation was more common than in children >2 months (9% vs 4%, OR = 2.3, CI 1.3-3.9), as well as persistent cough (99%), violent cough (87%) and pneumonia (91%). Comparing non-vaccinated (172 cases, 19%) and DPT vaccinated patients >2 months of age hospitalisation was 106-fold higher (149.6 vs 1.39 per 100 000 population), and proportion of severe patients, length of hospital stay and hospitalisation costs were significantly greater (23.9% vs 12.8%; 13 vs 10 days; 826 USD vs 582 USD, CI 23-423, P = .03). CONCLUSION Incidence and proportion of complications among under 2-month infants were higher than in older patients. DPT vaccination protects children from pertussis infection, and in case of pertussis infection decreases severity. Results indicate that the Ministry of Health should consider adding a booster vaccine for pregnant women in an extended vaccination programme.
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Affiliation(s)
- Nhung T. H. Pham
- Vietnam National Children’s Hospital Ha Noi Vietnam
- Field Epidemiology Training Program ‐ Ministry of Health Ha Noi Vietnam
| | - Nhan D. T. Le
- Field Epidemiology Training Program ‐ Ministry of Health Ha Noi Vietnam
- Institute of Public Health Ho Chi Minh City Vietnam
| | - Ngai K. Le
- Vietnam National Children’s Hospital Ha Noi Vietnam
| | - Khoa D. Nguyen
- General Department of Preventive Medicine ‐ Ministry of Health Ha Noi Vietnam
| | - Mattias Larsson
- Department of Global Public Health Karolinska Institutet Stockholm Sweden
- Training and Research Academic Collaboration Stockholm Sweden
- Training and Research Academic Collaboration Hanoi Vietnam
| | - Linus Olson
- Department of Global Public Health Karolinska Institutet Stockholm Sweden
- Training and Research Academic Collaboration Stockholm Sweden
- Training and Research Academic Collaboration Hanoi Vietnam
- Department of Women’s and Children’s Health Karolinska Institutet Stockholm Sweden
| | - Dien M. Tran
- Vietnam National Children’s Hospital Ha Noi Vietnam
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Ismail MB, Omari SA, Rafei R, Dabboussi F, Hamze M. COVID-19 in children: Could pertussis vaccine play the protective role? Med Hypotheses 2020; 145:110305. [PMID: 33032174 PMCID: PMC7521348 DOI: 10.1016/j.mehy.2020.110305] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/19/2020] [Accepted: 09/23/2020] [Indexed: 12/12/2022]
Abstract
While COVID-19 continues to spread across the globe, diligent efforts are made to understand its attributes and dynamics to help develop treatment and prevention measures. The paradox pertaining to children being the least affected by severe illness poses exciting opportunities to investigate potential protective factors. In this paper, we propose that childhood vaccination against pertussis (whooping cough) might play a non-specific protective role against COVID-19 through heterologous adaptive responses in this young population. Pertussis is a vaccine-preventable infectious disease of the respiratory tract and it shares many similarities with COVID-19 including transmission and clinical features. Although pertussis is caused by a bacterium (Bordetella pertussis) while COVID-19 is a viral infection (SARS-CoV-2), previous data showed that cross-reactivity and heterologous adaptive responses can be seen with unrelated agents of highly divergent groups, such as between bacteria and viruses. While we build the arguments of this hypothesis on theoretical and previous empirical evidence, we also outline suggested lines of research from different fields to test its credibility. Besides, we highlight some concerns that may arise when attempting to consider such an approach as a potential public health preventive intervention against COVID-19.
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Affiliation(s)
- Mohamad Bachar Ismail
- Laboratoire Microbiologie, Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon; Faculty of Sciences, Lebanese University, Tripoli, Lebanon
| | - Sarah Al Omari
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Rayane Rafei
- Laboratoire Microbiologie, Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Fouad Dabboussi
- Laboratoire Microbiologie, Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Monzer Hamze
- Laboratoire Microbiologie, Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon.
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Alimohamadi Y, Zahraei SM, Karami M, Yaseri M, Lotfizad M, Holakouie-Naieni K. Alarm Thresholds for Pertussis Outbreaks in Iran: National Data Analysis. Osong Public Health Res Perspect 2020; 11:309-318. [PMID: 33117636 PMCID: PMC7577381 DOI: 10.24171/j.phrp.2020.11.5.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives The purpose of the current study was to determine the upper threshold number of cases for which pertussis infection would reach an outbreak level nationally in Iran. Methods Data on suspected cases of pertussis from the 25th February 2012 to the 23rd March 2018 from the Center for Disease Control and Prevention in Iran was used. The national upper threshold level was estimated using the exponentially weighted moving average (EWMA) method and the Poisson regression method. Results In total, 2,577 (33.6%) and 1,714 (22.3%) cases were reported in the Spring and Summer respectively. There were 1,417 (18.5%) and 1,971 (25.6%) cases reported in the Autumn and Winter, respectively. The overall upper threshold using the EWMA and the Poisson regression methods, was estimated as a daily occurrence of 8 (7.55) and 7.50 (4.48–11.06) suspected cases per 10,000,000 people, respectively. The daily seasonal thresholds estimated by the EWMA and the Poisson regression methods were 10, 7, 6, 8 cases and 10, 7, 7, 9 cases for the Spring, Summer, Autumn, and Winter, respectively. Conclusion The overall and seasonal estimated thresholds by the 2 methods were similar. Therefore, the estimated thresholds of 6–10 cases in a day, per 10,000,000 people could be used to detect pertussis outbreaks and epidemics by health policymakers.
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Affiliation(s)
- Yousef Alimohamadi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohsen Zahraei
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Manoochehr Karami
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Lotfizad
- School of Electrical and Computer Engineering, Tarbiat Modares University, Tehran, Iran
| | - Kourosh Holakouie-Naieni
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Noel G, Badmasti F, Nikbin VS, Zahraei SM, Madec Y, Tavel D, Aït-Ahmed M, Guiso N, Shahcheraghi F, Taieb F. Transversal sero-epidemiological study of Bordetella pertussis in Tehran, Iran. PLoS One 2020; 15:e0238398. [PMID: 32870922 PMCID: PMC7462262 DOI: 10.1371/journal.pone.0238398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 08/15/2020] [Indexed: 12/28/2022] Open
Abstract
Objectives Pertussis remains endemic despite high vaccine coverage in infants and toddlers. Pertussis vaccines confer protection but immunity wanes overtime and boosters are needed in a lifetime. Iran, eligible for the Expanded Program on Immunization that includes the primary immunization, implemented two additional booster doses using a whole-cell vaccine (wPV) at 18 months-old and about 6 years-old. Duration of protection induced by the wPVs currently in use and their impact as pre-school booster are not well documented. This study aimed at assessing vaccination compliance and at estimating the duration of protection conferred by vaccination with wPV in children aged < 15 years in Tehran, Iran. Methods Detailed information on vaccination history and capillary blood samples were obtained from 1047 children aged 3–15 years who completed the 3 doses-primary pertussis immunization, in Tehran. Anti-pertussis toxin IgG levels were quantified by ELISA. Results Compliance was very high with 93.3% of children who received the three primary and 1st booster doses in a timely manner. Timeliness of the 2nd booster was lower (63.3%). Rate of seropositive samples continuously and significantly increased from 1–2 to 5–6 years after 1st booster attaining 30.4% of children exhibiting serological sign of recent contact with B. pertussis. Second booster dating back 1 or 2 years was associated with high antibody titers, which significantly decreased within 3 years from injection. Among children who received 2nd booster injection more than 2 years before serum analysis, seroprevalence of pertussis infection was 8.4% and seropositivity rate was higher from the 10 years-old group. Conclusion Seropositivity in children aged 6–7 years with no 2nd booster supports the need for a vaccination at that age. Adolescent booster may also be considered.
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Affiliation(s)
- Gaelle Noel
- Institut Pasteur, Center for Translational Research, Paris, France
| | - Farzad Badmasti
- Department of Bacteriology, Pertussis Reference Laboratory, Pasteur Institute of Iran, Tehran, Iran
| | - Vajihe S. Nikbin
- Department of Bacteriology, Pertussis Reference Laboratory, Pasteur Institute of Iran, Tehran, Iran
| | - Seyed M. Zahraei
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Yoann Madec
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Paris, France
| | - David Tavel
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Paris, France
| | - Mohand Aït-Ahmed
- Institut Pasteur, Centre for Translational Science, Clinical Coordination, Paris, France
| | - Nicole Guiso
- Institut Pasteur, Center for Translational Research, Paris, France
| | - Fereshteh Shahcheraghi
- Department of Bacteriology, Pertussis Reference Laboratory, Pasteur Institute of Iran, Tehran, Iran
| | - Fabien Taieb
- Institut Pasteur, Center for Translational Research, Paris, France
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Paris, France
- * E-mail:
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Countering Vaccine Hesitancy among Pregnant Women in England: The Case of Boostrix-IPV. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17144984. [PMID: 32664369 PMCID: PMC7400283 DOI: 10.3390/ijerph17144984] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/23/2020] [Accepted: 07/07/2020] [Indexed: 11/17/2022]
Abstract
This study explored the effects of message framing on vaccine hesitancy for the antenatal whooping cough vaccine. The study also assessed whether the Theory of Planned Behaviour (TPB) constructs had any explanatory utility for vaccine intentions and behaviours in pregnant women. A between-subjects, cross-sectional design was employed. Participants (n = 282) were women who were pregnant (mean = 28 weeks, SD = 7.0), living in England and between 18 and 44 years of age. A self-report web-based survey was used to collect data. Participants were randomly assigned to read either (i) disease risk, (ii) myth busting, or (iii) control information before answering questions based on the TPB. No significant effects of message framing were found. Attitudes (Beta = 0.699; p < 0.001) and subjective norms (Beta = 0.262, p < 0.001) significantly predicted intention to vaccinate but perceived behavioural control did not. The TPB constructs accounted for 86% and 36% of the variance in vaccine intention and vaccine history respectively. Disease risk information did not influence vaccine acceptability in this sample of English pregnant women. The study offered preliminary evidence that interventions targeting constructs from the TPB may promote vaccine acceptability among pregnant women.
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Seroprevalence of Bordetella pertussis toxin antibodies in children and adolescents in Tunis, Tunisia. Epidemiol Infect 2020; 147:e199. [PMID: 31364527 PMCID: PMC6536764 DOI: 10.1017/s0950268819000840] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Pertussis remains a public health concern in most countries. This cross-sectional study aims to investigate the distribution of pertussis toxin antibodies (anti-PT IgG) in Tunisian children and adolescents aged 3–18 years, to define optimal age for booster vaccination. Anti-PT IgG concentrations of enrolled participants were measured using commercial enzyme-linked immunosorbent assay. Concentrations were classified as: indicative of current/recent infection if ⩾100 IU/ml, indicative of recent exposure to Bordetella pertussis within the last year if 40–100 IU/ml and less likely revealing a recent exposure to B. pertussis if <40 IU/ml. Between March and June 2018, a total of 304 participants (mean age: 9.3 years) were included in this study. Overall, 12.8% (95% confidence interval (CI) 9.1%–16.6%) were seropositive (IgG levels ⩾40 IU/ml). Among them, 14.7% (95% CI 2.3%–23.3%) had levels indicative of a current/recent infection. The multivariate Poisson regression analysis suggested associations between female gender, as well as age group 13–18 years and 3–5 years and higher anti-PT IgG concentrations. Our results are consistent with the notion that vaccine-induced immunity decline, as well as circulation of pertussis among school children and adolescents enables them to be reservoirs of infection and disease transmission to vulnerable infants. Booster dose of acellular pertussis vaccine for school entrants is therefore recommended.
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Basir NABA, Rahman NAA, Haque M. Knowledge, Attitude and Practice Regarding Pertussis among a Public University Students in Malaysia. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2020. [DOI: 10.1590/pboci.2020.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | - Mainul Haque
- National Defence University of Malaysia, Malaysia
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Marchi S, Montomoli E, Remarque EJ, Monteverde Spencer GT, Azzarello A, Viviani S, Trombetta CM. Pertussis over two decades: seroepidemiological study in a large population of the Siena Province, Tuscany Region, Central Italy. BMJ Open 2019; 9:e032987. [PMID: 31666278 PMCID: PMC6830678 DOI: 10.1136/bmjopen-2019-032987] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To evaluate seroprevalence against Bordetella pertussis in Tuscany, a large Italian region, from 1992 to 2005 and from 2013 to 2016. DESIGN Seroepidemiological study. PARTICIPANTS 1812 serum samples collected in Tuscany from subjects older than 12 years from 1992 to 2005 and from 2013 to 2016. OUTCOME MEASURES Specific antibody levels were determined by means of standard commercial ELISA using a dual cut-off of 50 and 125 IU/mL as markers of past and recent infection/vaccination, respectively. RESULTS The highest values of IgG titres were observed in 1992-1994 in all subjects (69.5 IU/mL), with prevalence values of subjects with IgG titres of >50 and >125 IU/mL of 68.3% and 23.8%, respectively. IgG titres decreased in the years thereafter (37.8 IU/mL in 2002-2005), together with prevalence values (41.7% and 8.1% in 2002-2005). In 2013-2016, both IgG titres and prevalence values showed a slight increase (50.6 IU/mL, 53.9% and 14.7%, respectively). IgG titres and prevalence followed the same age-related trend in all time periods considered, with the highest values in subjects aged 12-22 years. The lowest values were found in the age group of subjects aged 23-35 years (OR 0.54). CONCLUSIONS Since 2002, approximately half of the population over 22 years of age have low IgG titres and are presumably susceptible to acquiring and transmitting pertussis infection. In addition, in 2013-2016, almost one-third of subjects aged 12-22 years, that is, the age group most likely to have been vaccinated against pertussis in infancy, had low antibody levels. Improving vaccination coverage and implementing careful surveillance are therefore recommended in order to prevent morbidity and mortality due to pertussis.
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Affiliation(s)
- Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- VisMederi srl, Siena, Italy
| | - Edmond J Remarque
- Department of Virology, Biomedical Primate Research Centre, Rijswijk, The Netherlands
| | | | - Angela Azzarello
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Simonetta Viviani
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
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Swift MD, Behrman AJ. Vaccines for Health Care Personnel. Mayo Clin Proc 2019; 94:2127-2141. [PMID: 31515104 DOI: 10.1016/j.mayocp.2019.01.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 01/16/2019] [Accepted: 01/31/2019] [Indexed: 01/01/2023]
Abstract
Medical Center Occupational Health (MCOH) programs must protect health care personnel (HCP) against the occupational risk of vaccine-preventable diseases. This thematic review outlines the rationale for the use of recommended vaccines in HCP; summarizes the available evidence regarding vaccine effectiveness, administration, and assessment of immunity; and provides guidance for MCOH programs navigating challenging situations.
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Affiliation(s)
- Melanie D Swift
- Division of Preventive Occupational and Aerospace Medicine, Mayo Clinic, Rochester, MN.
| | - Amy J Behrman
- Department of Emergency Medicine, Perelman School of Medicine, Philadelphia, PA
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Acceptance of pregnant women's vaccination against pertussis among French women and health professionals: PREVACOQ-1 and -2 studies. Med Mal Infect 2019; 49:593-601. [PMID: 31570170 DOI: 10.1016/j.medmal.2019.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 10/16/2018] [Accepted: 09/02/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Protection of French young infants against pertussis only relies on their relatives' vaccination. The alternative is vaccination of pregnant women against pertussis (cocooning strategy), but this strategy is not yet recommended in France. We assessed the acceptance of this strategy among French postpartum women and health professionals. PATIENTS AND METHODS We performed a multicenter survey in 2016 among postpartum women and health professionals (family physicians, obstetricians-gynecologists, midwives, and medical students) to determine the acceptance of anti-pertussis vaccination. We evaluated knowledge, perception, and attitude towards vaccination to identify factors associated with acceptance. RESULTS Questionnaires were completed by 52% (1208/2337) of women and 40% (694/1754) of health professionals. Seventy-seven per cent of women (95% CI: 74-79) and 93% of health professionals (95% CI: 91-95) were favorable to anti-pertussis vaccination of pregnant women. Thirty-three per cent (227/687) of health professionals believed that pertussis induced life-long immunity and 20% (136/687) of them were not aware of the cocooning strategy. In multivariate analysis, factors associated with acceptance among women were younger age, higher knowledge, having received advice during pregnancy, being vaccinated against influenza, and having never refused any vaccine; among health professionals, factors associated with acceptance were belief that inactivated vaccines are obstetrically safe, regular practice of influenza vaccination in pregnant women, pertussis cocooning strategy, and never prescribing preventive homeopathy for influenza. CONCLUSION Vaccination of pregnant women against pertussis should be well-accepted by informed mothers and health professionals. If this strategy were to be implemented in France, efforts should be made towards adequate information.
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Tate J, Aguado T, Belie JD, Holt D, Karafillakis E, Larson HJ, Nye S, Salisbury D, Votta M, Wait S. The life-course approach to vaccination: Harnessing the benefits of vaccination throughout life. Vaccine 2019; 37:6581-6583. [PMID: 31558327 DOI: 10.1016/j.vaccine.2019.09.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 08/30/2019] [Accepted: 09/05/2019] [Indexed: 10/25/2022]
Abstract
Vaccination beyond childhood brings significant benefits at the individual, community and socio-economic levels. Despite this, immunisation programmes often fail to deliver the vaccines which could protect those at risk of vaccine-preventable diseases. In this commentary, we argue that the benefits of vaccination beyond childhood must be more widely understood and furthermore, that action must be taken by policymakers, healthcare professionals and patient and civil society organisations to ensure that the benefits of vaccination are fully realised. We outline five areas where change is needed to ensure vaccination across the life-course becomes truly embedded in national immunisation programmes. This includes investing in robust data collection and analysis; ensuring coordinated, multidisciplinary leadership from the top; engaging healthcare professionals; changing public perceptions of vaccination; and integrating vaccination into schools and workplaces.
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Affiliation(s)
- Jody Tate
- The Health Policy Partnership, 68-69 St Martin's Lane, London WC2N 4JS, United Kingdom.
| | | | - Jan De Belie
- Pharmaceutical Group of the European Union (PGEU), Rue du Luxembourg 19, 1000 Brussels, Belgium.
| | - Daphne Holt
- Coalition for Life Course Immunisation (CLCI), Horts House, 22 Whitecourt, GL11 5TG, United Kingdom.
| | - Emilie Karafillakis
- Vaccine Confidence Project, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom.
| | - Heidi J Larson
- Vaccine Confidence Project, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom.
| | - Sam Nye
- Confederation of Meningitis Organisations (CoMO), Newminster House, Baldwin Street, Bristol, BS1 1L, United Kingdom.
| | - David Salisbury
- Centre on Global Health Security, The Royal Institute of International Affairs, Chatham House, 10 St James's Square, London, SW1Y 4LE, United Kingdom.
| | - Mariano Votta
- Cittadinanzattiva-Active Citizenship Network (ACN), Via Cereate 6, 00183 Rome, Italy.
| | - Suzanne Wait
- The Health Policy Partnership, 68-69 St Martin's Lane, London WC2N 4JS, United Kingdom.
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Babachenko IV, Nesterova YV, Chernyshova YY, Karasev VV, Pochinyaeva LM, Kalisnikova EL. Clinical-epidemiological aspects of whooping cough in children in conditions of mass vaccinoprophylactics. ACTA ACUST UNITED AC 2019. [DOI: 10.22625/2072-6732-2019-11-2-88-96] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The aim of the study was to present clinical, epidemiological and laboratory characteristics of modern pertussis in hospitalized children, as well as to assess the frequency of pertussis infection as an etiological factor of long – term cough in children and adolescents.Materials and methods: medical records of 545 patients hospitalized in Children’s city clinical hospital №5 named after N.F. Filatov (Saint-Petersburg) in the period 2015–2017 were analyzed. Detailed clinical and laboratory analysis with subsequent follow-up of patients was carried out in 80 patients with pertussis aged 1 month to 18 years. The DNA of the causative agents of pertussis infection was identified by PCR using a commercial kit “AmpliSens Bordetella multi-FL” (Moscow); parallel was determined the bacterial load by quantitative PCRRT (real time) using test systems production, Gamaleya Research Institute of Epidemiology and Microbiology (Moscow), allowing to detect a single genome-equivalents (GE) of B. pertussis in smears from the nasopharynx. Pertussis convalescents were examined 1, 3 and 6 months after discharge.Results. Among hospitalized children dominated the first 2 years of life (70.8%), 78% were unvaccinated children. The sources of infection for children of the first two years of life were family members in 77% of cases, for preschoolers-in 67%, for schoolchildren-in 14%. Patients of moderate severity were 81.1%, severe – 10.3%; mild – 7%. Of the specific complications, respiratory rhythm disturbances were notedin 11.6%, including respiratory arrest-in 2.8%; pneumonia of mixed etiology was recorded in 6.2% of cases. Introduction of PCR method allows to increase laboratory confirmation up to 87.2%. In 63.6% of cases pertussis of pertussis were detected by PCR genome-equivalents of DNA in 6 months from hospital discharge. In patients with long – term cough, pertussis wand DNA was detected in preschool children in 11.14% of cases, in patients 7–12 years – in 25.93%, in adolescents-in 20% of cases.Conclusion. Whooping cough is a common infection among schoolchildren and adolescents, despite the high coverage of young children with preventive vaccinations. Pertussis convalescents can release the DNA of the pathogen for a long time, which may have epidemiological significance for unvaccinated and those children and adults, who have lost postvaccinal immunity, in the foci of infection.
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Affiliation(s)
| | | | | | - V. V. Karasev
- Pediatric Research and Clinical Center for Infectious Diseases
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Kandeil W, Atanasov P, Avramioti D, Fu J, Demarteau N, Li X. The burden of pertussis in older adults: what is the role of vaccination? A systematic literature review. Expert Rev Vaccines 2019; 18:439-455. [PMID: 30887849 DOI: 10.1080/14760584.2019.1588727] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Pertussis (whooping cough) is a vaccine-preventable disease; however, neither natural- nor vaccine-induced protection is life-long. Although generally not severe in adults, pertussis can be associated with complications in patients with chronic conditions such as asthma or chronic obstructive pulmonary disease, and can be readily transmitted to more vulnerable populations, including neonates before they complete their primary vaccination. Furthermore, as the global population ages, the health and economic burden of the disease is expected to rise. Areas covered: A systematic literature review was conducted to ascertain the current epidemiological and financial burden of pertussis in older adults and to discuss the potential value of a booster vaccination in this population. Expert commentary: Our review indicates a considerable underestimation of the pertussis burden amongst older adults. Seroprevalence studies consistently demonstrate that the reported incidence may be much lower than the actual incidence. Tetanus toxoid-reduced diphtheria toxoid and acellular pertussis vaccines are immunogenic in older adults, induce high booster responses and are well-tolerated. There is therefore a good rationale for the advocacy of booster pertussis vaccination throughout life to prevent pertussis infection and its transmission, especially in adults aged ≥50 years.
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Plans-Rubió P, Navas E, Godoy P, Carmona G, Domínguez A, Jané M, Muñoz-Almagro C, Brotons P. Reduction of Direct Health Costs Associated with Pertussis Vaccination with Acellular Vaccines in Children Aged 0-9 Years with Pertussis in Catalonia (Spain). PHARMACOECONOMICS - OPEN 2019; 3:55-69. [PMID: 29761340 PMCID: PMC6393282 DOI: 10.1007/s41669-018-0081-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The aim of this study was to assess direct health costs in children with pertussis aged 0-9 years who were vaccinated, partially vaccinated, and unvaccinated during childhood, and to assess the association between pertussis costs and pertussis vaccination in Catalonia (Spain) in 2012-2013. METHODS Direct healthcare costs included pertussis treatment, pertussis detection, and preventive chemotherapy of contacts. Pertussis patients were considered vaccinated when they had received 4-5 doses, and unvaccinated or partially vaccinated when they had received 0-3 doses of vaccine. The Chi square test and the odds ratios were used to compare percentages and the t test was used to compare mean pertussis costs in different groups, considering a p < 0.05 as statistically significant. The correlation between pertussis costs and study variables was assessed using the Spearman's ρ, with a p < 0.05 as statistically significant. Multiple linear regression analysis (IBM-SPSS program) was used to quantify the association of pertussis vaccination and other study variables with pertussis costs. RESULTS Vaccinated children with pertussis aged 0-9 years had significantly lower odds ratios of hospitalizations (OR 0.02, p < 0.001), laboratory confirmation (OR 0.21, p < 0.001), and severe disease (OR 0.02, p < 0.001) than unvaccinated or partially vaccinated children with pertussis of the same age. Mean direct healthcare costs were significantly lower (p < 0.001) in vaccinated patients (€190.6) than in unvaccinated patients (€3550.8), partially vaccinated patients (€1116.9), and unvaccinated/partially vaccinated patients (€2330). Multivariable linear regression analysis showed that pertussis vaccination with 4-5 doses was associated with a non-significant reduction of pertussis costs of €107.9 per case after taking into account the effect of other study variables, and €200 per case after taking into account pertussis severity. CONCLUSIONS Direct healthcare costs were lower in children with pertussis aged 0-9 years vaccinated with 4-5 doses of acellular vaccines than in unvaccinated or partially vaccinated children with pertussis of the same age.
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Affiliation(s)
- Pedro Plans-Rubió
- Department of Health of Catalonia, Public Health Agency of Catalonia, Roc Boronat 83-95, 08005, Barcelona, Spain.
- CIBERESP, Madrid, Spain.
| | - Encarna Navas
- Department of Health of Catalonia, Public Health Agency of Catalonia, Roc Boronat 83-95, 08005, Barcelona, Spain
| | - Pere Godoy
- Department of Health of Catalonia, Public Health Agency of Catalonia, Roc Boronat 83-95, 08005, Barcelona, Spain
- CIBERESP, Madrid, Spain
| | - Gloria Carmona
- Department of Health of Catalonia, Public Health Agency of Catalonia, Roc Boronat 83-95, 08005, Barcelona, Spain
| | - Angela Domínguez
- Department of Public Health, University of Barcelona, Barcelona, Spain
- CIBERESP, Madrid, Spain
| | - Mireia Jané
- Department of Health of Catalonia, Public Health Agency of Catalonia, Roc Boronat 83-95, 08005, Barcelona, Spain
- CIBERESP, Madrid, Spain
| | | | - Pedro Brotons
- Sant Joan de Deu Hospital, Barcelona, Spain
- CIBERESP, Madrid, Spain
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Affiliation(s)
- Dipesh P Gopal
- Centre for Primary Care and Public Health, Barts and The London School of Medicine & Dentistry, London E1 2AB, UK
| | - John Barber
- Research Department of Primary Care and Population Health, University College London Medical School (Royal Free Campus), London NW3 2PF, UK
| | - Daniel Toeg
- Caversham Group Practice, London NW5 2UP, UK
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Park C, Huh DH, Han SB, Choi GS, Kang KR, Kim JA, Kang JH. Development and implementation of standardized method for detecting immunogenicity of acellular pertussis vaccines in Korea. Clin Exp Vaccine Res 2019; 8:35-42. [PMID: 30775349 PMCID: PMC6369126 DOI: 10.7774/cevr.2019.8.1.35] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 01/14/2019] [Accepted: 01/18/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose There is no standard method for confirming the immunogenicity of acellular pertussis vaccines. We tried to develop a local standard method for evaluating the immunogenicity of the three-component of acellular pertussis vaccines which was developed by a Korean local company. Materials and Methods The developed pertussis antigens (pertussis toxin, filamentous hemagglutinin, pertactin) were evaluated by in-house enzyme-linked immunosorbent assay (ELISA) using 189 negative sera, 25 positive sera, and 73 paired sera (pre- and post-Tdap [tetanus, diphtheria, and acellular pertussis] vaccinated sera). ELISA units were calculated by the reference line method, compared with World Health Organization reference sera, and the cut-off value was calculated using negative sera. Results When compared to National Institute for Biological Standards and Control control antigen (NIBSC) control antigens, the developed pertussis toxin (PT) and filamentous haemagglutinin (FHA) antigens were 203.48 and 61.60 IU/µg, respectively. Each in-house ELISA was established by validating the coefficients of variation % (PT, 11.53%; FHA, 8.60%; pertactin [PRN], 9.86%) obtained from the results of inter- and intra-assay variation. Also, the cut-off values of PT, FHA, and PRN were 11.65, 38.95, and 5.66 EU/mL, respectively. The distributions of antibody levels in paired showed that 93.15% (68/73) in anti-PT IgG, 97.26% (72/73) in anti-FHA IgG, and 100% in anti-PRN IgG were higher than a 100% increase after vaccination. Additionally, the values of 89.04% (65/73) in anti-PT IgG, 97.26% (72/73) in anti-FHA IgG, and 100% in anti-PRN IgG were below each cut-off point. Conclusion We established an in-house ELISA method using self-developed antigens, and these immunoassays have provided a way to standardize measuring the immunogenicity of newly developed vaccines, through single- and dual-serology.
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Affiliation(s)
- Chulmin Park
- Vaccine Bio Research Institute, The Catholic University of Korea, Seoul, Korea
| | - Dong Ho Huh
- Vaccine Bio Research Institute, The Catholic University of Korea, Seoul, Korea
| | - Seung Beom Han
- Vaccine Bio Research Institute, The Catholic University of Korea, Seoul, Korea.,Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | | | - Kyu Ri Kang
- Vaccine Bio Research Institute, The Catholic University of Korea, Seoul, Korea
| | - Ji Ahn Kim
- Vaccine Bio Research Institute, The Catholic University of Korea, Seoul, Korea
| | - Jin Han Kang
- Vaccine Bio Research Institute, The Catholic University of Korea, Seoul, Korea.,Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Nakayama T, Suga S, Okada K, Okabe N. Persistence of Antibodies against Diphtheria, Tetanus, Pertussis, and Poliovirus Types I, II, and III Following Immunization with DTaP Combined with Inactivated Wild-Type Polio Vaccine (DTaP-wIPV). Jpn J Infect Dis 2019; 72:49-52. [DOI: 10.7883/yoken.jjid.2018.314] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Tetsuo Nakayama
- Kitasato Institute for Life Sciences, Laboratory of Viral Infection
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Human Immune Responses to Pertussis Vaccines. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1183:99-113. [PMID: 31342460 DOI: 10.1007/5584_2019_406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Pertussis still represents a major cause of morbidity and mortality worldwide. Although vaccination is the most powerful tool in preventing pertussis and despite nearly 70 years of universal childhood vaccination, incidence of the disease has been rising in the last two decades in countries with high vaccination coverage. Two types of vaccines are commercially available against pertussis: whole-cell pertussis vaccines (wPVs) introduced in the 1940s and still in use especially in low and middle-income countries; less reactogenic acellular pertussis vaccines (aPVs), licensed since the mid-1990s.In the last years, studies on pertussis vaccination have highlighted significant gaps and major differences between the two types of vaccines in the induction of protective anti-pertussis immunity in humans. This chapter will discuss the responses of the immune system to wPVs and aPVs, with the aim to enlighten critical points needing further efforts to reach a good level of protection in vaccinated individuals.
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Pertussis in Low and Medium Income Countries: A Pragmatic Approach. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1183:137-149. [DOI: 10.1007/5584_2019_409] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Ben Fraj I, Kechrid A, Guillot S, Bouchez V, Brisse S, Guiso N, Smaoui H. Pertussis epidemiology in Tunisian infants and children and characterization of Bordetella pertussis isolates: results of a 9-year surveillance study, 2007 to 2016. J Med Microbiol 2018; 68:241-247. [PMID: 30526740 DOI: 10.1099/jmm.0.000892] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Pertussis remains a public health concern in most countries. Our study aimed to prospectively explore the epidemiology of pertussis in the Tunis area of Tunisia between 2007 and 2016, and to characterize the virulence-associated genes of the collected Bordetella pertussis isolates. METHODOLOGY Infants and children hospitalized at the Children's Hospital of Tunis, Tunisia, between 2007 and 2016 for suspicion of pertussis were enrolled in the study. Culture and real-time PCR (qPCR) assays targeting IS481, IS1001, recA, H-IS1001 and ptxP were used to confirm the pertussis diagnosis. Phenotypic and genotypic characterization of recovered isolates was performed.Results/Key findings. A total of 1844 children were included in the study. Overall, 306 children (16.6 %) with Bordetella infection were confirmed by qPCR. Among them, 265 (86.6 %) were confirmed as having B. pertussis (IS481+, ptxP+, H-IS1001-), 18 (5.9 %) as having Bordetella parapertussis (IS481-, IS1001+) and 11 (3.6 %) as having Bordetella spp. (IS481+, ptxP-, H-IS1001-). No Bordetella holmesii (IS481+, IS1001-, H-IS1001+) was identified. The estimated pertussis incidence in the Tunis area was 134/100 000 in children aged less than 5 years. Two epidemic peaks were observed in 2009 and 2014. Ten B. pertussis isolates were cultured and characterized. Deficiency in pertactin expression was not observed, and genotyping of the isolates revealed a predominant allelic profile: ptxP3-ptxA1-prn2-fim2-1-fim3-2. CONCLUSION This study demonstrated that pertussis is still present as a cyclical disease in Tunisia, despite high primo-vaccination coverage with a pertussis whole-cell vaccine. The predominant genotype of Tunisian B. pertussis isolates is similar to isolates circulating in countries using the acellular vaccine.
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Affiliation(s)
- Ikram Ben Fraj
- 1University of Tunis El Manar, Children's Hospital of Tunis, Laboratory of Microbiology, UR12ES01, Tunis, Tunisia
| | - Amel Kechrid
- 1University of Tunis El Manar, Children's Hospital of Tunis, Laboratory of Microbiology, UR12ES01, Tunis, Tunisia
| | - Sophie Guillot
- 2Biodiversity and Epidemiology of Bacterial Pathogens Unit, Institut Pasteur, Paris, France
- 3National Reference Center for Whooping Cough and Other Bordetella Infections, Institut Pasteur, Paris, France
| | - Valérie Bouchez
- 2Biodiversity and Epidemiology of Bacterial Pathogens Unit, Institut Pasteur, Paris, France
- 3National Reference Center for Whooping Cough and Other Bordetella Infections, Institut Pasteur, Paris, France
| | - Sylvain Brisse
- 2Biodiversity and Epidemiology of Bacterial Pathogens Unit, Institut Pasteur, Paris, France
- 3National Reference Center for Whooping Cough and Other Bordetella Infections, Institut Pasteur, Paris, France
| | - Nicole Guiso
- 3National Reference Center for Whooping Cough and Other Bordetella Infections, Institut Pasteur, Paris, France
| | - Hanen Smaoui
- 1University of Tunis El Manar, Children's Hospital of Tunis, Laboratory of Microbiology, UR12ES01, Tunis, Tunisia
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Seroprevalence of pertussis among healthcare workers: A cross-sectional study from Tunisia. Vaccine 2018; 37:109-112. [PMID: 30459070 DOI: 10.1016/j.vaccine.2018.11.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/15/2018] [Accepted: 11/12/2018] [Indexed: 01/14/2023]
Abstract
This cross-sectional study aimed to assess pertussis seroprevalence among healthy healthcare workers (HCW) of the Children's Hospital of Tunis, Tunisia. During the study period, 236 blood samples were obtained to determine HCW exposure to pertussis. Concentrations of immunoglobulin G (IgG) to pertussis toxin (PT) were measured using a commercial enzyme-linked immunosorbent assay. Cut-offs values used were 40 and 100 IU/ml, respectively indicative of an infection within the last year and a current/recent infection. Overall, seropositivity rate was 11.4% (95% CI 7.4-15.5) and 2.5% (95% CI 0.5-4.6) of ELISA results were indicative of a current infection. Seroprevalence was significantly most important in nurses (p = 0.03) and in participants aged 21-31y (p = 0.009). Our study confirmed that pertussis is circulating in hospital settings and affecting Tunisian HCW, in close contact with infants. Therefore, a booster dose of acellular pertussis vaccine needs to be considered.
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Recommendations to control pertussis prioritized relative to economies: A Global Pertussis Initiative update. Vaccine 2018; 36:7270-7275. [PMID: 30337176 DOI: 10.1016/j.vaccine.2018.10.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 10/03/2018] [Accepted: 10/04/2018] [Indexed: 11/21/2022]
Abstract
Pertussis is a vaccine-preventable disease that causes morbidity and mortality, particularly in infants and children <5 years of age. The Global Pertussis Initiative (GPI) recommendations represent a systematic evaluation and prioritization of strategies to prevent pertussis-related infant and child deaths, reduce global disease burden and prevent resurgence through vaccination strategies and public health policies at national, regional and local levels. The GPI recommendations are based on clinical trials and observational and surveillance data, which are essential in the planning, implementation and evaluation of vaccination practices and best use of available resources. Many low- and middle-income countries (LMIC) continue to use whole-cell pertussis (wP) vaccines for primary vaccination, while most high-income countries have replaced wP with the less-reactogenic acellular pertussis (aP) vaccines. This present manuscript pertains to discussions held during the GPI's meeting on November 11-13, 2016, in Cape Town, Republic of South Africa. The GPI recommends that LMIC aim for high coverage of infant series pertussis vaccines as a priority. In LMIC and countries with constrained vaccine funding, if wP vaccines are currently used, wP should continue to be used. Furthermore, given that protection against disease and death due to pertussis in neonates is a key priority of the GPI, it recommends that ap immunization in pregnancy should be implemented as a priority in all countries if resources allow. Given that surveillance and epidemiology data on which to base vaccine decisions are important, the GPI also suggests that, in areas where wP vaccines are implemented, standardization and calibration of wP vaccines are checked, considering the many different manufacturers and variable standards of production and quality control. In addition, as immunity to pertussis wanes following the primary infant series of vaccination, the GPI further recommends that toddlers, adolescents, healthcare and childcare workers receive booster vaccine doses, where resources allow.
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Ramos-Fernández JM, Sánchez-Pérez M, Sánchez-González JM, Calvo-Cillán A, Moreno-Pérez D. Apnea in infants hospitalized with pertussis: Incidence and gestational smoking association. Pediatr Int 2018; 60:943-947. [PMID: 30074664 DOI: 10.1111/ped.13668] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 07/10/2018] [Accepted: 08/01/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Apnea is a life-threatening complication of pertussis, now a re-emerging cause of infant hospitalization worldwide. The incidence of apnea during pertussis ranges widely. The aim of this study was therefore to determine the incidence of apnea in hospitalized infants diagnosed with pertussis and to identify relevant risk factors for apnea. METHODS This was a retrospective analytical study. We included children hospitalized with pertussis at a tertiary hospital during a 5 year period from 2010 to 2015. Nasopharyngeal aspirates (NPA) were obtained in all subjects. Real-time polymerase chain reaction was used to test NPA samples for Bordetella pertussis. The daily charts were assessed to identify inpatients with apnea. Multivariable logistic regression was performed to identify independent risk factors for inpatient apnea. RESULTS Inpatient apnea was identified in 51 of 147 infants with pertussis confirmation (34.7%: 95%CI: 27-42%). Maternal smoking during pregnancy was the only statistically significant, independent predictor of inpatient apnea (OR: 4.48; 95%CI: 1.35-14.8). No statistically significant association was found with gender, corrected age; birthweight, caregiver smoking; lactation, weight at admission <3rd percentile, or hematological parameters. CONCLUSIONS The incidence of pertussis apnea was nearly one in three hospitalized infants, and was fourfold more frequent in infants whose mothers smoked during pregnancy.
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Affiliation(s)
- José Miguel Ramos-Fernández
- Department of Pediatrics, Regional Maternal-Child University Hospital, Malaga, Spain.,IBIMA Multidisciplinary Group for Pediatric Research, Malaga, Spain
| | | | | | - Alicia Calvo-Cillán
- Department of Pediatrics, Regional Maternal-Child University Hospital, Malaga, Spain
| | - David Moreno-Pérez
- Department of Pediatrics, Regional Maternal-Child University Hospital, Malaga, Spain.,IBIMA Multidisciplinary Group for Pediatric Research, Malaga, Spain.,Malaga University, Malaga, Spain
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van der Lee S, Stoof SP, van Ravenhorst MB, van Gageldonk PGM, van der Maas NAT, Sanders EAM, Buisman AM, Berbers GAM. Enhanced Bordetella pertussis acquisition rate in adolescents during the 2012 epidemic in the Netherlands and evidence for prolonged antibody persistence after infection. ACTA ACUST UNITED AC 2018; 22. [PMID: 29183555 PMCID: PMC5710659 DOI: 10.2807/1560-7917.es.2017.22.47.17-00011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In 2012 a large epidemic of pertussis occurred in the Netherlands. We assessed pertussis toxin (PT) antibody levels in longitudinal serum samples from Dutch 10–18 year-olds, encompassing the epidemic, to investigate pertussis infection incidence. Methods: Blood was sampled in October 2011 (n = 239 adolescents), then 1 year (2012; n = 228) and 3 years (2014; n = 167) later. PT-IgG concentrations were measured by immunoassay and concentrations ≥50 IU/mL (seropositive) assumed indicative of an infection within the preceding year. Results: During the 2012 epidemic, 10% of participants became seropositive, while this was just 3% after the epidemic. The pertussis acquisition rate proved to be sixfold higher during the epidemic (97 per 1,000 person-years) compared with 2012–2014 (16 per 1,000 person-years). In 2012, pertussis notifications among adolescents nationwide were 228/100,000 (0.23%), which is at least 40 times lower than the seropositivity percentage. Remarkably, 17 of the 22 seropositive participants in 2011, were still seropositive in 2012 and nine remained seropositive for at least 3 years. Discussion: Longitudinal studies allow a better estimation of pertussis infections in the population. A PT-IgG concentration ≥50 IU/mL as indication of recent infection may overestimate these numbers in cross-sectional serosurveillance and should be used carefully.
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Affiliation(s)
- Saskia van der Lee
- Department of Peadiatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands.,Centre for Infectious Disease Control, National institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Susanne P Stoof
- Department of Peadiatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands.,Centre for Infectious Disease Control, National institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Mariette B van Ravenhorst
- Department of Peadiatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands.,Centre for Infectious Disease Control, National institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Pieter G M van Gageldonk
- Centre for Infectious Disease Control, National institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Nicoline A T van der Maas
- Centre for Infectious Disease Control, National institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Elisabeth A M Sanders
- Department of Peadiatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands
| | - Anne-Marie Buisman
- Centre for Infectious Disease Control, National institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Guy A M Berbers
- Centre for Infectious Disease Control, National institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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