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Calvo AE, Tristán Urrutia AG, Vargas-Zambrano JC, López Castillo H. Pertussis vaccine effectiveness following country-wide implementation of a hexavalent acellular pertussis immunization schedule in infants and children in Panama. Hum Vaccin Immunother 2024; 20:2389577. [PMID: 39164002 PMCID: PMC11340738 DOI: 10.1080/21645515.2024.2389577] [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: 05/15/2024] [Revised: 07/31/2024] [Accepted: 08/04/2024] [Indexed: 08/22/2024] Open
Abstract
Despite high pediatric vaccination coverage rates (VCRs), pertussis incidence has increased worldwide, including in several countries in Latin America in the last two decades. Given the few vaccine effectiveness (VE) studies in Latin American countries, this retrospective, observational, cohort study estimated the effectiveness of hexavalent acellular (aP) primary and booster vaccination (wP) against pertussis in infants (6.5-18.5 months) and children (18.5-48.5 and 48.5-72.5 months) in Panama. Age-specific incidence rates (IRs) were calculated for the vaccine's pre-initiation (2001-2013), initiation (2014), and post-initiation (2015-2019) periods. VCRs and trends were determined, and VE was analyzed using a case coverage or screening method to compare proportions of vaccinated cases and vaccinated individuals in the population. Between 2001-2019, 868 confirmed pertussis cases were reported in Panama; 712 (82.0%; 54.8 cases/year) during the pre-initiation period, 19 (2.2%; 19 cases/year) during the initiation period, and 137 (15.8%; 27.4 cases/year) during the post-initiation period. Panama underwent cyclical increases in IRs, which varied between age groups. VCRs increased for primary and booster doses. Between 2015 and 2019, third-dose yearly vaccine coverage increased, on average, 3.3%. Specifically, during the post-initiation period, 109/137 (79.6%) of cases were unvaccinated. Relative VE was estimated at 96.2% [95% CI: 86.5%, 98.9%] with three doses; 100% with 4 and 5 booster doses. Absolute VE was estimated at 99.3% with three doses only. These results show that vaccination played an important role in maintaining a low number of pertussis cases in Panama, affirming the need for sustained investment and commitment to vaccination programs.
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Affiliation(s)
- Arlene E. Calvo
- College of Public Health, University of South Florida, Panama Program at City of Knowledge, Tampa, FL, USA
- Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | | | | | - Humberto López Castillo
- Department of Health Sciences, College of Health Professions and Sciences, Academic Health Sciences Center, University of Central Florida, Orlando, FL, USA
- Department of Population Health Sciences, College of Medicine, Academic Health Sciences Center, University of Central Florida, Orlando, FL, USA
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2
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Domenech de Cellès M, Rohani P. Pertussis vaccines, epidemiology and evolution. Nat Rev Microbiol 2024; 22:722-735. [PMID: 38907021 DOI: 10.1038/s41579-024-01064-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2024] [Indexed: 06/23/2024]
Abstract
Pertussis, which is caused by Bordetella pertussis, has plagued humans for at least 800 years, is highly infectious and can be fatal in the unvaccinated, especially very young infants. Although the rollout of whole-cell pertussis (wP) vaccines in the 1940s and 1950s was associated with a drastic drop in incidence, concerns regarding the reactogenicity of wP vaccines led to the development of a new generation of safer, acellular (aP) vaccines that have been adopted mainly in high-income countries. Over the past 20 years, some countries that boast high aP coverage have experienced a resurgence in pertussis, which has led to substantial debate over the basic immunology, epidemiology and evolutionary biology of the bacterium. Controversy surrounds the duration of natural immunity and vaccine-derived immunity, the ability of vaccines to prevent transmission and severe disease, and the impact of evolution on evading vaccine immunity. Resolving these issues is made challenging by incomplete detection of pertussis cases, the absence of a serological marker of immunity, modest sequencing of the bacterial genome and heterogeneity in diagnostic methods of surveillance. In this Review, we lay out the complexities of contemporary pertussis and, where possible, propose a parsimonious explanation for apparently incongruous observations.
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Affiliation(s)
| | - Pejman Rohani
- Odum School of Ecology, University of Georgia, Athens, GA, USA.
- Center of Ecology of Infectious Diseases, Athens, GA, USA.
- Department of Infectious Diseases, College for Veterinary Medicine, University of Georgia, Athens, GA, USA.
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3
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Gillard J, Suffiotti M, Brazda P, Venkatasubramanian PB, Versteegen P, de Jonge MI, Kelly D, Bibi S, Pinto MV, Simonetti E, Babiceanu M, Kettring A, Teodosio C, de Groot R, Berbers G, Stunnenberg HG, Schanen B, Fenwick C, Huynen MA, Diavatopoulos DA. Antiviral responses induced by Tdap-IPV vaccination are associated with persistent humoral immunity to Bordetella pertussis. Nat Commun 2024; 15:2133. [PMID: 38459022 PMCID: PMC10923912 DOI: 10.1038/s41467-024-46560-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/01/2024] [Indexed: 03/10/2024] Open
Abstract
Many countries continue to experience pertussis epidemics despite widespread vaccination. Waning protection after booster vaccination has highlighted the need for a better understanding of the immunological factors that promote durable protection. Here we apply systems vaccinology to investigate antibody responses in adolescents in the Netherlands (N = 14; NL) and the United Kingdom (N = 12; UK) receiving a tetanus-diphtheria-acellular pertussis-inactivated poliovirus (Tdap-IPV) vaccine. We report that early antiviral and interferon gene expression signatures in blood correlate to persistence of pertussis-specific antibody responses. Single-cell analyses of the innate response identified monocytes and myeloid dendritic cells (MoDC) as principal responders that upregulate antiviral gene expression and type-I interferon cytokine production. With public data, we show that Tdap vaccination stimulates significantly lower antiviral/type-I interferon responses than Tdap-IPV, suggesting that IPV may promote antiviral gene expression. Subsequent in vitro stimulation experiments demonstrate TLR-dependent, IPV-specific activation of the pro-inflammatory p38 MAP kinase pathway in MoDCs. Together, our data provide insights into the molecular host response to pertussis booster vaccination and demonstrate that IPV enhances innate immune activity associated with persistent, pertussis-specific antibody responses.
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Affiliation(s)
- Joshua Gillard
- Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Madeleine Suffiotti
- Service of Immunology and Allergy, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Peter Brazda
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | - Pauline Versteegen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Marien I de Jonge
- Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dominic Kelly
- Department of Paediatrics, Oxford Vaccine Group, University of Oxford, Oxford, UK
- Oxford NIHR Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Sagida Bibi
- Department of Paediatrics, Oxford Vaccine Group, University of Oxford, Oxford, UK
- Oxford NIHR Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Marta Valente Pinto
- Department of Paediatrics, Oxford Vaccine Group, University of Oxford, Oxford, UK
- Oxford NIHR Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, Almada, Portugal
| | - Elles Simonetti
- Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | | | - Cristina Teodosio
- Leiden University Medical Center, Immunohematology & Blood Transfusion, Leiden, The Netherlands
| | - Ronald de Groot
- Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Guy Berbers
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | | | - Craig Fenwick
- Service of Immunology and Allergy, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Martijn A Huynen
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dimitri A Diavatopoulos
- Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.
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Mikucki A, Kahler CM. Microevolution and Its Impact on Hypervirulence, Antimicrobial Resistance, and Vaccine Escape in Neisseria meningitidis. Microorganisms 2023; 11:3005. [PMID: 38138149 PMCID: PMC10745880 DOI: 10.3390/microorganisms11123005] [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: 11/06/2023] [Revised: 12/07/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
Neisseria meningitidis is commensal of the human pharynx and occasionally invades the host, causing the life-threatening illness invasive meningococcal disease. The meningococcus is a highly diverse and adaptable organism thanks to natural competence, a propensity for recombination, and a highly repetitive genome. These mechanisms together result in a high level of antigenic variation to invade diverse human hosts and evade their innate and adaptive immune responses. This review explores the ways in which this diversity contributes to the evolutionary history and population structure of the meningococcus, with a particular focus on microevolution. It examines studies on meningococcal microevolution in the context of within-host evolution and persistent carriage; microevolution in the context of meningococcal outbreaks and epidemics; and the potential of microevolution to contribute to antimicrobial resistance and vaccine escape. A persistent theme is the idea that the process of microevolution contributes to the development of new hyperinvasive meningococcal variants. As such, microevolution in this species has significant potential to drive future public health threats in the form of hypervirulent, antibiotic-resistant, vaccine-escape variants. The implications of this on current vaccination strategies are explored.
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Affiliation(s)
- August Mikucki
- Marshall Centre for Infectious Diseases Research and Training, School of Biomedical Sciences, University of Western Australia, Perth, WA 6009, Australia;
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia
| | - Charlene M. Kahler
- Marshall Centre for Infectious Diseases Research and Training, School of Biomedical Sciences, University of Western Australia, Perth, WA 6009, Australia;
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia
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Fadlyana E, Rusmil K, Dhamayanti M, Tarigan R, Kartasasmita CB, Sari RM, Putra MGD, Sukandar H. Comparison of Immunogenicity and Safety of Diphtheria-Tetanus-Pertussis-Hepatitis B- Haemophilus influenza B (Bio Farma) with Pentabio ® Vaccine Primed with Recombinant Hepatitis B at Birth (Using Different Source of Hepatitis B) in Indonesian Infants. Vaccines (Basel) 2023; 11:498. [PMID: 36992082 PMCID: PMC10052185 DOI: 10.3390/vaccines11030498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 02/24/2023] Open
Abstract
Satisfying the needs of the national immunization program requires maintaining diphtheria-tetanus-pertussis (DTP)-hepatitis B (HB)-Haemophilus influenza B (Hib) production. Therefore, new hepatitis B sources are needed. This study aimed to evaluate the immunogenicity of the DTP-HB-Hib vaccine (Bio Farma) that used a different source of hepatitis B. A prospective randomized, double-blind, bridging study was conducted. Subjects were divided into two groups with different batch numbers. Healthy infants 6-11 weeks of age at enrollment were immunized with three doses of the DTP-HB-Hib vaccine after a birth dose of hepatitis B vaccine. Blood samples were obtained prior to vaccination and 28 days after the third dose. Adverse events were recorded until 28 days after each dose. Of the 220 subjects, 205 (93.2%) completed the study protocol. The proportion of infants with anti-diphtheria and anti-tetanus titers ≥ 0.01 IU/mL was 100%, with anti-HBsAg titers ≥ 10 mIU/mL was 100%, and with Polyribosylribitol Phosphate-Tetanus Conjugate (PRP-TT) titers > 0.15 µg/mL was 96.1%. The pertussis response rate was 84.9%. No serious adverse events related to the study vaccine occurred. The three-dose DTP-HB-Hib vaccine (Bio Farma) is immunogenic, well tolerated, and suitable to replace licensed-equivalent vaccines.
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Affiliation(s)
- Eddy Fadlyana
- Child and Health Department, Faculty of Medicine, Padjajaran University, Hasan Sadikin Hospital West Java Indonesia, Bandung 40161, Indonesia
| | - Kusnandi Rusmil
- Child and Health Department, Faculty of Medicine, Padjajaran University, Hasan Sadikin Hospital West Java Indonesia, Bandung 40161, Indonesia
| | - Meita Dhamayanti
- Child and Health Department, Faculty of Medicine, Padjajaran University, Hasan Sadikin Hospital West Java Indonesia, Bandung 40161, Indonesia
| | - Rodman Tarigan
- Child and Health Department, Faculty of Medicine, Padjajaran University, Hasan Sadikin Hospital West Java Indonesia, Bandung 40161, Indonesia
| | - Cissy B. Kartasasmita
- Child and Health Department, Faculty of Medicine, Padjajaran University, Hasan Sadikin Hospital West Java Indonesia, Bandung 40161, Indonesia
| | - Rini Mulia Sari
- Surveillance & Clinical Research Division PT Bio Farma, Bandung 40161, Indonesia
| | - Muhammad Gilang Dwi Putra
- Child and Health Department, Faculty of Medicine, Padjajaran University, Hasan Sadikin Hospital West Java Indonesia, Bandung 40161, Indonesia
| | - Hadyana Sukandar
- Public Health Department, Faculty of Medicine, Padjajaran University, Bandung 40161, Indonesia
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Caulfield AD, Callender M, Harvill ET. Generating enhanced mucosal immunity against Bordetella pertussis: current challenges and new directions. Front Immunol 2023; 14:1126107. [PMID: 36895562 PMCID: PMC9990818 DOI: 10.3389/fimmu.2023.1126107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 02/08/2023] [Indexed: 02/23/2023] Open
Abstract
Bordetella pertussis (Bp) is the highly transmissible etiologic agent of pertussis, a severe respiratory disease that causes particularly high morbidity and mortality in infants and young children. Commonly known as "whooping cough," pertussis is one of the least controlled vaccine-preventable diseases worldwide with several countries experiencing recent periods of resurgence despite broad immunization coverage. While current acellular vaccines prevent severe disease in most cases, the immunity they confer wanes rapidly and does not prevent sub clinical infection or transmission of the bacterium to new and vulnerable hosts. The recent resurgence has prompted new efforts to generate robust immunity to Bp in the upper respiratory mucosa, from which colonization and transmission originate. Problematically, these initiatives have been partially hindered by research limitations in both human and animal models as well as potent immunomodulation by Bp. Here, we consider our incomplete understanding of the complex host-pathogen dynamics occurring in the upper airway to propose new directions and methods that may address critical gaps in research. We also consider recent evidence that supports the development of novel vaccines specifically designed to generate robust mucosal immune responses capable of limiting upper respiratory colonization to finally halt the ongoing circulation of Bordetella pertussis.
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Affiliation(s)
- Amanda D. Caulfield
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
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7
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Fakhraei R, Fung SG, Petrcich W, Crowcroft N, Bolotin S, Gaudet L, Amirthalingam G, Biringer A, Wilson K, Dubey V, Halperin SA, Jamieson F, Kwong JC, Sadarangani M, Cook J, Hawken S, Walker MC, Fell DB. Trends and characteristics of Tdap vaccination during pregnancy in Ontario, Canada: a retrospective cohort study. CMAJ Open 2022; 10:E1017-E1026. [PMID: 36735222 PMCID: PMC9744266 DOI: 10.9778/cmajo.20220058] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In February 2018, Canada's National Advisory Committee on Immunization (NACI) recommended tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccination during pregnancy to protect newborns against pertussis infection. We sought to describe pre- and postrecommendation trends in Tdap vaccination coverage among pregnant Ontario residents. METHODS Using linked health administrative databases, we conducted a population-based retrospective cohort study of all pregnant individuals who gave birth in Ontario hospitals between April 2012 and March 2020. We described Tdap vaccination patterns in pregnancy for the entire study period and before and after the NACI recommendation. We used log-binomial regression to identify characteristics associated with Tdap vaccination during pregnancy. RESULTS Among the 991 850 deliveries included, 7.0% of pregnant individuals received the Tdap vaccination during pregnancy. Vaccine coverage increased from 0.4% in 2011/12 to 29.2% in 2019/20. Coverage was highest among individuals who were older, had no previous live births, had adequate prenatal care and received maternity care primarily from a family physician. After adjustment, characteristics associated with lower coverage included younger maternal age, having a multiple birth, residing in a rural location and higher area material deprivation. In 2019/20, 71.0% of vaccinated individuals received the Tdap vaccination during the recommended gestational window (27-32 wk). Stratified analyses of the pre- and postrecommendation cohorts yielded similar findings to the main analyses with a few gradient differences after adjustment. INTERPRETATION During pregnancy, Tdap vaccination coverage increased substantially in Ontario between 2011/12 and 2019/20, most notably after recommendations for universal Tdap vaccination during pregnancy began in Canada. To further improve vaccine coverage in the obstetric setting, public health strategies should consider tailoring their programs to reach subpopulations with lower vaccine coverage.
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Affiliation(s)
- Romina Fakhraei
- Children's Hospital of Eastern Ontario (CHEO) Research Institute (Fakhraei, Fung, Fell); Ottawa Hospital Research Institute (Fakhraei, Wilson, Hawken, Walker); University of Ottawa (Fakhraei, Cook, Hawken, Walker, Fell); ICES uOttawa (Petrcich, Hawken, Fell), Ottawa, Ont.; ICES Central (Crowcroft, Kwong), University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; UK Health Security Agency (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Bruyère Research Institute (Wilson), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Center for Vaccinology (Halperin); Dalhousie University (Halperin); Nova Scotia Health (Halperin); IWK Health (Halperin), Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC; The Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont
| | - Stephen G Fung
- Children's Hospital of Eastern Ontario (CHEO) Research Institute (Fakhraei, Fung, Fell); Ottawa Hospital Research Institute (Fakhraei, Wilson, Hawken, Walker); University of Ottawa (Fakhraei, Cook, Hawken, Walker, Fell); ICES uOttawa (Petrcich, Hawken, Fell), Ottawa, Ont.; ICES Central (Crowcroft, Kwong), University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; UK Health Security Agency (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Bruyère Research Institute (Wilson), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Center for Vaccinology (Halperin); Dalhousie University (Halperin); Nova Scotia Health (Halperin); IWK Health (Halperin), Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC; The Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont
| | - William Petrcich
- Children's Hospital of Eastern Ontario (CHEO) Research Institute (Fakhraei, Fung, Fell); Ottawa Hospital Research Institute (Fakhraei, Wilson, Hawken, Walker); University of Ottawa (Fakhraei, Cook, Hawken, Walker, Fell); ICES uOttawa (Petrcich, Hawken, Fell), Ottawa, Ont.; ICES Central (Crowcroft, Kwong), University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; UK Health Security Agency (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Bruyère Research Institute (Wilson), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Center for Vaccinology (Halperin); Dalhousie University (Halperin); Nova Scotia Health (Halperin); IWK Health (Halperin), Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC; The Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont
| | - Natasha Crowcroft
- Children's Hospital of Eastern Ontario (CHEO) Research Institute (Fakhraei, Fung, Fell); Ottawa Hospital Research Institute (Fakhraei, Wilson, Hawken, Walker); University of Ottawa (Fakhraei, Cook, Hawken, Walker, Fell); ICES uOttawa (Petrcich, Hawken, Fell), Ottawa, Ont.; ICES Central (Crowcroft, Kwong), University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; UK Health Security Agency (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Bruyère Research Institute (Wilson), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Center for Vaccinology (Halperin); Dalhousie University (Halperin); Nova Scotia Health (Halperin); IWK Health (Halperin), Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC; The Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont
| | - Shelly Bolotin
- Children's Hospital of Eastern Ontario (CHEO) Research Institute (Fakhraei, Fung, Fell); Ottawa Hospital Research Institute (Fakhraei, Wilson, Hawken, Walker); University of Ottawa (Fakhraei, Cook, Hawken, Walker, Fell); ICES uOttawa (Petrcich, Hawken, Fell), Ottawa, Ont.; ICES Central (Crowcroft, Kwong), University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; UK Health Security Agency (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Bruyère Research Institute (Wilson), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Center for Vaccinology (Halperin); Dalhousie University (Halperin); Nova Scotia Health (Halperin); IWK Health (Halperin), Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC; The Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont
| | - Laura Gaudet
- Children's Hospital of Eastern Ontario (CHEO) Research Institute (Fakhraei, Fung, Fell); Ottawa Hospital Research Institute (Fakhraei, Wilson, Hawken, Walker); University of Ottawa (Fakhraei, Cook, Hawken, Walker, Fell); ICES uOttawa (Petrcich, Hawken, Fell), Ottawa, Ont.; ICES Central (Crowcroft, Kwong), University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; UK Health Security Agency (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Bruyère Research Institute (Wilson), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Center for Vaccinology (Halperin); Dalhousie University (Halperin); Nova Scotia Health (Halperin); IWK Health (Halperin), Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC; The Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont
| | - Gayatri Amirthalingam
- Children's Hospital of Eastern Ontario (CHEO) Research Institute (Fakhraei, Fung, Fell); Ottawa Hospital Research Institute (Fakhraei, Wilson, Hawken, Walker); University of Ottawa (Fakhraei, Cook, Hawken, Walker, Fell); ICES uOttawa (Petrcich, Hawken, Fell), Ottawa, Ont.; ICES Central (Crowcroft, Kwong), University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; UK Health Security Agency (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Bruyère Research Institute (Wilson), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Center for Vaccinology (Halperin); Dalhousie University (Halperin); Nova Scotia Health (Halperin); IWK Health (Halperin), Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC; The Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont
| | - Anne Biringer
- Children's Hospital of Eastern Ontario (CHEO) Research Institute (Fakhraei, Fung, Fell); Ottawa Hospital Research Institute (Fakhraei, Wilson, Hawken, Walker); University of Ottawa (Fakhraei, Cook, Hawken, Walker, Fell); ICES uOttawa (Petrcich, Hawken, Fell), Ottawa, Ont.; ICES Central (Crowcroft, Kwong), University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; UK Health Security Agency (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Bruyère Research Institute (Wilson), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Center for Vaccinology (Halperin); Dalhousie University (Halperin); Nova Scotia Health (Halperin); IWK Health (Halperin), Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC; The Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont
| | - Kumanan Wilson
- Children's Hospital of Eastern Ontario (CHEO) Research Institute (Fakhraei, Fung, Fell); Ottawa Hospital Research Institute (Fakhraei, Wilson, Hawken, Walker); University of Ottawa (Fakhraei, Cook, Hawken, Walker, Fell); ICES uOttawa (Petrcich, Hawken, Fell), Ottawa, Ont.; ICES Central (Crowcroft, Kwong), University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; UK Health Security Agency (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Bruyère Research Institute (Wilson), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Center for Vaccinology (Halperin); Dalhousie University (Halperin); Nova Scotia Health (Halperin); IWK Health (Halperin), Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC; The Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont
| | - Vinita Dubey
- Children's Hospital of Eastern Ontario (CHEO) Research Institute (Fakhraei, Fung, Fell); Ottawa Hospital Research Institute (Fakhraei, Wilson, Hawken, Walker); University of Ottawa (Fakhraei, Cook, Hawken, Walker, Fell); ICES uOttawa (Petrcich, Hawken, Fell), Ottawa, Ont.; ICES Central (Crowcroft, Kwong), University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; UK Health Security Agency (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Bruyère Research Institute (Wilson), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Center for Vaccinology (Halperin); Dalhousie University (Halperin); Nova Scotia Health (Halperin); IWK Health (Halperin), Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC; The Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont
| | - Scott A Halperin
- Children's Hospital of Eastern Ontario (CHEO) Research Institute (Fakhraei, Fung, Fell); Ottawa Hospital Research Institute (Fakhraei, Wilson, Hawken, Walker); University of Ottawa (Fakhraei, Cook, Hawken, Walker, Fell); ICES uOttawa (Petrcich, Hawken, Fell), Ottawa, Ont.; ICES Central (Crowcroft, Kwong), University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; UK Health Security Agency (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Bruyère Research Institute (Wilson), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Center for Vaccinology (Halperin); Dalhousie University (Halperin); Nova Scotia Health (Halperin); IWK Health (Halperin), Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC; The Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont
| | - Frances Jamieson
- Children's Hospital of Eastern Ontario (CHEO) Research Institute (Fakhraei, Fung, Fell); Ottawa Hospital Research Institute (Fakhraei, Wilson, Hawken, Walker); University of Ottawa (Fakhraei, Cook, Hawken, Walker, Fell); ICES uOttawa (Petrcich, Hawken, Fell), Ottawa, Ont.; ICES Central (Crowcroft, Kwong), University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; UK Health Security Agency (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Bruyère Research Institute (Wilson), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Center for Vaccinology (Halperin); Dalhousie University (Halperin); Nova Scotia Health (Halperin); IWK Health (Halperin), Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC; The Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont
| | - Jeffrey C Kwong
- Children's Hospital of Eastern Ontario (CHEO) Research Institute (Fakhraei, Fung, Fell); Ottawa Hospital Research Institute (Fakhraei, Wilson, Hawken, Walker); University of Ottawa (Fakhraei, Cook, Hawken, Walker, Fell); ICES uOttawa (Petrcich, Hawken, Fell), Ottawa, Ont.; ICES Central (Crowcroft, Kwong), University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; UK Health Security Agency (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Bruyère Research Institute (Wilson), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Center for Vaccinology (Halperin); Dalhousie University (Halperin); Nova Scotia Health (Halperin); IWK Health (Halperin), Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC; The Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont
| | - Manish Sadarangani
- Children's Hospital of Eastern Ontario (CHEO) Research Institute (Fakhraei, Fung, Fell); Ottawa Hospital Research Institute (Fakhraei, Wilson, Hawken, Walker); University of Ottawa (Fakhraei, Cook, Hawken, Walker, Fell); ICES uOttawa (Petrcich, Hawken, Fell), Ottawa, Ont.; ICES Central (Crowcroft, Kwong), University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; UK Health Security Agency (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Bruyère Research Institute (Wilson), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Center for Vaccinology (Halperin); Dalhousie University (Halperin); Nova Scotia Health (Halperin); IWK Health (Halperin), Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC; The Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont
| | - Jocelynn Cook
- Children's Hospital of Eastern Ontario (CHEO) Research Institute (Fakhraei, Fung, Fell); Ottawa Hospital Research Institute (Fakhraei, Wilson, Hawken, Walker); University of Ottawa (Fakhraei, Cook, Hawken, Walker, Fell); ICES uOttawa (Petrcich, Hawken, Fell), Ottawa, Ont.; ICES Central (Crowcroft, Kwong), University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; UK Health Security Agency (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Bruyère Research Institute (Wilson), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Center for Vaccinology (Halperin); Dalhousie University (Halperin); Nova Scotia Health (Halperin); IWK Health (Halperin), Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC; The Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont
| | - Steven Hawken
- Children's Hospital of Eastern Ontario (CHEO) Research Institute (Fakhraei, Fung, Fell); Ottawa Hospital Research Institute (Fakhraei, Wilson, Hawken, Walker); University of Ottawa (Fakhraei, Cook, Hawken, Walker, Fell); ICES uOttawa (Petrcich, Hawken, Fell), Ottawa, Ont.; ICES Central (Crowcroft, Kwong), University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; UK Health Security Agency (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Bruyère Research Institute (Wilson), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Center for Vaccinology (Halperin); Dalhousie University (Halperin); Nova Scotia Health (Halperin); IWK Health (Halperin), Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC; The Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont
| | - Mark C Walker
- Children's Hospital of Eastern Ontario (CHEO) Research Institute (Fakhraei, Fung, Fell); Ottawa Hospital Research Institute (Fakhraei, Wilson, Hawken, Walker); University of Ottawa (Fakhraei, Cook, Hawken, Walker, Fell); ICES uOttawa (Petrcich, Hawken, Fell), Ottawa, Ont.; ICES Central (Crowcroft, Kwong), University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; UK Health Security Agency (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Bruyère Research Institute (Wilson), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Center for Vaccinology (Halperin); Dalhousie University (Halperin); Nova Scotia Health (Halperin); IWK Health (Halperin), Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC; The Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont
| | - Deshayne B Fell
- Children's Hospital of Eastern Ontario (CHEO) Research Institute (Fakhraei, Fung, Fell); Ottawa Hospital Research Institute (Fakhraei, Wilson, Hawken, Walker); University of Ottawa (Fakhraei, Cook, Hawken, Walker, Fell); ICES uOttawa (Petrcich, Hawken, Fell), Ottawa, Ont.; ICES Central (Crowcroft, Kwong), University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; UK Health Security Agency (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Bruyère Research Institute (Wilson), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Center for Vaccinology (Halperin); Dalhousie University (Halperin); Nova Scotia Health (Halperin); IWK Health (Halperin), Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC; The Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont.
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8
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Choe YJ, Vidor E, Manson C. Post-Marketing Surveillance of Tetravalent Diphtheria-Tetanus-Acellular Pertussis and Inactivated Poliovirus (DTaP-IPV) Vaccine in South Korea, 2009 to 2015. Infect Dis Ther 2022; 11:1479-1492. [PMID: 35575974 PMCID: PMC9334467 DOI: 10.1007/s40121-022-00650-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/22/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction TETRAXIM™ (Sanofi), a combined diphtheria, tetanus, acellular pertussis, and inactivated poliovirus (DTaP-IPV) vaccine, has been licensed in South Korea since 2009. In accordance with the Ministry of Food and Drug Safety regulations, this post-marketing surveillance (PMS) study evaluated the safety of the DTaP-IPV vaccine in real-world clinical practice in infants and children who received it as either a part of the three-dose primary series dose at 2, 4, and 6 months or school entry booster between 4 and 6 years of age. Methods This multicenter, observational, PMS study was conducted in real-world practice in South Korea for 6 years (2009–2015) in participants aged between 2 months and 6 years. The study outcomes included solicited reactions, unsolicited adverse events (AEs)/adverse drug reactions (ADRs), unexpected AEs/ADRs, and serious AEs (SAEs)/ADRs. Results Data from 647 participants was included in the safety analysis. Overall, 268 AEs were reported by 181 (28%) participants: 47 (17.5%) solicited reactions, 220 (82.1%) unsolicited AEs, and 1 (0.4%) unsolicited ADR. A total of 48 AEs (including 47 solicited reactions) were reported to have a causal relationship with the DTaP-IPV vaccine and were reported by 36 (5.6%) participants. A total of 212 unexpected AEs were reported by 152 (23.5%) participants, none of which had a causal relationship with the DTaP-IPV vaccine. Neither immediate AEs nor SAEs were reported during the study. Among the participants who reported AEs, 220 (34%) were on concomitant medications. Most AEs were of mild intensity, and all participants recovered. Conclusion No safety concerns related to the DTaP-IPV vaccine in a real-world setting were raised in participants aged 2–6 months for the primary series and 4–6 years for the school-entry booster dose in the Korean population. The DTaP-IPV vaccine was well tolerated and can be continued as part of routine immunization programs in infants and children. Trial Registration: NCT01437423.
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9
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Long-Term Immunogenicity upon Pertussis Booster Vaccination in Young Adults and Children in Relation to Priming Vaccinations in Infancy. Vaccines (Basel) 2022; 10:vaccines10050693. [PMID: 35632449 PMCID: PMC9146390 DOI: 10.3390/vaccines10050693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/22/2022] [Accepted: 04/26/2022] [Indexed: 02/01/2023] Open
Abstract
Booster vaccinations for pertussis are advised in many countries during childhood or adulthood. In a phase IV longitudinal interventional study, we assessed long-term immunity following an extra pertussis booster vaccination in children and adults. Children (9 years of age) were primed in infancy with either the Dutch whole cell pertussis (wP) vaccine (n = 49) or acellular pertussis (aP) vaccines (n = 59), and all children received a preschool aP booster. Adults (25–29 years, n = 86) were wP-primed in infancy and did not receive a preschool booster. All were followed-up for approximately 6 years. After the additional booster, antibody responses to pertussis were more heterogeneous but generally higher in adults compared with children, and additional modelling showed that antibody concentrations remained higher for at least a decade. Serologic parameters indicative of recent pertussis infection were more often found in aP-primed children (12%) compared with wP-primed individuals (2%) (p = 0.052). This suggests that the aP booster vaccination in aP-primed children offers less long-term protection against pertussis infection and consequently against transmission. Together, these data show that aP priming in combination with aP boosting may not be sufficient to prevent circulation and transmission, while wP-primed adults may benefit from enhanced long-lasting immunity.
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10
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Lefrancq N, Bouchez V, Fernandes N, Barkoff AM, Bosch T, Dalby T, Åkerlund T, Darenberg J, Fabianova K, Vestrheim DF, Fry NK, González-López JJ, Gullsby K, Habington A, He Q, Litt D, Martini H, Piérard D, Stefanelli P, Stegger M, Zavadilova J, Armatys N, Landier A, Guillot S, Hong SL, Lemey P, Parkhill J, Toubiana J, Cauchemez S, Salje H, Brisse S. Global spatial dynamics and vaccine-induced fitness changes of Bordetella pertussis. Sci Transl Med 2022; 14:eabn3253. [PMID: 35476597 DOI: 10.1126/scitranslmed.abn3253] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
As with other pathogens, competitive interactions between Bordetella pertussis strains drive infection risk. Vaccines are thought to perturb strain diversity through shifts in immune pressures; however, this has rarely been measured because of inadequate data and analytical tools. We used 3344 sequences from 23 countries to show that, on average, there are 28.1 transmission chains circulating within a subnational region, with the number of chains strongly associated with host population size. It took 5 to 10 years for B. pertussis to be homogeneously distributed throughout Europe, with the same time frame required for the United States. Increased fitness of pertactin-deficient strains after implementation of acellular vaccines, but reduced fitness otherwise, can explain long-term genotype dynamics. These findings highlight the role of vaccine policy in shifting local diversity of a pathogen that is responsible for 160,000 deaths annually.
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Affiliation(s)
- Noémie Lefrancq
- Insitut Pasteur, Université Paris Cité, Mathematical Modelling of Infectious Diseases Unit, UMR2000, CNRS, 75015 Paris, France.,Department of Genetics, University of Cambridge, Cambridge CB2 3EH, UK
| | - Valérie Bouchez
- Institut Pasteur, Université Paris Cité, Biodiversity and Epidemiology of Bacterial Pathogens, 75724 Paris, France.,National Reference Center for Whooping Cough and Other Bordetella Infections, 75724 Paris, France
| | - Nadia Fernandes
- Institut Pasteur, Université Paris Cité, Biodiversity and Epidemiology of Bacterial Pathogens, 75724 Paris, France
| | - Alex-Mikael Barkoff
- University of Turku UTU, Institute of Biomedicine, Research Center for Infections and Immunity, FI-20520 Turku, Finland
| | - Thijs Bosch
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), 3720 BA Bilthoven, Netherlands
| | - Tine Dalby
- Statens Serum Institut, Bacteria, Parasites and Fungi/Infectious Disease Preparedness, 2300 Copenhagen, Denmark
| | - Thomas Åkerlund
- The Public Health Agency of Sweden, Unit for Laboratory Surveillance of Bacterial Pathogens, SE-171 82 Solna, Sweden
| | - Jessica Darenberg
- The Public Health Agency of Sweden, Unit for Laboratory Surveillance of Bacterial Pathogens, SE-171 82 Solna, Sweden
| | - Katerina Fabianova
- National Institute of Public Health, Department of Infectious Diseases Epidemiology, CZ-10000 Prague, Czech Republic
| | - Didrik F Vestrheim
- Norwegian Institute of Public Health, Department of Infectious Disease Control and Vaccine, N-0213 Oslo, Norway
| | - Norman K Fry
- Respiratory and Vaccine Preventable Bacteria Reference Unit, Public Health England-National Infection Service, London NW9 5EQ, UK.,Immunisation and Countermeasures Division, Public Health England-National Infection Service, London NW9 5EQ, UK
| | - Juan José González-López
- University Hospital Vall d'Hebron, Microbiology Department, 08035 Barcelona, Spain.,Universitat Autònoma de Barcelona, Department of Genetics and Microbiology, 08193 Barcelona, Spain
| | - Karolina Gullsby
- Centre for Research and Development, Uppsala University/Region Gävleborg, 80187 Gävle, Sweden
| | - Adele Habington
- Molecular Microbiology Laboratory, Children's Health Ireland, Crumlin, D12 N512 Dublin, Ireland
| | - Qiushui He
- University of Turku UTU, Institute of Biomedicine, Research Center for Infections and Immunity, FI-20520 Turku, Finland.,InFLAMES Research Flagship Center, University of Turku, FI-20520 Turku, Finland
| | - David Litt
- Respiratory and Vaccine Preventable Bacteria Reference Unit, Public Health England-National Infection Service, London NW9 5EQ, UK
| | - Helena Martini
- Department of Microbiology, National Reference Centre for Bordetella pertussis, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), B-1090 Brussels, Belgium
| | - Denis Piérard
- Department of Microbiology, National Reference Centre for Bordetella pertussis, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), B-1090 Brussels, Belgium
| | - Paola Stefanelli
- Department of Infectious Diseases, Istituto Superiore di Sanità, IT-00161 Rome, Italy
| | - Marc Stegger
- Statens Serum Institut, Bacteria, Parasites and Fungi/Infectious Disease Preparedness, 2300 Copenhagen, Denmark
| | - Jana Zavadilova
- National Institute of Public Health, National Reference Laboratory for Pertussis and Diphtheria, 100 00 Prague, Czech Republic
| | - Nathalie Armatys
- Institut Pasteur, Université Paris Cité, Biodiversity and Epidemiology of Bacterial Pathogens, 75724 Paris, France.,National Reference Center for Whooping Cough and Other Bordetella Infections, 75724 Paris, France
| | - Annie Landier
- Institut Pasteur, Université Paris Cité, Biodiversity and Epidemiology of Bacterial Pathogens, 75724 Paris, France.,National Reference Center for Whooping Cough and Other Bordetella Infections, 75724 Paris, France
| | - Sophie Guillot
- Institut Pasteur, Université Paris Cité, Biodiversity and Epidemiology of Bacterial Pathogens, 75724 Paris, France.,National Reference Center for Whooping Cough and Other Bordetella Infections, 75724 Paris, France
| | - Samuel L Hong
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium
| | - Philippe Lemey
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium
| | - Julian Parkhill
- Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, UK
| | - Julie Toubiana
- Institut Pasteur, Université Paris Cité, Biodiversity and Epidemiology of Bacterial Pathogens, 75724 Paris, France.,National Reference Center for Whooping Cough and Other Bordetella Infections, 75724 Paris, France.,Université Paris Cité, Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants Malades Hospital, APHP, 75015 Paris, France
| | - Simon Cauchemez
- Insitut Pasteur, Université Paris Cité, Mathematical Modelling of Infectious Diseases Unit, UMR2000, CNRS, 75015 Paris, France
| | - Henrik Salje
- Insitut Pasteur, Université Paris Cité, Mathematical Modelling of Infectious Diseases Unit, UMR2000, CNRS, 75015 Paris, France.,Department of Genetics, University of Cambridge, Cambridge CB2 3EH, UK
| | - Sylvain Brisse
- Institut Pasteur, Université Paris Cité, Biodiversity and Epidemiology of Bacterial Pathogens, 75724 Paris, France.,National Reference Center for Whooping Cough and Other Bordetella Infections, 75724 Paris, France
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11
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Sunarno S, Sofiah SN, Amalia N, Hartoyo Y, Rizki A, Puspandari N, Saraswati RD, Febriyana D, Febrianti T, Susanti I, Khariri K, Sariadji K, Muna F, Rukminiati Y, Sulistyaningrum N, Riana DA, Maha MS, Fitriana F, Voronika V, Muslih M, Kamal M, Setiawaty V. Laboratory and epidemiology data of pertussis cases and close contacts: A 5-year case-based surveillance of pertussis in Indonesia, 2016–2020. PLoS One 2022; 17:e0266033. [PMID: 35442946 PMCID: PMC9020744 DOI: 10.1371/journal.pone.0266033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 03/11/2022] [Indexed: 11/19/2022] Open
Abstract
Pertussis cases have been reported most frequently in developed countries, but they are predicted to be the most prevalent in developing countries. Indonesia, a developing country, routinely conducts case-based surveillance for pertussis. We reviewed the data on pertussis cases and close contacts based on clinical sample documents examined in the National Reference Laboratory for pertussis, Indonesia (2016–2020). Our objective was to analyze the laboratory and epidemiological aspects of pertussis cases and close contacts, particularly to evaluate the implementation of a 5-year case-based surveillance of pertussis in Indonesia. Data were collected from sample documents and annual laboratory reports between January 2016 and December 2020. We analyzed the proportion of pertussis cases and close contacts by geographic region, year, age, and sex. We used the χ2 test to correlate the laboratory and epidemiological data. In total, 274 clinical cases of pertussis and 491 close contacts were recorded in 15 provinces. The peak number of cases occurred in 2019, with a positivity rate (percentage of laboratory-confirmed cases) of 41.23% (47/114). Clinical cases were dominated by infants aged <1 year (55.5%), and 52.9% of them were aged <6 months. Similarly, 72.3% (68/94) of the laboratory-confirmed cases were infants. Both clinical cases and positivity rates tended to be higher in females (155 cases, 38.1%) than in males (119 cases, 29.4%). No confirmed cases were found in children aged ≥10 years, although positive results still occurred in close contact. Age-group and laboratory-confirmed cases were correlated (p = 0.00). Clinical and confirmed cases of pertussis occurred mostly in the early age group and may be lower in those aged ≥10 years, especially in confirmed cases. New policies are needed for pertussis prevention at an early age, as well as the application of serology tests to increase laboratory-confirmed cases in children aged ≥10 years.
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Affiliation(s)
- Sunarno Sunarno
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Jakarta, Indonesia
- National Research and Innovation Agency (BRIN), Jakarta, Indonesia
- * E-mail:
| | - Sundari Nur Sofiah
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Jakarta, Indonesia
| | - Novi Amalia
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Jakarta, Indonesia
| | - Yudi Hartoyo
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Jakarta, Indonesia
| | - Aulia Rizki
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Jakarta, Indonesia
| | - Nelly Puspandari
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Jakarta, Indonesia
| | - Ratih Dian Saraswati
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Jakarta, Indonesia
| | - Dwi Febriyana
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Jakarta, Indonesia
| | - Tati Febrianti
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Jakarta, Indonesia
| | - Ida Susanti
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Jakarta, Indonesia
| | - Khariri Khariri
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Jakarta, Indonesia
- National Research and Innovation Agency (BRIN), Jakarta, Indonesia
| | - Kambang Sariadji
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Jakarta, Indonesia
| | - Fauzul Muna
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Jakarta, Indonesia
| | - Yuni Rukminiati
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Jakarta, Indonesia
| | - Novi Sulistyaningrum
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Jakarta, Indonesia
| | - Dyah Armi Riana
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Jakarta, Indonesia
| | - Masri Sembiring Maha
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Jakarta, Indonesia
- National Research and Innovation Agency (BRIN), Jakarta, Indonesia
| | - Fitriana Fitriana
- National Research and Innovation Agency (BRIN), Jakarta, Indonesia
- Centre for Research and Development of Health Resources and Services, National Institute of Health Research and Development, Jakarta, Indonesia
| | - Vivi Voronika
- Directorate General of Disease Prevention and Control, Ministry of Health, Jakarta, Indonesia
| | - Muamar Muslih
- Directorate General of Disease Prevention and Control, Ministry of Health, Jakarta, Indonesia
| | - Mushtofa Kamal
- World Health Organization Country Office for Indonesia, Jakarta, Indonesia
| | - Vivi Setiawaty
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Jakarta, Indonesia
- Sulianti Saroso Hospital, Jakarta, Indonesia
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12
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Saeidpour A, Bansal S, Rohani P. Dissecting recurrent waves of pertussis across the boroughs of London. PLoS Comput Biol 2022; 18:e1009898. [PMID: 35421101 PMCID: PMC9041754 DOI: 10.1371/journal.pcbi.1009898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/26/2022] [Accepted: 02/04/2022] [Indexed: 11/19/2022] Open
Abstract
Pertussis has resurfaced in the UK, with incidence levels not seen since the 1980s. While the fundamental causes of this resurgence remain the subject of much conjecture, the study of historical patterns of pathogen diffusion can be illuminating. Here, we examined time series of pertussis incidence in the boroughs of Greater London from 1982 to 2013 to document the spatial epidemiology of this bacterial infection and to identify the potential drivers of its percolation. The incidence of pertussis over this period is characterized by 3 distinct stages: a period exhibiting declining trends with 4-year inter-epidemic cycles from 1982 to 1994, followed by a deep trough until 2006 and the subsequent resurgence. We observed systematic temporal trends in the age distribution of cases and the fade-out profile of pertussis coincident with increasing national vaccine coverage from 1982 to 1990. To quantify the hierarchy of epidemic phases across the boroughs of London, we used the Hilbert transform. We report a consistent pattern of spatial organization from 1982 to the early 1990s, with some boroughs consistently leading epidemic waves and others routinely lagging. To determine the potential drivers of these geographic patterns, a comprehensive parallel database of borough-specific features was compiled, comprising of demographic, movement and socio-economic factors that were used in statistical analyses to predict epidemic phase relationships among boroughs. Specifically, we used a combination of a feed-forward neural network (FFNN), and SHapley Additive exPlanations (SHAP) values to quantify the contribution of each covariate to model predictions. Our analyses identified a number of predictors of a borough's historical epidemic phase, specifically the age composition of households, the number of agricultural and skilled manual workers, latitude, the population of public transport commuters and high-occupancy households. Univariate regression analysis of the 2012 epidemic identified the ratio of cumulative unvaccinated children to the total population and population of Pakistan-born population to have moderate positive and negative association, respectively, with the timing of epidemic. In addition to providing a comprehensive overview of contemporary pertussis transmission in a large metropolitan population, this study has identified the characteristics that determine the spatial spread of this bacterium across the boroughs of London.
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Affiliation(s)
- Arash Saeidpour
- Odum School of Ecology, University of Georgia, Athens, Georgia, United States of America
| | - Shweta Bansal
- Department of Biology, Georgetown University, Washington, D.C., United States of America
| | - Pejman Rohani
- Odum School of Ecology, University of Georgia, Athens, Georgia, United States of America
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, Georgia, United States of America
- Center for Influenza Disease & Emergence Research (CIDER), Athens, Georgia, United States of America
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Bbvac: A Live Vaccine Candidate That Provides Long-Lasting Anamnestic and Th17-Mediated Immunity against the Three Classical Bordetella spp. mSphere 2022; 7:e0089221. [PMID: 35196124 PMCID: PMC8865921 DOI: 10.1128/msphere.00892-21] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Acute pathogens such as Bordetella pertussis can cause severe disease but are ultimately cleared by the immune response. This has led to the accepted paradigm that convalescent immunity is optimal and therefore broadly accepted as the “gold standard” against which vaccine candidates should be compared. However, successful pathogens like B. pertussis have evolved multiple mechanisms for suppressing and evading host immunity, raising the possibility that disruption of these mechanisms could result in substantially stronger or better immunity. Current acellular B. pertussis vaccines, delivered in a 5-dose regimen, induce only short-term immunity against disease and even less against colonization and transmission. Importantly, they provide modest protection against other Bordetella species that cause substantial human disease. A universal vaccine that protects against the three classical Bordetella spp. could decrease the burden of whooping cough-like disease in humans and other animals. Our recent work demonstrated that Bordetella spp. suppress host inflammatory responses and that disrupting the regulation of immunosuppressive mechanisms can allow the host to generate substantially stronger sterilizing immunity against the three classical Bordetella spp. Here, we identify immune parameters impacted by Bordetella species immunomodulation, including the generation of robust Th17 and B cell memory responses. Disrupting immunomodulation augmented the immune response, providing strong protection against the prototypes of all three classical Bordetella spp. as well as recent clinical isolates. Importantly, the protection in mice lasted for at least 15 months and was associated with recruitment of high numbers of B and T cells in the lungs as well as enhanced Th17 mucosal responses and persistently high titers of antibodies. These findings demonstrate that disrupting bacterial immunomodulatory pathways can generate much stronger and more protective immune responses to infection, with important implications for the development of better vaccines. IMPORTANCE Infectious diseases are a major cause of morbidity and mortality in the United States, accounting for over 40 million hospitalizations since 1998. Therefore, novel vaccine strategies are imperative, which can be improved with a better understanding of the mechanisms that bacteria utilize to suppress host immunity, a key mechanism for establishing colonization. Bordetella spp., the causative agents of whooping cough, suppress host immunity, which allows for persistent colonization. We discovered a regulator of a bacterial immunosuppressive pathway, which, when mutated in Bordetella spp., allows for rapid clearance of infection and subsequent generation of protective immunity for at least 15 months. After infection with the mutant strain, mice exhibited sterilizing immunity against the three classical Bordetella spp., suggesting that the immune response can be both stronger and cross-protective. This work presents a strategy for vaccine development that can be applied to other immunomodulatory pathogens.
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Zahraei SM, Mohamadi P, Moradi G, Shirzadi S, Azimian F, Khazaei Z, Naemi H, Goodarzi E. Epidemiology incidence and geographical distribution of Pertussis using GIS and its incidence prediction in Iran in 2021. Med J Islam Repub Iran 2021; 35:108. [PMID: 34956954 PMCID: PMC8683795 DOI: 10.47176/mjiri.35.108] [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] [Received: 02/14/2020] [Indexed: 11/25/2022] Open
Abstract
Background: Pertussis is a respiratory tract infection caused by Bordetella pertussis, which causes inflammation of the lungs and respiratory tract. The purpose of this study was to investigate the incidence and geographical distribution of pertussis using the geographic information system (GIS) and to predict its incidence in Iran in 2021.
Methods: This was a descriptive analytical study. Information on pertussis was obtained from the Center for Communicable Diseases Control during 2009-2015. In the next step, the ArcGIS 9.3 was used to prepare geographic maps of the disease incidence and frequency. Therefore, the disease prediction map was drawn. using the Raster Calculator tool.
Results: The results showed that the highest incidence of pertussis during 2009-2015 was in Zanjan, Qom, Mazandaran, and Qazvin provinces. The incidence of pertussis in Iran increased from 0.74 in 2009 to 1.53 in 2015. Based on the modeling results for Iran, Qom, Mazandaran, Tehran, Qazvin, and Zanjan provinces, with 76.76%, 73.69%, 66.32%, 30.94% and 24.18% of their areas (Km2), are at high risk for pertussis in the coming years, respectively.
Conclusion: The incidence of the disease has been increasing in recent years, indicating the emergence of the disease in Iran. The modeling maps show that the Iranian provinces of Qom, Tehran, Zanjan, and Qazvin are at risk of the disease incidence in the coming years, indicating the need for planning, appropriate interventions and more precise implementation of the vaccination program against the disease.
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Affiliation(s)
- Seyed Mohsen Zahraei
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Parvin Mohamadi
- Department of Medical Sciences, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | | | - Fatemeh Azimian
- Iranian Center for Communicable Disease Control, Ministry of Health & Medical Education, Tehran, Iran
| | - Zaher Khazaei
- Department of Public Health, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran
| | - Hasan Naemi
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Elham Goodarzi
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
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Tandy CB, Odoi A. Geographic disparities and socio-demographic predictors of pertussis risk in Florida. PeerJ 2021; 9:e11902. [PMID: 34540361 PMCID: PMC8415280 DOI: 10.7717/peerj.11902] [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: 03/25/2021] [Accepted: 07/13/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Pertussis is a toxin-mediated respiratory illness caused by Bordetella pertussis that can result in severe complications and death, particularly in infants. Between 2008 and 2011, children less than 3 months old accounted for 83% of the pertussis deaths in the United States. Understanding the geographic disparities in the distribution of pertussis risk and identifying high risk geographic areas is necessary for guiding resource allocation and public health control strategies. Therefore, this study investigated geographic disparities and temporal changes in pertussis risk in Florida from 2010 to 2018. It also investigated socioeconomic and demographic predictors of the identified disparities. METHODS Pertussis data covering the time period 2010-2018 were obtained from Florida HealthCHARTS web interface. Spatial patterns and temporal changes in geographic distribution of pertussis risk were assessed using county-level choropleth maps for the time periods 2010-2012, 2013-2015, 2016-2018 and 2010-2018. Tango's flexible spatial scan statistics were used to identify high-risk spatial clusters which were displayed in maps. Ordinary least squares (OLS) regression was used to identify significant predictors of county-level risk. Residuals of the OLS model were assessed for model assumptions including spatial autocorrelation. RESULTS County-level pertussis risk varied from 0 to 116.31 cases per 100,000 people during the study period. A total of 11 significant (p < 0.05) spatial clusters were identified with risk ratios ranging from 1.5 to 5.8. Geographic distribution remained relatively consistent over time with areas of high risk persisting in the western panhandle, northeastern coast, and along the western coast. Although county level pertussis risks generally increased from 2010-2012 to 2013-2015, risk tended to be lower during the 2016-2018 time period. Significant predictors of county-level pertussis risk were rurality, percentage of females, and median income. Counties with high pertussis risk tended to be rural (p = 0.021), those with high median incomes (p = 0.039), and those with high percentages of females (p < 0.001). CONCLUSION There is evidence that geographic disparities exist and have persisted over time in Florida. This study highlights the application and importance of Geographic Information Systems (GIS) technology and spatial statistical/epidemiological tools in identifying areas of highest disease risk so as to guide resource allocation to reduce health disparities and improve health for all.
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Affiliation(s)
- Corinne B. Tandy
- Biomedical and Diagnostic Sciences, University of Tennessee, Knoxville, Tennessee, United States
| | - Agricola Odoi
- Biomedical and Diagnostic Sciences, University of Tennessee, Knoxville, Tennessee, United States
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Wu S, Hu Q, Yang C, Zhou H, Chen H, Zhang Y, Jiang M, He Y, Shi X. Molecular epidemiology of Bordetella pertussis and analysis of vaccine antigen genes from clinical isolates from Shenzhen, China. Ann Clin Microbiol Antimicrob 2021; 20:53. [PMID: 34407803 PMCID: PMC8371876 DOI: 10.1186/s12941-021-00458-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 07/28/2021] [Indexed: 11/10/2022] Open
Abstract
Background Although pertussis cases globally have been controlled through the Expanded Programme on Immunization (EPI), the incidence of pertussis has increased significantly in recent years, with a “resurgence” of pertussis occurring in developed countries with high immunization coverage. Attracted by its fast-developing economy, the population of Shenzhen has reached 14 million and has become one of the top five largest cities by population size in China. The incidence of pertussis here was about 2.02/100,000, far exceeding that of the whole province and the whole country (both < 1/100,000). There are increasing numbers of reports demonstrating variation in Bordetella pertussis antigens and genes, which may be associated with the increased incidence. Fifty strains of Bordetella pertussis isolated from 387 suspected cases were collected in Shenzhen in 2018 for genotypic and molecular epidemiological analysis. Methods There were 387 suspected cases of pertussis enrolled at surveillance sites in Shenzhen from June to August 2018. Nasopharyngeal swabs from suspected pertussis cases were collected for bacterial culture and the identity of putative Bordetella pertussis isolates was confirmed by real-time PCR. The immunization history of each patient was taken. The acellular pertussis vaccine (APV) antigen genes for pertussis toxin (ptxA, ptxC), pertactin (prn) and fimbriae (fim2 and fim3) together with the pertussis toxin promoter region (ptxP) were analyzed by second-generation sequencing. Genetic and phylogenetic analysis was performed using sequences publicly available from GenBank, National Institutes of Health, Bethesda, MD, USA (https://www.ncbi.nlm.nih.gov/genbank/). The antimicrobial susceptibility was test by Kirby-Bauer disk diffusion. Results Fifty strains of Bordetella pertussis were successfully isolated from nasopharyngeal swabs of 387 suspected cases, with a positivity rate of 16.79%, including 28 males and 22 females, accounting for 56.0% and 44.0% respectively. Thirty-eight of the 50 (76%) patients were found to be positive for B. pertussis by culture. Among the positive cases with a history of vaccination, 30 of 42 (71.4%) cases had an incomplete pertussis vaccination history according to the national recommendation. Three phylogenetic groups (PG1-PG3) were identified each containing a predominant genotype. The two vaccines strains, CS and Tohama I, were distantly related to these three groups. Thirty-one out of fifty (62%) isolates belonged to genotype PG1, with the allelic profile prn2/ptxC2/ptxP3/ptxA1/fim3-1/fim2-1. Eighteen out of fifty (36%) isolates contained the A2047G mutation and were highly resistant to erythromycin, and all belonged to genotype PG3 (prn1/ptxA1/ptxP1/ptxC1/fim3-1/fim2-1), which is closely related to the recent epidemic strains found in northern China. Conclusions The positive rate of cases under one-year-old was significantly higher than that of other age groups and should be monitored. The dominant antigen genotypes of 50 Shenzhen isolates are closely related to the epidemic strains in the United States, Australia and many countries in Europe. Despite high rates of immunization with APV, epidemics of pertussis have recently occurred in these countries. Therefore, genomic analysis of circulating isolates of B. pertussis should be continued, for it will benefit the control of whooping cough and development of improved vaccines and therapeutic strategies.
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Affiliation(s)
- Shuang Wu
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Road, Nanshan District, Shenzhen, China
| | - Qinghua Hu
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Road, Nanshan District, Shenzhen, China
| | - Chao Yang
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Road, Nanshan District, Shenzhen, China
| | - Haijian Zhou
- National Institute for Communicable Disease Control and Prevention (ICDC) of China CDC, Beijing, China
| | - Hongyu Chen
- Shenzhen Children's Hospital, Shenzhen, China
| | - Yanwei Zhang
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Road, Nanshan District, Shenzhen, China
| | - Min Jiang
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Road, Nanshan District, Shenzhen, China
| | - Yuxiang He
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Road, Nanshan District, Shenzhen, China
| | - Xiaolu Shi
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Road, Nanshan District, Shenzhen, China.
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Rane MS, Rohani P, Halloran ME. Association of Diphtheria-Tetanus-Acellular Pertussis Vaccine Timeliness and Number of Doses With Age-Specific Pertussis Risk in Infants and Young Children. JAMA Netw Open 2021; 4:e2119118. [PMID: 34374773 PMCID: PMC8356064 DOI: 10.1001/jamanetworkopen.2021.19118] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE In most countries, the diphtheria-tetanus-acellular pertussis (DTaP) vaccine is administered as a 3-dose infant series followed by additional booster doses in the first 5 years of life. Short-term immunity from the DTaP vaccine can depend on the number, timing, and interval between doses. Not receiving doses in a timely manner might be associated with a higher pertussis risk. OBJECTIVE To examine the association between number and timeliness of vaccine doses and age-specific pertussis risk. DESIGN, SETTING, AND PARTICIPANTS This population-based, retrospective cohort study used Washington State Immunization Information System data and pertussis surveillance data from Public Health Seattle and King County, Washington. Included participants were children aged 3 months to 9 years born or living in King County, Washington, between January 1, 2008, and December 31, 2017. Data were analyzed from June 30 to December 1, 2019. EXPOSURES Being undervaccinated (receiving fewer than recommended doses at a given age) or delayed vaccination (not receiving doses within time frames recommended by Centers for Disease Control and Prevention). MAIN OUTCOMES AND MEASURES Suspected, probable, and confirmed pertussis diagnosis. RESULTS A total of 316 404 children (median age, 65.2 months [interquartile range, 35.3-94.1 months]; 162 025 boys [51.2%]) as of December 31, 2017, with 17.4 million person-months of follow-up were included in the analysis. A total of 19 943 children (6.3%) had no vaccines recorded in the Immunization Information System, 116 193 (36.7%) received a vaccine with a delay, and 180 268 (56.9%) were fully vaccinated with no delay. Delayed vaccination and undervaccination rates were higher for older children (17.6% delayed or undervaccinated at age 2 months for dose 1 at 3 months vs 41.6% at age 5 years for dose 5) but improved for successive birth cohorts (52.2% for 2008 birth cohort vs 32.3% for 2017 birth cohort). Undervaccination was significantly associated with higher risk of pertussis for the 3-dose primary series (adjusted relative risk [aRR], 4.8; 95% CI, 3.1-7.6), the first booster (aRR, 3.2; 95% CI, 2.3-4.5), and the second booster (aRR, 4.6; 95% CI, 2.6-8.2). However, delay in vaccination among children who received the recommended number of vaccine doses was not associated with pertussis risk. CONCLUSIONS AND RELEVANCE The results of this cohort study suggest that undervaccination is associated with higher pertussis risk. Short delays in vaccine receipt may be less important if the age-appropriate number of doses is administered, but delaying doses is not recommended. Ensuring that children receive all doses of pertussis vaccine, even if there is some delay, is important.
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Affiliation(s)
- Madhura S. Rane
- Department of Epidemiology, University of Washington, Seattle
- Institute for Implementation Science in Population Health, City University of New York, New York
| | - Pejman Rohani
- Odum School of Ecology, University of Georgia, Athens
- Department of Infectious Diseases, University of Georgia, Athens
| | - M. Elizabeth Halloran
- Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Biostatistics, University of Washington, Seattle
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Ma L, Caulfield A, Dewan KK, Harvill ET. Pertactin-Deficient Bordetella pertussis, Vaccine-Driven Evolution, and Reemergence of Pertussis. Emerg Infect Dis 2021; 27:1561-1566. [PMID: 34014152 PMCID: PMC8153889 DOI: 10.3201/eid2706.203850] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Recent reemergence of pertussis (whooping cough) in highly vaccinated populations and rapid expansion of Bordetella pertussis strains lacking pertactin (PRN), a common acellular vaccine antigen, have raised the specter of vaccine-driven evolution and potential return of what was once the major killer of children. The discovery that most circulating B. pertussis strains in the United States have acquired new and independent disruptive mutations in PRN is compelling evidence of strong selective pressure. However, the other 4 antigens included in acellular vaccines do not appear to be selected against so rapidly. We consider 3 aspects of PRN that distinguish it from other vaccine antigens, which might, individually or collectively, explain why only this antigen is being precipitously eliminated. An understanding of the increase in PRN-deficient strains should provide useful information for the current search for new protective antigens and provide broader lessons for the design of improved subunit vaccines.
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Pandolfi E, Gesualdo F, Rizzo C, Russo L, Campagna I, Carloni E, Concato C, Linardos G, Villani A, Ciampini S, Reale A, Boccuzzi E, Midulla F, Tozzi AE. The impact of pertussis in infants: insights from a hospital-based enhanced surveillance system, Lazio region, Italy, 2016 to 2019. ACTA ACUST UNITED AC 2021; 26. [PMID: 34142648 PMCID: PMC8212589 DOI: 10.2807/1560-7917.es.2021.26.24.2000562] [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: 01/10/2023]
Abstract
Background Routine surveillance systems for pertussis often suffer from under-recognition and under-reporting. Aim Our aim was to describe the epidemiology and the clinical features of pertussis in children younger than 1 year in an Italian region, detected through an enhanced hospital surveillance system. Methods From 2016 to 2019, we monitored the incidence and the clinical characteristics of hospitalised pertussis cases younger than 1 year in two paediatric hospitals involved in the PERTINENT project. Results We detected 141 pertussis cases, corresponding to an estimated incidence of 105.8 per 100.000 in 2016, 91.7 per 100.000 in 2017, 64.5 per 100.000 in 2018 and 40.9 per 100.000 in 2019, based on the hospitals’ catchment area, roughly corresponding to the Lazio region. A total of 101 cases (77.1%) had a household member with cough or other respiratory symptoms. The most frequent combination of symptoms was paroxysmal cough with apnoea in the absence of fever. Almost 40% had been prescribed an antibiotic treatment before hospitalisation, and the median time from symptom onset to contact with the hospital was 8 days. Thirty-one (22.0%) had complications. Conclusion An enhanced surveillance system showed a high incidence of pertussis among infants in the Lazio region, where the impact of this disease may still be underestimated. Increasing the coverage of pertussis immunisation among pregnant women and improving the capacity for early detection in primary care may contribute to reducing the impact of pertussis among infants.
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Affiliation(s)
- Elisabetta Pandolfi
- Bambino Gesù Children's Hospital, IRCCS, Multifactorial and Complex Disease Research Area, Rome, Italy
| | - Francesco Gesualdo
- Bambino Gesù Children's Hospital, IRCCS, Multifactorial and Complex Disease Research Area, Rome, Italy
| | - Caterina Rizzo
- Bambino Gesù Children's Hospital, IRCCS, Multifactorial and Complex Disease Research Area, Rome, Italy
| | - Luisa Russo
- Bambino Gesù Children's Hospital, IRCCS, Multifactorial and Complex Disease Research Area, Rome, Italy
| | - Ilaria Campagna
- Bambino Gesù Children's Hospital, IRCCS, Multifactorial and Complex Disease Research Area, Rome, Italy
| | - Emanuela Carloni
- Bambino Gesù Children's Hospital, IRCCS, Multifactorial and Complex Disease Research Area, Rome, Italy
| | - Carlo Concato
- Bambino Gesù Children's Hospital, IRCCS, Virology Unit, Rome, Italy
| | - Giulia Linardos
- Bambino Gesù Children's Hospital, IRCCS, Virology Unit, Rome, Italy
| | - Alberto Villani
- Bambino Gesù Children's Hospital, IRCCS, Paediatric and Infectious Diseases Unit, Rome, Italy
| | - Sara Ciampini
- Bambino Gesù Children's Hospital, IRCCS, Multifactorial and Complex Disease Research Area, Rome, Italy
| | - Antonino Reale
- Bambino Gesù Children's Hospital, IRCCS, Emergency Department, Rome, Italy
| | - Elena Boccuzzi
- Bambino Gesù Children's Hospital, IRCCS, Emergency Department, Rome, Italy
| | - Fabio Midulla
- Sapienza University, Department of Paediatrics, Rome, Italy
| | - Alberto E Tozzi
- Bambino Gesù Children's Hospital, IRCCS, Multifactorial and Complex Disease Research Area, Rome, Italy
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Leong RNF, Wood JG, Liu B, Menzies R, Newall AT. Estimating pertussis incidence in general practice using a large Australian primary care database. Vaccine 2021; 39:4153-4159. [PMID: 34119346 DOI: 10.1016/j.vaccine.2021.05.079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/22/2021] [Accepted: 05/24/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND While pertussis is notifiable in most countries, notifications typically underestimate the true pertussis burden. We explored the incidence of pertussis in general practice in Australia. METHODS Using MedicineInsight, a large longitudinal electronic medical record database of general practice (primary care) encounters which includes >1.5 million patients, we first defined a cohort of active patients and then used free-text search algorithms to identify patients with pertussis-related encounters. We defined and identified pertussis-related encounters in four patient categories: pertussis-associated (category 1), potential pertussis (category 2), epidemiologically-linked pertussis (category 3), and symptoms consistent with pertussis (category 4). Incident pertussis-related encounter rates per 100,000 active patients were calculated from Jan 2008 to Aug 2015. RESULTS Estimated mean annual pertussis incidence increased as definitions were expanded, from 94.3 (category 1 patients only) to 148.8 (categories 1+2+3 patients combined) per 100,000 active patients per year. Monthly time-series corresponding to the first three categories were highly correlated (Pearson's r > 90% for each pair), but each was poorly correlated with category 4. For categories 1+2+3, the highest incidence was among 0-4 and 5-9 year olds. Incidence was 30% higher in females than males (i.e. 184.5 vs 139.8 per 100,00 active patients for categories 1-3 patients combined). Pertussis-associated incidence (category 1) was similar to national pertussis notification rates. Categories 2 and 3 added 25% and 33%, respectively, on average relative to category 1 incidence. The estimated incidence from categories 1+2+3 together were on average 64% higher than national pertussis notification rates. CONCLUSION We provide comprehensive estimates of pertussis-related incidence in general practice (primary care), well in excess of notified pertussis incidence in Australia. This highlights the utility of MedicineInsight data in providing a greater understanding of the burden of medically-attended pertussis infections.
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Affiliation(s)
| | - James G Wood
- School of Population Health, UNSW Sydney, NSW, Australia
| | - Bette Liu
- School of Population Health, UNSW Sydney, NSW, Australia
| | - Robert Menzies
- Kirby Institute, UNSW Sydney, NSW, Australia; Sanofi Pasteur, Macquarie Park, NSW, Australia
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Gill CJ, Gunning CE, MacLeod WB, Mwananyanda L, Thea DM, Pieciak RC, Kwenda G, Mupila Z, Rohani P. Asymptomatic Bordetella pertussis infections in a longitudinal cohort of young African infants and their mothers. eLife 2021; 10:65663. [PMID: 34097599 PMCID: PMC8184211 DOI: 10.7554/elife.65663] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 05/26/2021] [Indexed: 12/17/2022] Open
Abstract
Recent pertussis resurgence in numerous countries may be driven by asymptomatic infections. Most pertussis surveillance studies are cross-sectional and cannot distinguish asymptomatic from pre-symptomatic infections. Longitudinal surveillance could overcome this barrier, providing more information about the true burden of pertussis at the population level. Here we analyze 17,442 nasopharyngeal samples from a longitudinal cohort of 1320 Zambian mother/infant pairs. Our analysis has two elements. First, we demonstrate that the full range of IS481 qPCR CT values provides insight into pertussis epidemiology, showing concordance of low and high CT results over time, within mother/infant pairs, and in relation to symptomatology. Second, we exploit these full-range qPCR data to demonstrate a high incidence of asymptomatic pertussis, including among infants. Our results demonstrate a wider burden of pertussis infection than we anticipated in this population, and expose key limitations of threshold-based interpretation of qPCR results in infectious disease surveillance.
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Affiliation(s)
- Christopher J Gill
- Boston University School of Public Health, Department of Global Health, Boston, United States
| | | | - William B MacLeod
- Boston University School of Public Health, Department of Global Health, Boston, United States
| | - Lawrence Mwananyanda
- Boston University School of Public Health, Department of Global Health, Boston, United States.,Right to Care, Lusaka, Zambia
| | - Donald M Thea
- Boston University School of Public Health, Department of Global Health, Boston, United States
| | - Rachel C Pieciak
- Boston University School of Public Health, Department of Global Health, Boston, United States
| | - Geoffrey Kwenda
- University of Zambia, School of Health Sciences, Department of Biomedical Science, Lusaka, Zambia
| | | | - Pejman Rohani
- University of Georgia, Odum School of Ecology, Athens, Georgia.,University of Georgia, Center for the Ecology of Infectious Diseases, Athens, Georgia.,University of Georgia, Department of Infectious Diseases, Athens, Georgia
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Fakhraei R, Crowcroft N, Bolotin S, Sucha E, Hawken S, Wilson K, Gaudet L, Amirthalingam G, Biringer A, Cook J, Dubey V, Halperin SA, Jamieson F, Kwong JC, Sadarangani M, Walker MC, Laverty M, Fell DB. Obstetric and perinatal health outcomes after pertussis vaccination during pregnancy in Ontario, Canada: a retrospective cohort study. CMAJ Open 2021; 9:E349. [PMID: 33849984 PMCID: PMC8084546 DOI: 10.9778/cmajo.20200239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND In February 2018, Canada's National Advisory Committee on Immunization recommended maternal vaccination with tetanus-diphtheria-acellular pertussis (Tdap) vaccine during pregnancy to prevent severe pertussis infection in young infants. This study assessed the relation between maternal Tdap vaccination and obstetric and perinatal outcomes in Ontario. METHODS We performed a population-based cohort study of all births from April 2012 to March 2017 using multiple linked health administrative databases. We used Cox regression with a time-dependent exposure variable to estimate adjusted hazard ratios (HRs) for preterm birth (< 37 wk), very preterm birth (< 32 wk) and stillbirth. We assessed remaining outcomes (gestational hypertension, chorioamnionitis, postpartum hemorrhage, severe postpartum hemorrhage, being small for gestational age, neonatal intensive care unit stay > 24 h, composite neonatal morbidity) using log-binomial regression to generate adjusted risk ratios (RRs). We adjusted estimates for potential confounding using propensity score weighting. RESULTS Of 615 213 infants (live births and stillbirths), 11 519 were exposed to Tdap vaccination in utero. There was no increased risk for preterm birth (adjusted HR 0.98, 95% confidence interval [CI] 0.91-1.06), very preterm birth (adjusted HR 1.10, 95% CI 0.86-1.41), stillbirth (adjusted HR 1.15, 95% CI 0.82-1.60) or being small for gestational age (adjusted RR 0.96, 95% CI 0.90-1.02). The risks of a neonatal intensive care unit stay exceeding 24 hours (adjusted RR 0.82, 95% CI 0.76-0.88) and neonatal morbidity (adjusted RR 0.81, 95% CI 0.75-0.87) were decreased. There was no association with chorioamnionitis (adjusted RR 1.17, 95% CI 0.99-1.39), postpartum hemorrhage (adjusted RR 1.01, 95% CI 0.91-1.13) or severe postpartum hemorrhage (adjusted RR 0.79, 95% CI 0.55-1.13), but we observed a reduced risk of gestational hypertension (adjusted RR 0.87, 95% CI 0.78-0.96). INTERPRETATION Our results complement evidence that maternal Tdap vaccination is not associated with adverse outcomes in mothers or infants. Ongoing evaluation in Canada is needed as maternal Tdap vaccination coverage increases in coming years.
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Affiliation(s)
- Romina Fakhraei
- Children's Hospital of Eastern Ontario Research Institute (Fakhraei, Sucha, Fell); Ottawa Hospital Research Institute (Fakhraei, Hawken, Wilson, Walker), Ottawa, Ont.; ICES Central (Crowcroft, Hawken, Kwong, Fell); University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; ICES uOttawa (Sucha); University of Ottawa (Hawken, Cook, Walker, Laverty, Fell); Bruyère Research Institute (Wilson), Ottawa, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; Public Health England (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Centre for Vaccinology (Halperin), Dalhousie University and IWK Health Centre, Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC
| | - Natasha Crowcroft
- Children's Hospital of Eastern Ontario Research Institute (Fakhraei, Sucha, Fell); Ottawa Hospital Research Institute (Fakhraei, Hawken, Wilson, Walker), Ottawa, Ont.; ICES Central (Crowcroft, Hawken, Kwong, Fell); University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; ICES uOttawa (Sucha); University of Ottawa (Hawken, Cook, Walker, Laverty, Fell); Bruyère Research Institute (Wilson), Ottawa, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; Public Health England (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Centre for Vaccinology (Halperin), Dalhousie University and IWK Health Centre, Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC
| | - Shelly Bolotin
- Children's Hospital of Eastern Ontario Research Institute (Fakhraei, Sucha, Fell); Ottawa Hospital Research Institute (Fakhraei, Hawken, Wilson, Walker), Ottawa, Ont.; ICES Central (Crowcroft, Hawken, Kwong, Fell); University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; ICES uOttawa (Sucha); University of Ottawa (Hawken, Cook, Walker, Laverty, Fell); Bruyère Research Institute (Wilson), Ottawa, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; Public Health England (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Centre for Vaccinology (Halperin), Dalhousie University and IWK Health Centre, Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC
| | - Ewa Sucha
- Children's Hospital of Eastern Ontario Research Institute (Fakhraei, Sucha, Fell); Ottawa Hospital Research Institute (Fakhraei, Hawken, Wilson, Walker), Ottawa, Ont.; ICES Central (Crowcroft, Hawken, Kwong, Fell); University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; ICES uOttawa (Sucha); University of Ottawa (Hawken, Cook, Walker, Laverty, Fell); Bruyère Research Institute (Wilson), Ottawa, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; Public Health England (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Centre for Vaccinology (Halperin), Dalhousie University and IWK Health Centre, Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC
| | - Steven Hawken
- Children's Hospital of Eastern Ontario Research Institute (Fakhraei, Sucha, Fell); Ottawa Hospital Research Institute (Fakhraei, Hawken, Wilson, Walker), Ottawa, Ont.; ICES Central (Crowcroft, Hawken, Kwong, Fell); University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; ICES uOttawa (Sucha); University of Ottawa (Hawken, Cook, Walker, Laverty, Fell); Bruyère Research Institute (Wilson), Ottawa, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; Public Health England (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Centre for Vaccinology (Halperin), Dalhousie University and IWK Health Centre, Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC
| | - Kumanan Wilson
- Children's Hospital of Eastern Ontario Research Institute (Fakhraei, Sucha, Fell); Ottawa Hospital Research Institute (Fakhraei, Hawken, Wilson, Walker), Ottawa, Ont.; ICES Central (Crowcroft, Hawken, Kwong, Fell); University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; ICES uOttawa (Sucha); University of Ottawa (Hawken, Cook, Walker, Laverty, Fell); Bruyère Research Institute (Wilson), Ottawa, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; Public Health England (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Centre for Vaccinology (Halperin), Dalhousie University and IWK Health Centre, Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC
| | - Laura Gaudet
- Children's Hospital of Eastern Ontario Research Institute (Fakhraei, Sucha, Fell); Ottawa Hospital Research Institute (Fakhraei, Hawken, Wilson, Walker), Ottawa, Ont.; ICES Central (Crowcroft, Hawken, Kwong, Fell); University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; ICES uOttawa (Sucha); University of Ottawa (Hawken, Cook, Walker, Laverty, Fell); Bruyère Research Institute (Wilson), Ottawa, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; Public Health England (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Centre for Vaccinology (Halperin), Dalhousie University and IWK Health Centre, Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC
| | - Gayatri Amirthalingam
- Children's Hospital of Eastern Ontario Research Institute (Fakhraei, Sucha, Fell); Ottawa Hospital Research Institute (Fakhraei, Hawken, Wilson, Walker), Ottawa, Ont.; ICES Central (Crowcroft, Hawken, Kwong, Fell); University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; ICES uOttawa (Sucha); University of Ottawa (Hawken, Cook, Walker, Laverty, Fell); Bruyère Research Institute (Wilson), Ottawa, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; Public Health England (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Centre for Vaccinology (Halperin), Dalhousie University and IWK Health Centre, Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC
| | - Anne Biringer
- Children's Hospital of Eastern Ontario Research Institute (Fakhraei, Sucha, Fell); Ottawa Hospital Research Institute (Fakhraei, Hawken, Wilson, Walker), Ottawa, Ont.; ICES Central (Crowcroft, Hawken, Kwong, Fell); University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; ICES uOttawa (Sucha); University of Ottawa (Hawken, Cook, Walker, Laverty, Fell); Bruyère Research Institute (Wilson), Ottawa, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; Public Health England (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Centre for Vaccinology (Halperin), Dalhousie University and IWK Health Centre, Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC
| | - Jocelynn Cook
- Children's Hospital of Eastern Ontario Research Institute (Fakhraei, Sucha, Fell); Ottawa Hospital Research Institute (Fakhraei, Hawken, Wilson, Walker), Ottawa, Ont.; ICES Central (Crowcroft, Hawken, Kwong, Fell); University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; ICES uOttawa (Sucha); University of Ottawa (Hawken, Cook, Walker, Laverty, Fell); Bruyère Research Institute (Wilson), Ottawa, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; Public Health England (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Centre for Vaccinology (Halperin), Dalhousie University and IWK Health Centre, Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC
| | - Vinita Dubey
- Children's Hospital of Eastern Ontario Research Institute (Fakhraei, Sucha, Fell); Ottawa Hospital Research Institute (Fakhraei, Hawken, Wilson, Walker), Ottawa, Ont.; ICES Central (Crowcroft, Hawken, Kwong, Fell); University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; ICES uOttawa (Sucha); University of Ottawa (Hawken, Cook, Walker, Laverty, Fell); Bruyère Research Institute (Wilson), Ottawa, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; Public Health England (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Centre for Vaccinology (Halperin), Dalhousie University and IWK Health Centre, Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC
| | - Scott A Halperin
- Children's Hospital of Eastern Ontario Research Institute (Fakhraei, Sucha, Fell); Ottawa Hospital Research Institute (Fakhraei, Hawken, Wilson, Walker), Ottawa, Ont.; ICES Central (Crowcroft, Hawken, Kwong, Fell); University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; ICES uOttawa (Sucha); University of Ottawa (Hawken, Cook, Walker, Laverty, Fell); Bruyère Research Institute (Wilson), Ottawa, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; Public Health England (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Centre for Vaccinology (Halperin), Dalhousie University and IWK Health Centre, Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC
| | - Frances Jamieson
- Children's Hospital of Eastern Ontario Research Institute (Fakhraei, Sucha, Fell); Ottawa Hospital Research Institute (Fakhraei, Hawken, Wilson, Walker), Ottawa, Ont.; ICES Central (Crowcroft, Hawken, Kwong, Fell); University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; ICES uOttawa (Sucha); University of Ottawa (Hawken, Cook, Walker, Laverty, Fell); Bruyère Research Institute (Wilson), Ottawa, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; Public Health England (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Centre for Vaccinology (Halperin), Dalhousie University and IWK Health Centre, Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC
| | - Jeffrey C Kwong
- Children's Hospital of Eastern Ontario Research Institute (Fakhraei, Sucha, Fell); Ottawa Hospital Research Institute (Fakhraei, Hawken, Wilson, Walker), Ottawa, Ont.; ICES Central (Crowcroft, Hawken, Kwong, Fell); University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; ICES uOttawa (Sucha); University of Ottawa (Hawken, Cook, Walker, Laverty, Fell); Bruyère Research Institute (Wilson), Ottawa, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; Public Health England (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Centre for Vaccinology (Halperin), Dalhousie University and IWK Health Centre, Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC
| | - Manish Sadarangani
- Children's Hospital of Eastern Ontario Research Institute (Fakhraei, Sucha, Fell); Ottawa Hospital Research Institute (Fakhraei, Hawken, Wilson, Walker), Ottawa, Ont.; ICES Central (Crowcroft, Hawken, Kwong, Fell); University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; ICES uOttawa (Sucha); University of Ottawa (Hawken, Cook, Walker, Laverty, Fell); Bruyère Research Institute (Wilson), Ottawa, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; Public Health England (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Centre for Vaccinology (Halperin), Dalhousie University and IWK Health Centre, Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC
| | - Mark C Walker
- Children's Hospital of Eastern Ontario Research Institute (Fakhraei, Sucha, Fell); Ottawa Hospital Research Institute (Fakhraei, Hawken, Wilson, Walker), Ottawa, Ont.; ICES Central (Crowcroft, Hawken, Kwong, Fell); University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; ICES uOttawa (Sucha); University of Ottawa (Hawken, Cook, Walker, Laverty, Fell); Bruyère Research Institute (Wilson), Ottawa, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; Public Health England (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Centre for Vaccinology (Halperin), Dalhousie University and IWK Health Centre, Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC
| | - Meghan Laverty
- Children's Hospital of Eastern Ontario Research Institute (Fakhraei, Sucha, Fell); Ottawa Hospital Research Institute (Fakhraei, Hawken, Wilson, Walker), Ottawa, Ont.; ICES Central (Crowcroft, Hawken, Kwong, Fell); University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; ICES uOttawa (Sucha); University of Ottawa (Hawken, Cook, Walker, Laverty, Fell); Bruyère Research Institute (Wilson), Ottawa, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; Public Health England (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Centre for Vaccinology (Halperin), Dalhousie University and IWK Health Centre, Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC
| | - Deshayne B Fell
- Children's Hospital of Eastern Ontario Research Institute (Fakhraei, Sucha, Fell); Ottawa Hospital Research Institute (Fakhraei, Hawken, Wilson, Walker), Ottawa, Ont.; ICES Central (Crowcroft, Hawken, Kwong, Fell); University of Toronto (Crowcroft, Bolotin, Biringer, Dubey, Jamieson, Kwong); Public Health Ontario (Bolotin, Jamieson, Kwong), Toronto, Ont.; ICES uOttawa (Sucha); University of Ottawa (Hawken, Cook, Walker, Laverty, Fell); Bruyère Research Institute (Wilson), Ottawa, Ont.; Kingston Health Sciences Centre (Gaudet); Queen's University (Gaudet), Kingston, Ont.; Public Health England (Amirthalingam), London, UK; Mount Sinai Hospital (Biringer), Toronto, Ont.; Society of Obstetricians and Gynaecologists of Canada (Cook), Ottawa, Ont.; Toronto Public Health (Dubey), Toronto, Ont.; Canadian Centre for Vaccinology (Halperin), Dalhousie University and IWK Health Centre, Halifax, NS; Vaccine Evaluation Center (Sadarangani), BC Children's Hospital Research Institute; Department of Pediatrics (Sadarangani), University of British Columbia, Vancouver, BC
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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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Dhillon A, Deme JC, Furlong E, Roem D, Jongerius I, Johnson S, Lea SM. Molecular Basis for Bordetella pertussis Interference with Complement, Coagulation, Fibrinolytic, and Contact Activation Systems: the Cryo-EM Structure of the Vag8-C1 Inhibitor Complex. mBio 2021; 12:e02823-20. [PMID: 33758081 PMCID: PMC8092270 DOI: 10.1128/mbio.02823-20] [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: 10/03/2020] [Accepted: 02/18/2021] [Indexed: 12/27/2022] Open
Abstract
Complement, contact activation, coagulation, and fibrinolysis are serum protein cascades that need strict regulation to maintain human health. Serum glycoprotein, a C1 inhibitor (C1-INH), is a key regulator (inhibitor) of serine proteases of all the above-mentioned pathways. Recently, an autotransporter protein, virulence-associated gene 8 (Vag8), produced by the whooping cough pathogen, Bordetella pertussis, was shown to bind to C1-INH and interfere with its function. Here, we present the structure of the Vag8-C1-INH complex determined using cryo-electron microscopy at a 3.6-Å resolution. The structure shows a unique mechanism of C1-INH inhibition not employed by other pathogens, where Vag8 sequesters the reactive center loop of C1-INH, preventing its interaction with the target proteases.IMPORTANCE The structure of a 10-kDa protein complex is one of the smallest to be determined using cryo-electron microscopy at high resolution. The structure reveals that C1-INH is sequestered in an inactivated state by burial of the reactive center loop in Vag8. By so doing, the bacterium is able to simultaneously perturb the many pathways regulated by C1-INH. Virulence mechanisms such as the one described here assume more importance given the emerging evidence about dysregulation of contact activation, coagulation, and fibrinolysis leading to COVID-19 pneumonia.
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Affiliation(s)
- Arun Dhillon
- Sir William Dunn School of Pathology, Oxford, United Kingdom
| | - Justin C Deme
- Sir William Dunn School of Pathology, Oxford, United Kingdom
- Central Oxford Structural Molecular Imaging Centre, Oxford, United Kingdom
| | - Emily Furlong
- Sir William Dunn School of Pathology, Oxford, United Kingdom
| | - Dorina Roem
- Sanquin Research, Department of Immunopathology, and Landsteiner Laboratory, Amsterdam University Medical Centre, Amsterdam Infection and Immunity Institute, Amsterdam, the Netherlands
| | - Ilse Jongerius
- Sanquin Research, Department of Immunopathology, and Landsteiner Laboratory, Amsterdam University Medical Centre, Amsterdam Infection and Immunity Institute, Amsterdam, the Netherlands
- Department of Pediatric Immunology, Rheumatology, and Infectious Diseases, Emma Children's Hospital, Amsterdam University Medical Centre, Amsterdam, the Netherlands
| | - Steven Johnson
- Sir William Dunn School of Pathology, Oxford, United Kingdom
| | - Susan M Lea
- Sir William Dunn School of Pathology, Oxford, United Kingdom
- Central Oxford Structural Molecular Imaging Centre, Oxford, United Kingdom
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de Graaf H, Ibrahim M, Hill AR, Gbesemete D, Vaughan AT, Gorringe A, Preston A, Buisman AM, Faust SN, Kester KE, Berbers GAM, Diavatopoulos DA, Read RC. Controlled Human Infection With Bordetella pertussis Induces Asymptomatic, Immunizing Colonization. Clin Infect Dis 2021; 71:403-411. [PMID: 31562530 PMCID: PMC7353841 DOI: 10.1093/cid/ciz840] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 09/02/2019] [Indexed: 11/13/2022] Open
Abstract
Background Bordetella pertussis is among the leading causes of vaccine-preventable deaths and morbidity globally. Human asymptomatic carriage as a reservoir for community transmission of infections might be a target of future vaccine strategies, but has not been demonstrated. Our objective was to demonstrate that asymptomatic nasopharyngeal carriage of Bordetella pertussis is inducible in humans and to define the microbiological and immunological features of presymptomatic infection. Methods Healthy subjects aged 18–45 years with an antipertussis toxin immunoglobin G (IgG) concentration of <20 international units/ml were inoculated intranasally with nonattenuated, wild-type Bordetella pertussis strain B1917. Safety, colonization, and shedding were monitored over 17 days in an inpatient facility. Colonization was assessed by culture and quantitative polymerase chain reaction. Azithromycin was administered from Day 14. The inoculum dose was escalated, aiming to colonize at least 70% of participants. Immunological responses were measured. Results There were 34 participants challenged, in groups of 4 or 5. The dose was gradually escalated from 103 colony-forming units (0% colonized) to 105 colony-forming units (80% colonized). Minor symptoms were reported in a minority of participants. Azithromycin eradicated colonization in 48 hours in 88% of colonized individuals. Antipertussis toxin IgG seroconversion occurred in 9 out of 19 colonized participants and in none of the participants who were not colonized. Nasal wash was a more sensitive method to detect colonization than pernasal swabs. No shedding of Bordetella pertussis was detected in systematically collected environmental samples. Conclusions Bordetella pertussis colonization can be deliberately induced and leads to a systemic immune response without causing pertussis symptoms. Clinical Trials Registration NCT03751514.
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Affiliation(s)
- Hans de Graaf
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Academic Unit of Clinical Experimental Sciences, National Institute of Health Research (NIHR) Clinical Research Facility and NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, United Kingdom
| | - Muktar Ibrahim
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
| | - Alison R Hill
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
| | - Diane Gbesemete
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Academic Unit of Clinical Experimental Sciences, National Institute of Health Research (NIHR) Clinical Research Facility and NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, United Kingdom
| | - Andrew T Vaughan
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
| | | | - Andrew Preston
- The Milner Centre for Evolution and Department of Biology and Biochemistry, University of Bath, Bath, United Kingdom
| | - Annemarie M Buisman
- Centre for Infectious Disease and Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Saul N Faust
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Academic Unit of Clinical Experimental Sciences, National Institute of Health Research (NIHR) Clinical Research Facility and NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, United Kingdom
| | - Kent E Kester
- Translational Science and Biomarkers, Sanofi Pasteur, Swiftwater, USA
| | - Guy A M Berbers
- Centre for Infectious Disease and Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Dimitri A Diavatopoulos
- Section of Paediatric Infectious Diseases, Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Radboud Center for Infectious Diseases, Nijmegen, The Netherlands
| | - Robert C Read
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Academic Unit of Clinical Experimental Sciences, National Institute of Health Research (NIHR) Clinical Research Facility and NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, United Kingdom
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Abstract
This review summarizes the published data on epidemiology and burden of pertussis in South Korea as these may be under-categorized. A systematic literature review of PubMed, SCOPUS, EMBASE and KMBASE was performed to identify published literature in South Korea since 2000. Pertussis detection rates among 19 eligible studies range from 0.7% to 100% across different age groups, detection methods and study settings. Highest rates are observed in infants, while adolescents and adults with pertussis infection may suffer from persistent coughing. Vaccination uptake of pertussis booster dose among adolescents and adults remains low while seropositivity (detection of anti-pertussis immunoglobulin G), is high among adults. This review reveals a high burden of vaccine-preventable pertussis in South Korea. Besides primary childhood vaccination, strategies like maternal immunization and decennial revaccination of adults should be considered. Active testing, reporting and better utilization of vaccine registries may provide insights for decision-makers nationwide.
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Affiliation(s)
| | - Hyungwoo Kim
- Medical Affairs, GSK, Yongsan-gu, Seoul, Republic of Korea
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27
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Craig R, Kunkel E, Crowcroft NS, Fitzpatrick MC, de Melker H, Althouse BM, Merkel T, Scarpino SV, Koelle K, Friedman L, Arnold C, Bolotin S. Asymptomatic Infection and Transmission of Pertussis in Households: A Systematic Review. Clin Infect Dis 2021; 70:152-161. [PMID: 31257450 DOI: 10.1093/cid/ciz531] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Indexed: 12/28/2022] Open
Abstract
We conducted a systematic review to describe the frequency of mild, atypical, and asymptomatic infection among household contacts of pertussis cases and to explore the published literature for evidence of asymptomatic transmission. We included studies that obtained and tested laboratory specimens from household contacts regardless of symptom presentation and reported the proportion of cases with typical, mild/atypical, or asymptomatic infection. After screening 6789 articles, we included 26 studies. Fourteen studies reported household contacts with mild/atypical pertussis. These comprised up to 46.2% of all contacts tested. Twenty-four studies reported asymptomatic contacts with laboratory-confirmed pertussis, comprising up to 55.6% of those tested. Seven studies presented evidence consistent with asymptomatic pertussis transmission between household contacts. Our results demonstrate a high prevalence of subclinical infection in household contacts of pertussis cases, which may play a substantial role in the ongoing transmission of disease. Our review reveals a gap in our understanding of pertussis transmission.
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Affiliation(s)
- Rodger Craig
- Applied Immunization Research and Evaluation, Public Health Ontario,Toronto.,Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Montreal, Canada
| | - Elizabeth Kunkel
- Applied Immunization Research and Evaluation, Public Health Ontario,Toronto.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | - Natasha S Crowcroft
- Applied Immunization Research and Evaluation, Public Health Ontario,Toronto.,Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Montreal, Canada.,Department of Laboratory Medicine, University of Toronto, Toronto, Ontario, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Meagan C Fitzpatrick
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore
| | - Hester de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Benjamin M Althouse
- Institute for Disease Modeling, Bellevue, Washington.,Information School, University of Washington, Seattle.,Department of Biology, New Mexico State University, Las Cruces
| | - Tod Merkel
- Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - Samuel V Scarpino
- Network Science Institute, Northeastern University, Boston, Massachusetts.,Institute for Scientific Interchange Foundation, Torino, Italy
| | - Katia Koelle
- Department of Biology, Emory University, Atlanta, Georgia
| | - Lindsay Friedman
- Applied Immunization Research and Evaluation, Public Health Ontario,Toronto
| | - Callum Arnold
- Division of Infectious Diseases,The Hospital for Sick Children, Toronto, Canada
| | - Shelly Bolotin
- Applied Immunization Research and Evaluation, Public Health Ontario,Toronto.,Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Montreal, Canada.,Department of Laboratory Medicine, University of Toronto, Toronto, Ontario, Canada
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28
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Cole LE, Zhang J, Pacheco KM, Lhéritier P, Anosova NG, Piolat J, Zheng L, Reveneau N. Immunological Distinctions between Acellular and Whole-Cell Pertussis Immunizations of Baboons Persist for at Least One Year after Acellular Vaccine Boosting. Vaccines (Basel) 2020; 8:vaccines8040729. [PMID: 33276673 PMCID: PMC7761625 DOI: 10.3390/vaccines8040729] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/19/2020] [Accepted: 11/26/2020] [Indexed: 01/17/2023] Open
Abstract
While both whole-cell (wP) and acellular pertussis (aP) vaccines have been highly effective at reducing the global pertussis disease burden, there are concerns that compared to wP vaccination, the immune responses to aP vaccination may wane more rapidly. To gain insights into the vaccine elicited immune responses, pre-adult baboons were immunized with either aP or wP vaccines, boosted with an aP vaccine, and observed over a nearly two-year period. Priming with a wP vaccine elicited a more Th17-biased response than priming with aP, whereas priming with an aP vaccine led to a more Th2-biased response than priming with wP. These differences were maintained after aP vaccine boost immunizations. Compared to aP, animals primed with a wP vaccine exhibited greater numbers of pertussis specific memory B cells. While aP and wP vaccine priming initially elicited similar levels of anti-pertussis toxin antibody, titers declined more rapidly in aP vaccine primed animals leading to a 4-fold difference. Both wP and aP vaccine immunization could induce serum bactericidal activity (SBA); however, only one wP vaccine immunization was required to elicit SBA while multiple aP vaccine immunizations were required to elicit lower, less durable SBA titers. In conclusion, when compared to aP vaccine, priming with wP vaccine elicits distinct cellular and humoral immune responses that persist after aP vaccine boosting.
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Affiliation(s)
- Leah E. Cole
- Sanofi Pasteur, Cambridge, MA 02139, USA; (J.Z.); (K.M.P.); (N.G.A.)
- Correspondence: (L.E.C.); (N.R.); Tel.: +1-617-866-4473 (L.E.C.); +33-4-37-66-8510 (N.R.)
| | - Jinrong Zhang
- Sanofi Pasteur, Cambridge, MA 02139, USA; (J.Z.); (K.M.P.); (N.G.A.)
| | - Kristl M. Pacheco
- Sanofi Pasteur, Cambridge, MA 02139, USA; (J.Z.); (K.M.P.); (N.G.A.)
| | | | | | - Julie Piolat
- Sanofi Pasteur, 69280 Marcy L’Etoile, France; (P.L.); (J.P.)
| | | | - Nathalie Reveneau
- Sanofi Pasteur, 69280 Marcy L’Etoile, France; (P.L.); (J.P.)
- Correspondence: (L.E.C.); (N.R.); Tel.: +1-617-866-4473 (L.E.C.); +33-4-37-66-8510 (N.R.)
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29
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Gill CJ, Gunning CE, MacLeod W, Mwananyanda L, Thea D, Pieciak R, Kwenda G, Mupila Z, Rohani P. Asymptomatic Bordetella pertussis infections in young African infants and their mothers identified within a longitudinal cohort. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.11.18.20231423. [PMID: 33236026 PMCID: PMC7685339 DOI: 10.1101/2020.11.18.20231423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Despite long-standing vaccination programs, pertussis incidence has increased in numerous countries; transmission by asymptomatic individuals is a suspected driver of this resurgence. However, unequivocal evidence documenting asymptomatic infections in adults and children is lacking due, in part, to the cross-sectional nature of most pertussis surveillance studies. In addition, modern pertussis surveillance relies on quantitative PCR (qPCR) using fixed diagnostic thresholds to identify cases. To address this gap, we present a longitudinal analysis of 17,442 nasopharyngeal samples collected from a cohort of 1,320 Zambian mother/infant pairs. Using full-range cycle threshold (CT) values from IS481 qPCR assays, we document widespread asymptomatic infections among mothers and also, surprisingly, among young infants. From an initial group of eight symptomatic infants who tested positive by qPCR, we identify frequent contemporaneous subclinical infections in mothers. Within the full cohort, we observe strong temporal correlation between low- and high-intensity qPCR signals. We compute a single time-averaged score for each individual summarizing the evidence for pertussis infection (EFI), and show that EFI strongly clusters within mother/infant pairs, and is strongly associated with clinical symptomatology and antibiotic use. Overall, the burden of pertussis here is substantially underestimated when restricting diagnostic criteria to IS481 CT≤35. Rather, we find that full-range CT values provide valuable insights into pertussis epidemiology in this population, and illuminate the infection arc within individuals. These findings have significant implications for quantifying asymptomatic pertussis prevalence and its contribution to overall transmission. Our results also expose limitations of threshold-based interpretations of qPCR assays in infectious disease surveillance.
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Affiliation(s)
- C J Gill
- Boston University School of Public Health, Deptartment of Global Health
| | - C E Gunning
- University of Georgia, Odum School of Ecology
| | - W MacLeod
- Boston University School of Public Health, Deptartment of Global Health
| | - L Mwananyanda
- Boston University School of Public Health, Deptartment of Global Health
- Right to Care - Zambia
| | - D Thea
- Boston University School of Public Health, Deptartment of Global Health
| | - R Pieciak
- Boston University School of Public Health, Deptartment of Global Health
| | - G Kwenda
- University of Zambia, School of Health Sciences, Department of Biomedical Science
| | | | - P Rohani
- University of Georgia, Odum School of Ecology
- University of Georgia, Center for the Ecology of Infectious Diseases
- University of Georgia, Department of Infectious Diseases
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30
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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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31
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O'Regan SM, O'Dea EB, Rohani P, Drake JM. Transient indicators of tipping points in infectious diseases. J R Soc Interface 2020; 17:20200094. [PMID: 32933375 DOI: 10.1098/rsif.2020.0094] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The majority of known early warning indicators of critical transitions rely on asymptotic resilience and critical slowing down. In continuous systems, critical slowing down is mathematically described by a decrease in magnitude of the dominant eigenvalue of the Jacobian matrix on the approach to a critical transition. Here, we show that measures of transient dynamics, specifically, reactivity and the maximum of the amplification envelope, also change systematically as a bifurcation is approached in an important class of models for epidemics of infectious diseases. Furthermore, we introduce indicators designed to detect trends in these measures and find that they reliably classify time series of case notifications simulated from stochastic models according to levels of vaccine uptake. Greater attention should be focused on the potential for systems to exhibit transient amplification of perturbations as a critical threshold is approached, and should be considered when searching for generic leading indicators of tipping points. Awareness of this phenomenon will enrich understanding of the dynamics of complex systems on the verge of a critical transition.
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Affiliation(s)
- Suzanne M O'Regan
- Department of Mathematics and Statistics, Marteena Hall, 1601 E. Market St., North Carolina A&T State University, Greensboro, NC 27411 USA
| | - Eamon B O'Dea
- Odum School of Ecology, University of Georgia, Athens, GA 30602, USA.,Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA 30602, USA
| | - Pejman Rohani
- Odum School of Ecology, University of Georgia, Athens, GA 30602, USA.,Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA 30602, USA.,Department of Infectious Diseases, University of Georgia, Athens, GA 30602, USA
| | - John M Drake
- Odum School of Ecology, University of Georgia, Athens, GA 30602, USA.,Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA 30602, USA
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32
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Emergence of pertactin-deficient pertussis strains in Australia can be explained by models of vaccine escape. Epidemics 2020; 31:100388. [DOI: 10.1016/j.epidem.2020.100388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 01/22/2020] [Accepted: 02/06/2020] [Indexed: 12/27/2022] Open
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33
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Dewan KK, Linz B, DeRocco SE, Harvill ET. Acellular Pertussis Vaccine Components: Today and Tomorrow. Vaccines (Basel) 2020; 8:vaccines8020217. [PMID: 32414005 PMCID: PMC7349526 DOI: 10.3390/vaccines8020217] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/05/2020] [Accepted: 05/07/2020] [Indexed: 12/21/2022] Open
Abstract
Pertussis is a highly communicable acute respiratory infection caused by Bordetella pertussis. Immunity is not lifelong after natural infection or vaccination. Pertussis outbreaks occur cyclically worldwide and effective vaccination strategies are needed to control disease. Whole-cell pertussis (wP) vaccines became available in the 1940s but have been replaced in many countries with acellular pertussis (aP) vaccines. This review summarizes disease epidemiology before and after the introduction of wP and aP vaccines, discusses the rationale and clinical implications for antigen inclusion in aP vaccines, and provides an overview of novel vaccine strategies aimed at better combating pertussis in the future.
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Affiliation(s)
- Kalyan K. Dewan
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA; (K.K.D.); (B.L.)
| | - Bodo Linz
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA; (K.K.D.); (B.L.)
| | | | - Eric T. Harvill
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA; (K.K.D.); (B.L.)
- Correspondence:
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Alai S, Ghattargi VC, Gautam M, Patel K, Pawar SP, Dhotre DP, Shaligram U, Gairola S. Comparative genomics of whole-cell pertussis vaccine strains from India. BMC Genomics 2020; 21:345. [PMID: 32381023 PMCID: PMC7204287 DOI: 10.1186/s12864-020-6724-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 04/06/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Despite high vaccination coverage using acellular (ACV) and whole-cell pertussis (WCV) vaccines, the resurgence of pertussis is observed globally. Genetic divergence in circulating strains of Bordetella pertussis has been reported as one of the contributing factors for the resurgence of the disease. Our current knowledge of B. pertussis genetic evolution in circulating strains is mostly based on studies conducted in countries using ACVs targeting only a few antigens used in the production of ACVs. To better understand the adaptation to vaccine-induced selection pressure, it will be essential to study B. pertussis populations in developing countries which are using WCVs. India is a significant user and global supplier of WCVs. We report here comparative genome analyses of vaccine and clinical isolates reported from India. Whole-genome sequences obtained from vaccine strains: WCV (J445, J446, J447 and J448), ACV (BP165) were compared with Tohama-I reference strain and recently reported clinical isolates from India (BPD1, BPD2). Core genome-based phylogenetic analysis was also performed using 166 isolates reported from countries using ACV. RESULTS Whole-genome analysis of vaccine and clinical isolates reported from India revealed high genetic similarity and conserved genome among strains. Phylogenetic analysis showed that clinical and vaccine strains share genetic closeness with reference strain Tohama-I. The allelic profile of vaccine strains (J445:ptxP1/ptxA2/prn1/fim2-1/fim3-1; J446: ptxP2/ptxA4/prn7/fim2-2/fim3-1; J447 and J448: ptxP1/ptxA1/ prn1/fim2-1/fim3-1), which matched entirely with clinical isolates (BPD1:ptxP1/ptxA1/prn1/fim2-1 and BPD2: ptxP1/ptxA1/prn1/fim2-1) reported from India. Multi-locus sequence typing (MLST) demonstrated the presence of dominant sequence types ST2 and primitive ST1 in vaccine strains which will allow better coverage against circulating strains of B. pertussis. CONCLUSIONS The study provides a detailed characterization of vaccine and clinical strains reported from India, which will further facilitate epidemiological studies on genetic shifts in countries which are using WCVs in their immunization programs.
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Affiliation(s)
- Shweta Alai
- Department of Health and Biological Sciences, Symbiosis International University, Pune, Maharashtra, 412115, India
| | - Vikas C Ghattargi
- National Centre for Microbial Resource, National Centre for Cell Science, Pune, Maharashtra, 411021, India
| | - Manish Gautam
- Serum Institute of India Pvt. Ltd, Pune, Maharashtra, 411028, India
| | - Krunal Patel
- Serum Institute of India Pvt. Ltd, Pune, Maharashtra, 411028, India
| | - Shrikant P Pawar
- National Centre for Microbial Resource, National Centre for Cell Science, Pune, Maharashtra, 411021, India
| | - Dhiraj P Dhotre
- National Centre for Microbial Resource, National Centre for Cell Science, Pune, Maharashtra, 411021, India
| | - Umesh Shaligram
- Serum Institute of India Pvt. Ltd, Pune, Maharashtra, 411028, India
| | - Sunil Gairola
- Serum Institute of India Pvt. Ltd, Pune, Maharashtra, 411028, India.
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Olivera I, Grau C, Dibarboure H, Torres JP, Mieres G, Lazarov L, Alvarez FP, Yescas JGL. Valuing the cost of improving Chilean primary vaccination: a cost minimization analysis of a hexavalent vaccine. BMC Health Serv Res 2020; 20:295. [PMID: 32272920 PMCID: PMC7147015 DOI: 10.1186/s12913-020-05115-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 03/17/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The phased withdrawal of oral polio vaccine (OPV) and the introduction of inactivated poliovirus vaccine (IPV) is central to the polio 'end-game' strategy. METHODS We analyzed the cost implications in Chile of a switch from the vaccination scheme consisting of a pentavalent vaccine with whole-cell pertussis component (wP) plus IPV/OPV vaccines to a scheme with a hexavalent vaccine with acellular pertussis component (aP) and IPV (Hexaxim®) from a societal perspective. Cost data were collected from a variety of sources including national estimates and previous vaccine studies. All costs were expressed in 2017 prices (US$ 1.00 = $Ch 666.26). RESULTS The overall costs associated with the vaccination scheme (4 doses of pentavalent vaccine plus 1 dose IPV and 3 doses OPV) from a societal perspective was estimated to be US$ 12.70 million, of which US$ 8.84 million were associated with the management of adverse events related to wP. In comparison, the cost associated with the 4-dose scheme with a hexavalent vaccine (based upon the PAHO reference price) was US$ 19.76 million. The cost of switching to the hexavalent vaccine would be an additional US$ 6.45 million. Overall, depending on the scenario, the costs of switching to the hexavalent scheme would range from an additional US$ 2.62 million to US$ 6.45 million compared with the current vaccination scheme. CONCLUSIONS The switch to the hexavalent vaccine schedule in Chile would lead to additional acquisition costs, which would be partially offset by improved logistics, and a reduction in adverse events associated with the current vaccines.
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Affiliation(s)
- Ignacio Olivera
- Centro de Investigaciones Económicas, CINVE, Salud, Montevideo, Uruguay
| | - Carlos Grau
- Centro de Investigaciones Económicas, CINVE, Salud, Montevideo, Uruguay
| | | | - Juan Pablo Torres
- Chile Departamento de Pediatría y Cirugía Infantil Oriente, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Gustavo Mieres
- Centro de Investigaciones Económicas, CINVE, Salud, Montevideo, Uruguay
| | - Luis Lazarov
- Centro de Investigaciones Económicas, CINVE, Salud, Montevideo, Uruguay
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36
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Kavitha TK, Samprathi M, Jayashree M, Gautam V, Sangal L. Clinical Profile of Critical Pertussis in Children at a Pediatric Intensive Care Unit in Northern India. Indian Pediatr 2020. [PMID: 32198862 PMCID: PMC7223409 DOI: 10.1007/s13312-020-1756-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective To delineate the clinical profile, complications, intensive care needs, and predictors of mortality in children with critical pertussis. Methods Retrospective analysis of case records of children in the pediatric intensive care unit of a tertiary-care hospital, with a diagnosis of critical pertussis over 3 years. Diagnostic criteria included CDC case definition and confirmation by polymerase chain reaction (PCR), when available. Survivors and nonsurvivors were compared to identify predictors of mortality. Results 36 records were analysed, most cases were infants (31, 86.1%). 10 (27.7%) were (below 6 weeks of age). In the rest, 16 (61.5%) were partially immunized or unimmunized against pertussis. Rapid breathing (88.9%), paroxysmal cough (86.1%) and apnea (41.7%) were common presenting complaints. Hypoxemia (97.2%), hyperleukocytosis (61.1%) and encephalopathy (52.8%) were common complications. Intensive care needs were mechanical ventilation in 11 (30.6%), vasoactive support in 7 (19.4%) and exchange transfusion in 3 (8.3%). Female gender, apnea, hyperleukocytosis, encephalopathy, need for vasoactive support, and mechanical ventilation predicted mortality. Conclusion Pertussis demands attention due to its varied presentation, increased complications and higher mortality.
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Affiliation(s)
- T K Kavitha
- Pediatric Emergency and Intensive Care Units, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Madhusudan Samprathi
- Pediatric Emergency and Intensive Care Units, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Muralidharan Jayashree
- Pediatric Emergency and Intensive Care Units, Post Graduate Institute of Medical Education and Research, Chandigarh, India. Correspondence to: Dr Muralidharan Jayashree, Professor, Pediatric Emergency and Intensive Care Units, Post Graduate Institute of Medical Education and Research, Chandigarh 160 012, India
| | - Vikas Gautam
- Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Lucky Sangal
- NPO-VPD laboratories, WHO Country Office for India
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Estimating seasonal variation in Australian pertussis notifications from 1991 to 2016: evidence of spring to summer peaks. Epidemiol Infect 2020; 147:e155. [PMID: 31063086 PMCID: PMC6518527 DOI: 10.1017/s0950268818003680] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Unlike for many other respiratory infections, the seasonality of pertussis is not well understood. While evidence of seasonal fluctuations in pertussis incidence has been noted in some countries, there have been conflicting findings including in the context of Australia. We investigated this issue by analysing the seasonality of pertussis notifications in Australia using monthly data from January 1991 to December 2016. Data were made available for all states and territories in Australia except for the Australian Capital Territory and were stratified into age groups. Using a time-series decomposition approach, we formulated a generalised additive model where seasonality is expressed using cosinor terms to estimate the amplitude and peak timing of pertussis notifications in Australia. We also compared these characteristics across different jurisdictions and age groups. We found evidence that pertussis notifications exhibit seasonality, with peaks observed during the spring and summer months (November–January) in Australia and across different states and territories. During peak months, notifications are expected to increase by about 15% compared with the yearly average. Peak notifications for children <5 years occurred 1–2 months later than the general population, which provides support to the theory that older household members remain an important source of pertussis infection for younger children. In addition, our results provide a more comprehensive spatial picture of seasonality in Australia, a feature lacking in previous studies. Finally, our findings suggest that seasonal forcing may be useful to consider in future population transmission models of pertussis.
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38
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Tdap vaccination during pregnancy interrupts a twenty-year increase in the incidence of pertussis. Vaccine 2020; 38:2700-2706. [PMID: 32070682 DOI: 10.1016/j.vaccine.2020.01.095] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 01/10/2020] [Accepted: 01/31/2020] [Indexed: 10/25/2022]
Abstract
Pertussis incidence in developed countries, including Israel, has increased over the past two decades despite the addition of two booster doses in children. However, as pertussis is characterized by a multi-annual periodicity, and since clinical diagnosis can miss cases, determining disease trends at the population level is challenging. To bridge this gap, we developed a simple statistical model to capture the temporal patterns of pertussis incidence in Israel. Our model was calibrated and tested using laboratory-confirmed cases of pertussis for the Israeli population between 1998 and 2019. The model identifies a clear four-year periodicity of pertussis incidence over the past two decades that is identical to the one observed in the pre-vaccine era. Accounting for this periodicity, the model shows a 325% increase in pertussis incidence from 2002 to 2014. These multi-year trends were interrupted shortly after the introduction of routine immunization of Tdap vaccine in pregnancy in 2015, after which we found a 59.7% (95% CI: 57.7-61.6%)decline in pertussis incidence and a 49.5% (36.0-61.6%) decline in hospitalizations compared to the model's projection. While this sharp decline cannot be fully attributed to the newly introduced vaccination policy, sharper reductions of 71.2% (65.6-76.1%) in incidence and 58.4% (39.6-72.7%) in hospitalizations, have been observed in infants of age two months and below - young infants that have yet to become vaccinated and are more likely to be protected by maternal vaccination. Our work suggests that Tdap vaccination during pregnancy is a promising policy for controlling pertussis. Furthermore, due to the stable periodicity of pertussis, public health decision-makers should invest continuous efforts in the implementation of this strategy with additional reinforcement in expected peak years.
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39
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Zhang Y, Bambrick H, Mengersen K, Tong S, Feng L, Zhang L, Liu G, Xu A, Hu W. Resurgence of Pertussis Infections in Shandong, China: Space-Time Cluster and Trend Analysis. Am J Trop Med Hyg 2020; 100:1342-1354. [PMID: 30994096 PMCID: PMC6553910 DOI: 10.4269/ajtmh.19-0013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Although vaccination is effective in preventing infection, pertussis remains endemic worldwide, including China. To lead better targeted prevention strategies, we examined dynamics of spatial and temporal patterns of pertussis transmission in Shandong, China, from 2009 to 2017. We used space-time cluster analysis, logistic regression analysis, and regression tree model to detect the changes in spatial patterns of pertussis infections in Shandong Province, China, between periods (2009–2011, 2012–2014, and 2015–2017). The yearly pertussis incidence rates dramatically increased by 16.8 times from 2009 to 2017. Shifting patterns of peaks of pertussis infections were observed over both time (from June–July to August–September) and space (from Linyi to Jinan), with increasing RR from 4.1 (95% CI: 2.3–7.4) (2009–2011) to 6.1 (95% CI: 5.6–6.7) (2015–2017) and obvious coincidence of peak time. West Shandong had larger odds of increased infections over the study period (odds ratio: 1.52 [95% CI: 1.05–2.17]), and pertussis had larger odds of spreading to east (odds ratio: 2.32 [95% CI: 1.63–3.31]) and north (odds ratio: 1.69 [95% CI: 1.06–2.99]) over time. Regression tree model indicated that the mean difference in yearly average pertussis incidence between 2009–2011 and 2015–2017 increased by more than 4-fold when the longitudes of counties are < 118.0°E. The geographic expansion of pertussis infection may increase the risk of epidemic peaks, coinciding with increased infections in the future. The findings might offer evidence for targeting preventive measures to the areas most in need to minimize the impact of the disease.
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Affiliation(s)
- Yuzhou Zhang
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Hilary Bambrick
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Kerrie Mengersen
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Shilu Tong
- Shanghai Children's Medical Centre, Shanghai Jiao-Tong University, Shanghai, China.,School of Public Health, Institute of Environment and Human Health, Anhui Medical University, Hefei, China.,School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Lei Feng
- Shandong Provincial Centre of Disease Control and Prevention, Jinan, China
| | - Li Zhang
- Shandong Provincial Centre of Disease Control and Prevention, Jinan, China
| | - Guifang Liu
- Shandong Provincial Centre of Disease Control and Prevention, Jinan, China
| | - Aiqiang Xu
- Shandong Provincial Centre of Disease Control and Prevention, Jinan, China
| | - Wenbiao Hu
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
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40
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Zhang Y, Bambrick H, Mengersen K, Tong S, Feng L, Zhang L, Liu G, Xu A, Hu W. Using big data to predict pertussis infections in Jinan city, China: a time series analysis. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:95-104. [PMID: 31478106 DOI: 10.1007/s00484-019-01796-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 07/06/2019] [Accepted: 08/27/2019] [Indexed: 05/14/2023]
Abstract
This study aims to use big data (climate data, internet query data and school calendar patterns (SCP)) to improve pertussis surveillance and prediction, and develop an early warning model for pertussis epidemics. We collected weekly pertussis notifications, SCP, climate and internet search query data (Baidu index (BI)) in Jinan, China between 2013 and 2017. Time series decomposition and temporal risk assessment were used for examining the epidemic features in pertussis infections. A seasonal autoregressive integrated moving average (SARIMA) model and regression tree model were developed to predict pertussis occurrence using identified predictors. Our study demonstrates clear seasonal patterns in pertussis epidemics, and pertussis activity was most significantly associated with BI at 2-week lag (rBI = 0.73, p < 0.05), temperature at 1-week lag (rtemp = 0.19, p < 0.05) and rainfall at 2-week lag (rrainfall = 0.27, p < 0.05). No obvious relationship between pertussis peaks and school attendance was found in the study. Pertussis cases were more likely to be temporally concentrated throughout the epidemics during the study period. SARIMA models with 2-week-lagged BI and 1-week-lagged temperature had better predictive performance (βsearch query = 0.06, p = 0.02; βtemp = 0.16, p = 0.03) with large correlation coefficients (r = 0.67, p < 0.01) and low root mean squared error (RMSE) value (r = 3.59). The regression tree model identified threshold values of potential predictors (search query, climate and SCP) for pertussis epidemics. Our results showed that internet query in conjunction with social and climatic data can predict pertussis epidemics, which is a foundation of using such data to develop early warning systems.
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Affiliation(s)
- Yuzhou Zhang
- School of Public Health and Social Work; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Hilary Bambrick
- School of Public Health and Social Work; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Kerrie Mengersen
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Shilu Tong
- School of Public Health and Social Work; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
- School of Public Health and Institute of Environment and Human Health, Anhui Medical University, Hefei, Anhui, China
- Shanghai Children's Medical Centre, Shanghai Jiao-Tong University, Shanghai, China
| | - Lei Feng
- Shandong Provincial Centre of Disease Control and Prevention, Jinan, China
| | - Li Zhang
- Shandong Provincial Centre of Disease Control and Prevention, Jinan, China
| | - Guifang Liu
- Shandong Provincial Centre of Disease Control and Prevention, Jinan, China
| | - Aiqiang Xu
- Shandong Provincial Centre of Disease Control and Prevention, Jinan, China
| | - Wenbiao Hu
- School of Public Health and Social Work; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
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41
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Miller IF, Metcalf CJ. Vaccine-driven virulence evolution: consequences of unbalanced reductions in mortality and transmission and implications for pertussis vaccines. J R Soc Interface 2019; 16:20190642. [PMID: 31822219 PMCID: PMC6936036 DOI: 10.1098/rsif.2019.0642] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 11/19/2019] [Indexed: 11/12/2022] Open
Abstract
Many vaccines have heterogeneous effects across individuals. Additionally, some vaccines do not prevent infection, but reduce disease-associated mortality and transmission. Both of these factors will alter selection pressures on pathogens and thus shape the evolution of pathogen virulence. We use a mathematical modelling framework to show that (i) the balance of how vaccines reduce transmission versus mortality and (ii) individual variability in protection conferred both shape the evolution of pathogen virulence. Epidemiological (burden of disease) and evolutionary (pathogen virulence) outcomes are both worse when vaccines confer smaller reductions in transmission than in mortality. Furthermore, outcomes are modulated by variability in vaccine effects, with increased variability limiting the extent of virulence evolution but in some cases preventing eradication. These findings are pertinent to current concerns about the global resurgence of pertussis and the efficacy of pertussis vaccines, as the two classes of these vaccines may reduce disease symptoms without preventing infection and differ in their ability to reduce transmission. Furthermore, these findings point to the importance of generating precise predictions for virulence evolution in Bordetella pertussis (and other similar pathogens) by incorporating empirical characterizations of vaccine effects into models capturing the epidemiological details of this system.
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Affiliation(s)
- Ian F. Miller
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
| | - C. Jessica Metcalf
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
- Woodrow Wilson School of Public Affairs, Princeton University, Princeton, NJ, USA
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42
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Zhu DD, Wang XL, Zhang XP, Ma JJ, Kong DL, Zhang MM, Guo XD, Wang C. A Dissolvable Microneedle Formulation of Bordetella pertussis Subunit Vaccine: Translational Development and Immunological Evaluation in Mice. ACS APPLIED BIO MATERIALS 2019; 2:5053-5061. [DOI: 10.1021/acsabm.9b00730] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Dan Dan Zhu
- Beijing Laboratory of Biomedical Materials, College of Materials Science and Engineering, Beijing University of Chemical Technology, Beijing 100029, People's Republic of China
| | - Xiao Li Wang
- Tianjin Key Laboratory of Biomedical Materials, Institute of Biomedical Engineering, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300192, People's Republic of China
| | - Xiao Peng Zhang
- Beijing Laboratory of Biomedical Materials, College of Materials Science and Engineering, Beijing University of Chemical Technology, Beijing 100029, People's Republic of China
| | - Jing Jing Ma
- Tianjin Key Laboratory of Biomedical Materials, Institute of Biomedical Engineering, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300192, People's Republic of China
| | - De Ling Kong
- Tianjin Key Laboratory of Biomedical Materials, Institute of Biomedical Engineering, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300192, People's Republic of China
- State Key Laboratory of Medicinal Chemical Biology, Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Sciences, Nankai University, Tianjin 300071, People's Republic of China
| | - Ming Ming Zhang
- Tianjin Key Laboratory of Biomedical Materials, Institute of Biomedical Engineering, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300192, People's Republic of China
| | - Xin Dong Guo
- Beijing Laboratory of Biomedical Materials, College of Materials Science and Engineering, Beijing University of Chemical Technology, Beijing 100029, People's Republic of China
| | - Chun Wang
- Department of Biomedical Engineering, University of Minnesota, 7-105 Hasselmo Hall, 312 Church Street S.E., Minneapolis, Minnesota 55455, United States
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43
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Domenech de Cellès M, Magpantay FMG, King AA, Rohani P. The impact of past vaccination coverage and immunity on pertussis resurgence. Sci Transl Med 2019; 10:10/434/eaaj1748. [PMID: 29593103 DOI: 10.1126/scitranslmed.aaj1748] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 03/20/2017] [Accepted: 10/06/2017] [Indexed: 01/01/2023]
Abstract
The resurgence of pertussis over the past decades has resulted in incidence levels not witnessed in the United States since the 1950s. The underlying causes have been the subject of much speculation, with particular attention paid to the shortcomings of the latest generation of vaccines. We formulated transmission models comprising competing hypotheses regarding vaccine failure and challenged them to explain 16 years of highly resolved incidence data from Massachusetts, United States. Our results suggest that the resurgence of pertussis is a predictable consequence of incomplete historical coverage with an imperfect vaccine that confers slowly waning immunity. We found evidence that the vaccine itself is effective at reducing overall transmission, yet that routine vaccination alone would be insufficient for elimination of the disease. Our results indicated that the core transmission group is schoolchildren. Therefore, efforts aimed at curtailing transmission in the population at large, and especially in vulnerable infants, are more likely to succeed if targeted at schoolchildren, rather than adults.
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Affiliation(s)
- Matthieu Domenech de Cellès
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI 48109, USA. .,Biostatistics, Biomathematics, Pharmacoepidemiology, and Infectious Diseases Unit, Institut Pasteur, Inserm U1181, University of Versailles St-Quentin-en-Yvelines, Versailles, France
| | - Felicia M G Magpantay
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI 48109, USA.,Department of Mathematics and Statistics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - Aaron A King
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI 48109, USA.,Department of Mathematics, University of Michigan, Ann Arbor, MI 48109, USA.,Center for the Study of Complex Systems, University of Michigan, Ann Arbor, MI 48109, USA
| | - Pejman Rohani
- Odum School of Ecology, University of Georgia, Athens, GA 30602, USA.,Department of Infectious Diseases, University of Georgia, Athens, GA 30602, USA.,Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA 30602, USA
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44
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Zerbo O, Bartlett J, Goddard K, Fireman B, Lewis E, Klein NP. Acellular Pertussis Vaccine Effectiveness Over Time. Pediatrics 2019; 144:peds.2018-3466. [PMID: 31182549 PMCID: PMC6615519 DOI: 10.1542/peds.2018-3466] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2019] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To determine pertussis risk by diphtheria-tetanus-acellular pertussis (DTaP) vaccination status and time since last DTaP dose. METHODS Children born at Kaiser Permanente Northern California between 1999 and 2016 were followed from 3 months of age until they tested positive for pertussis; disenrolled from Kaiser Permanente Northern California; received the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis, adsorbed vaccine; turned 11 years of age, or the end of the study period. DTaP vaccination status was categorized on the basis of the number of doses received in relation to the number of doses expected according to the Advisory Committee on Immunization Practice-recommended ages. RESULTS Among 469 982 children ages 3 months to 11 years, we identified 738 pertussis cases. A total of 99 cases were unvaccinated, 36 were undervaccinated, 515 were fully vaccinated, and 88 were fully vaccinated plus 1 dose. Pertussis risk was 13 times higher among unvaccinated (adjusted hazard ratio [aHR] = 13.53; 95% confidence interval [CI] 10.64-17.21) compared with fully vaccinated children and 1.9 times higher (aHR = 1.86; 95% CI 1.32-2.63) among undervaccinated children. Among vaccinated children ages 19 to <84 months, pertussis risk was 5 times higher (aHR = 5.04; 95% CI 1.84-13.80) ≥3 years vs <1 year after vaccination. Among children ages 84 to 132 months, risk was 2 times higher (aHR = 2.32; 95% CI 0.97-5.59) ≥6 years vs <3 years after vaccination. CONCLUSIONS Undervaccinated and especially unvaccinated children were at greater risk of pertussis. However, most pertussis cases occurred among children age-appropriately vaccinated who were further away from their last DTaP dose, suggesting that suboptimal vaccine effectiveness played a major role in recent pertussis epidemics.
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Affiliation(s)
- Ousseny Zerbo
- Division of Research, Vaccine Study Center, Kaiser Permanente Northern California, Oakland, California
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45
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Domenech de Cellès M, Rohani P, King AA. Duration of Immunity and Effectiveness of Diphtheria-Tetanus-Acellular Pertussis Vaccines in Children. JAMA Pediatr 2019; 173:588-594. [PMID: 31009031 PMCID: PMC6547082 DOI: 10.1001/jamapediatrics.2019.0711] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
IMPORTANCE The United States has experienced a nationwide resurgence of pertussis since the mid-1970s, despite high estimated vaccine coverage. Short-lived immunity induced by diphtheria-tetanus-acellular pertussis (DTaP) vaccines in young children is widely believed to be responsible for this growing burden, but the duration of protection conferred by DTaP vaccines remains incompletely quantified. OBJECTIVE To assess the duration of immunity and the effectiveness of DTaP vaccines in US children. DESIGN, SETTING, AND PARTICIPANTS A mathematical, age-structured model of pertussis transmission, previously validated empirically on incidence data in Massachusetts, was used in this simulation study to assess the duration of DTaP immunity most consistent with the empirical values of the relative increase in the odds of acquiring pertussis from recent epidemiologic studies in the United States. The study included 5 simulated cohorts of children born between January 1, 2001, and December 31, 2005, followed up between the ages of 5 and 9 years (study period, January 1, 2006, to December 31, 2014). Statistical analysis was performed from May 1 to December 1, 2017. INTERVENTIONS Vaccination with DTaP according to the US immunization schedule, with a range of assumptions regarding the degree of waning immunity. MAIN OUTCOMES AND MEASURES Vaccine effectiveness and relative change in the odds of acquiring pertussis (odds ratio) in children aged 5 to 9 years, duration of DTaP immunity, and vaccine population-level impact. RESULTS This study found a marked association between the degree of waning immunity, vaccine effectiveness, and the odds ratio. Counterintuitively, the odds ratio was positively associated with vaccine effectiveness, as a consequence of nonlinear, age-assortative transmission dynamics. Based on the empirical odds ratios (1.33; 95% CI, 1.23-1.43), it was estimated that vaccine effectiveness exceeded 75% in children aged 5 to 9 years and that more than 65% of children remained immune to pertussis 5 years after the last DTaP dose. CONCLUSIONS AND RELEVANCE The results of this study suggest that temporal trends in the odds of acquiring pertussis are an unreliable measure of the durability of vaccine-induced protection. They further demonstrate that DTaP vaccines confer imperfect, but long-lived protection. Control strategies should be based on the best available estimates of vaccine properties and the age structure of the transmission network.
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Affiliation(s)
- Matthieu Domenech de Cellès
- Biostatistics, Biomathematics, Pharmacoepidemiology, and Infectious Diseases Unit, Institut Pasteur, Inserm U1181, University of Versailles St-Quentin-en-Yvelines, Versailles, France
| | - Pejman Rohani
- Odum School of Ecology, University of Georgia, Athens,Department of Infectious Diseases, University of Georgia, Athens,Center for the Ecology of Infectious Diseases, University of Georgia, Athens
| | - Aaron A. King
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor,Department of Mathematics, University of Michigan, Ann Arbor,Center for the Study of Complex Systems, University of Michigan, Ann Arbor
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46
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Abstract
There is limited information on the roles of different age groups in propagating pertussis outbreaks, and the temporal changes in those roles since the introduction of acellular pertussis vaccines. The relative roles of different age groups in propagating the 2010 and the 2014 pertussis epidemics in California were evaluated using the relative risk (RR) statistic that measures the change in the group's proportion among all detected cases before vs. after the epidemic peak. For the 2010–11 epidemic, evidence for a predominant transmission age group was weak, with the largest RR estimates being 1.26 (95% CI 1.08–1.46) (aged 11–13 years); 1.19 (1.01–1.4) (aged 9–10 years); 1.17 (0.86–1.59) (aged 14–15 years); 1.12 (0.86–1.46) (aged 16–19 years) and 1.1 (0.89–1.36) (aged 7–8 years). The 2014 epidemic showed a strong signal of the role of older adolescents, with the highest RR estimate being in those aged 14–15 years (RR = 1.83, 1.61–2.07), followed by adolescents aged 16–19 years (RR = 1.41, 1.24–1.61) and 11–13 years (RR = 1.26, 1.12–1.41), with lower RR estimates in other age groups. As the time following introduction of acellular pertussis vaccines in California progressed, older adolescents played an increasing role in transmission during the major pertussis outbreaks. Booster pertussis vaccination for older adolescents with vaccines effective against pertussis transmission should be considered with the aim of mitigating future pertussis epidemics in the community.
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47
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Uriarte PS, Rodríguez SSJ, Sancristobal IG, Agirre NM. Effectiveness of dTpa vaccination during pregnancy in preventing whooping cough in infants under 3 months of age. Bizkaia, Basque Country, Spain. Heliyon 2019; 5:e01207. [PMID: 30815597 PMCID: PMC6378330 DOI: 10.1016/j.heliyon.2019.e01207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/18/2018] [Accepted: 01/31/2019] [Indexed: 10/27/2022] Open
Abstract
In response to an increase in the incidence of whooping cough in recent years, the Basque Country established a vaccination programme for pregnant women in the last trimester of the pregnancy seeking to protect young infants, a population that is at high risk of developing severe whooping cough. In the present study, based on the screening method, we assessed the effectiveness of this measure to prevent whooping cough in infants under 3 months of age. We found a vaccine effectiveness of 89% and 95% CI 72-96%. While the incidence of this disease remains high, we recommend continuing to vaccinate pregnant women in the last trimester of pregnancy.
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Affiliation(s)
- Patricia Sancho Uriarte
- Deputy Department of Public Health and Addictions of Álava/Araba, C/ Santiago 11, Vitoria-Gasteiz, Spain
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48
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Domenech de Cellès M, King AA, Rohani P. Commentary: resolving pertussis resurgence and vaccine immunity using mathematical transmission models. Hum Vaccin Immunother 2018; 15:683-686. [PMID: 30457424 PMCID: PMC6988877 DOI: 10.1080/21645515.2018.1549432] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 10/13/2018] [Indexed: 01/26/2023] Open
Abstract
The epidemiology of pertussis-a vaccine-preventable respiratory infection typically caused by the bacterium Bordetella pertussis-remains puzzling. Indeed, the disease seems nowhere close to eradication and has even re-emerged in certain countries-such as the US-that have maintained high vaccination coverage. Because the dynamics of pertussis are shaped by past vaccination and natural infection rates, with the relevant timescale spanning decades, the interpretation of such unexpected trends is not straightforward. In this commentary, we propose that mathematical transmission models play an essential role in helping to interpret the data and in closing knowledge gaps in pertussis epidemiology. We submit that recent advances in statistical inference methods now allow us to estimate key parameters, such as the nature and duration of vaccinal immunity, which have to date been difficult to quantify. We illustrate these points with the results of a recent study based on data from Massachusetts (Domenech de Cellès, Magpantay, King, and Rohani, Sci. Transl. Med. 2018;10: eaaj1748. doi:10.1126/scitranslmed.aaj1748), in which we used such methods to elucidate the mechanisms underlying the ongoing resurgence of pertussis. In addition, we list a number of safety checks that can be used to critically assess mathematical models. Finally, we discuss the remaining uncertainties surrounding pertussis vaccines, in particular the acellular vaccines used for teenage booster immunizations.
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Affiliation(s)
- M. Domenech de Cellès
- Biostatistics, Biomathematics, Pharmacoepidemiology, and Infectious Diseases (B2PHI) Unit, Institut Pasteur, Inserm U1181, University of Versailles St-Quentin-en-Yvelines
| | - A. A. King
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI, USA
- Department of Mathematics, University of Michigan, Ann Arbor, MI, USA
- Center for the Study of Complex Systems, University of Michigan, Ann Arbor, MI, USA
| | - P. Rohani
- Odum School of Ecology, University of Georgia, Athens, GA, USA
- Department of Infectious Diseases, University of Georgia, Athens, GA, USA
- Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA, USA
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Abstract
BACKGROUND To investigate the level of pertussis-related antibodies in pregnant women and newborns. METHODS A total of 286 serum samples from healthy pregnant women and 221 cord samples from newborns were collected in 2016 in Beijing. A routine blood sample from pregnant women was obtained at 35 weeks of gestational age, and cord samples were collected in 20 minutes after delivery. The values from cord samples were used as the infant values. Anti-pertussis toxin (PT) IgG concentration was measured by ELISA (Euroimmun, Lübeck, Germany) using purified PT as a coating antigen. Newborns with anti-PT IgG ≤40 IU/mL in cord samples were considered to be unprotected against pertussis. Anti-PT IgG ≥100 IU/mL was considered to be indicative of a recent pertussis infection in pregnant women. RESULTS The anti-PT IgG concentration below the lower limit of detection (<5 IU/mL) occurred in 74.1% (212/286) of pregnant women and 66.5% (147/221) of newborns. Even with detectable anti-PT antibodies, the majority of pregnant women (79.7%, 59/74) and newborns (73.0%, 54/74) had antibody level of 5 to <20 IU/mL, and 13.5% (10/74) of pregnant and 14.9% (11/74) of newborns had antibody level of 20 to <40 IU/mL. The 75% percentiles for anti-PT IgG of pregnant women and newborns were 5.08 and 6.98 IU/mL, respectively. The prevalence of unprotected newborns as defined by anti-PT IgG ≤40 IU/mL was 95.9% (202/211). The prevalence of recent pertussis infection in pregnant women as defined by anti-PT IgG ≥100 was 0.7% (2/286). CONCLUSIONS The pregnant women and newborns were generally lack of protective antibody and are vulnerable to pertussis in Beijing, China. Although acellular pertussis vaccine is administrated in infancy in China, a booster vaccination to pregnant women should be considered for protecting young infants who are too young to start pertussis vaccination.
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Goldstein E, Worby CJ, Lipsitch M. On the Role of Different Age Groups and Pertussis Vaccines During the 2012 Outbreak in Wisconsin. Open Forum Infect Dis 2018; 5:ofy082. [PMID: 29942818 PMCID: PMC5961225 DOI: 10.1093/ofid/ofy082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 04/13/2018] [Indexed: 11/26/2022] Open
Abstract
Background There is limited information on the roles of different age groups in propagating pertussis outbreaks, and on the impact of vaccination on pertussis transmission in the community. Methods The relative roles of different age groups in propagating the 2012 pertussis outbreak in Wisconsin were evaluated using the relative risk (RR) statistic that measures the change in the group’s proportion among all detected cases before vs after the epidemic peak. The impact of vaccination in different age groups against infection (that is potentially different from the protective effect against detectable disease) was evaluated using the odds ratios (ORs), within each age group, for being vaccinated vs undervaccinated before vs after the outbreak’s peak. Results The RR statistic suggests that children aged 13–14 years played the largest relative role during the outbreak’s ascent (with estimates consistent across the 3 regions in Wisconsin that were studied), followed by children aged 7–8, 9–10, and 11–12 years. Young children and older teenagers and adults played more limited relative roles during the outbreak. Results of the vaccination status analysis for the fifth dose of DTaP (for children aged 7–8 years: OR, 0.44; 95% confidence interval [CI], 0.23–0.86; for children aged 9–10 years: OR, 0.51; 95% CI, 0.27–0.95); and for Tdap for children aged 13–14 years (OR, 0.38, 95% CI, 0.16–0.89) are consistent with protective effect against infection. Conclusions While our epidemiological findings for the fifth dose of DTaP and for Tdap are consistent with protective effect against infection, further studies, including those estimating vaccine effectiveness against infection/transmission to others particularly for pertussis vaccines for adolescents, are needed to evaluate the impact of vaccination on the spread of pertussis in the community.
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Affiliation(s)
- Edward Goldstein
- Center for Communicable Disease Dynamics, Department of Epidemiology, Boston, Massachusetts
| | - Colin J Worby
- Center for Communicable Disease Dynamics, Department of Epidemiology, Boston, Massachusetts.,Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey
| | - Marc Lipsitch
- Center for Communicable Disease Dynamics, Department of Epidemiology, Boston, Massachusetts.,Department of Immunology and Infectious Disease, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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