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Meng Q, Wang B, Du Q, Zhang X, Li Z, He F, Ying F, Cong L, Ding J, Yao K. Seroprevalence of B. pertussis infection and the changes of specific antibody levels in health care workers during the first two years of COVID-19 in Wuhu, China. Vaccine 2024; 42:126239. [PMID: 39173193 DOI: 10.1016/j.vaccine.2024.126239] [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: 05/23/2024] [Revised: 08/02/2024] [Accepted: 08/14/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND The reported number of pertussis cases declined after the implementation of COVID-19 prevention and control measures, however, the burden of pertussis among adults in China remains largely unknown. Additionally, the waning of natural antibody level has also rarely been assessed. METHODS A total of 762 healthcare workers (HCWs) who had underwent the health examinations in 2021 and 2022 were included. Serum anti-PT IgG and IgA levels were determined by ELISA. Recent B. pertussis infection was defined as anti-PT IgG ≥100 IU/ml and/or anti-PT IgA ≥10 IU/ml. RESULTS In 2021, the seroprevalence of recent B. pertussis infection was 10.1 %, and those HCWs in outpatient department had a higher percentage (18.6 %), and geometric mean concentration (GMC) (6.3 IU/ml) than those in other departments. This seroprevalence decreased to 2.4 % in 2022, although the difference remained significant. In the 77 subjects with recent B. pertussis infection in 2021, anti-PT IgG was undetectable in 18 cases the following year. Majority (68/76) of the subjects with anti-PT IgA ≥10 IU/ml in 2021 no longer had detected this antibody in 2022. Among 95 pertussis cases, approximately 60.0 % of cases reported no history of cough. Among those with a documented cough history, 36 cases with suspected pertussis courses who had never been diagnosed. Prolonged cough with nocturnal exacerbation (29/38) was the most commonly reported clinical symptom, and whoop was confirmed in six cases. Uroclepsia and syncopes during the cough attacks were reported by three and one subjects, respectively. One case presented with subconjunctival hemorrhage and tensionic purpura during the course. CONCLUSIONS The results suggested a high prevalence of B. pertussis infection among HCWs. The presence of unrecognized adult pertussis cases and the rapid waning of antibody indicate the need to improve clinical management for suspected pertussis in adults, and to updated immunization schedule after childhood program.
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Affiliation(s)
- Qinghong Meng
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics, Laboratory of Infection and Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Bingsong Wang
- Pediatric Respiratory Department, Wuhu No.1 People's Hospital, Wuhu, Anhui, China
| | - Qianqian Du
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics, Laboratory of Infection and Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Xianlai Zhang
- Pediatric Respiratory Department, Wuhu No.1 People's Hospital, Wuhu, Anhui, China
| | - Zhen Li
- Department of Laboratory Medicine, Wuhu No.1 People's Hospital, Wuhu, Anhui, China
| | - Fang He
- Medical Centre, Wuhu No.1 People's Hospital, Wuhu, Anhui, China
| | - Fei Ying
- Department of Laboratory Medicine, Wuhu No.1 People's Hospital, Wuhu, Anhui, China
| | - Linyan Cong
- Medical Centre, Wuhu No.1 People's Hospital, Wuhu, Anhui, China
| | - Juanjuan Ding
- Pediatric Respiratory Department, Wuhu No.1 People's Hospital, Wuhu, Anhui, China
| | - Kaihu Yao
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics, Laboratory of Infection and Microbiology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
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Yang R, Xu H, Zhang Z, Liu Q, Wu X. Challenges and prospects in treating macrolide-resistant Bordetella pertussis in Chinese paediatric practice. J Infect 2024; 89:106185. [PMID: 38763390 DOI: 10.1016/j.jinf.2024.106185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 05/11/2024] [Indexed: 05/21/2024]
Affiliation(s)
- Ruling Yang
- Department of Infectious Diseases, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, The First Batch of Key Disciplines On Public Health in Chongqing, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing 400014, China
| | - Hongmei Xu
- Department of Infectious Diseases, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, The First Batch of Key Disciplines On Public Health in Chongqing, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing 400014, China
| | - Zhenzhen Zhang
- Department of Infectious Diseases, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, The First Batch of Key Disciplines On Public Health in Chongqing, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing 400014, China
| | - Quanbo Liu
- Department of Infectious Diseases, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, The First Batch of Key Disciplines On Public Health in Chongqing, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing 400014, China
| | - Xiaoying Wu
- Department of Infectious Diseases, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, The First Batch of Key Disciplines On Public Health in Chongqing, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing 400014, China.
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Chen Z, Liu X, Zhang Y, Peng X, Zhang N, Chen N, Li Y, He Q. Evaluation of serum anti-pertussis toxin IgA antibodies for the diagnosis of Bordetella pertussis infection in young children. J Infect Public Health 2023; 16:1167-1173. [PMID: 37269695 DOI: 10.1016/j.jiph.2023.05.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 05/02/2023] [Accepted: 05/22/2023] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND The determination of serum anti-pertussis toxin (PT) IgG antibodies is recommended for the diagnosis and surveillance of pertussis. However, the diagnostic power of anti-PT IgG can be hampered by possible interference from previous vaccinations. We aim to assess if anti-PT IgA antibodies can be well induced by Bordetella pertussis (B. pertussis) infections in children, and their capacity to improve pertussis serodiagnosis. METHODS Serum samples from 172 hospitalized children younger than 10 years old with confirmed pertussis were tested. Pertussis was confirmed by culture, PCR and/or serology. Anti-PT IgA antibodies were determined with commercial ELISA kits. RESULTS Sixty-four (37.2 %) subjects had anti-PT IgA antibodies greater than or equal to 15 IU/ml, and 52 (30.2 %) of them had anti-PT IgA antibodies greater than or equal to 20 IU/ml. No children with negative anti-PT IgG (less than 40 IU/ml) were observed to have anti-PT IgA antibodies greater than or equal to 15 IU/ml. Of patients younger than one year of age, about 50 % had an IgA antibody response. Moreover, the proportion of subjects with anti-PT IgA antibodies greater than or equal to 15 IU/ml among PCR negative subjects was significantly higher than that among PCR positive subjects (76.9 % vs 35.5 %). CONCLUSIONS The determination of anti-PT IgA antibodies does not seem to have added value for the serodiagnosis of pertussis in children older than one year of age. However, for infants, determination of serum anti-PT IgA antibodies appears to be useful for the diagnosis of pertussis especially when PCR and culture are negative. The results should be interpreted with caution as the number of subjects included in this study was limited.
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Affiliation(s)
- Zhiyun Chen
- Department of Medical Microbiology, Capital Medical University, Beijing, China
| | - Xiaoguai Liu
- The Third Department, Xi'an Children's Hospital, Xi'an, China
| | - Yuxiao Zhang
- Medical Research & Laboratory Diagnostic Center, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xiaokang Peng
- The Third Department, Xi'an Children's Hospital, Xi'an, China
| | - Nan Zhang
- Department of Medical Microbiology, Capital Medical University, Beijing, China
| | - Ning Chen
- Department of Medical Microbiology, Capital Medical University, Beijing, China; Center for adverse drug reactions monitoring of Beijing, Beijing, China
| | - Yarong Li
- The Third Department, Xi'an Children's Hospital, Xi'an, China.
| | - Qiushui He
- Department of Medical Microbiology, Capital Medical University, Beijing, China; Institute of Biomedicine, Research Center for Infections and Immunity, University of Turku, Turku, Finland.
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Zhang J, Deng J, Yang Y. Pertussis vaccination in Chinese children with increasing reported pertussis cases. THE LANCET. INFECTIOUS DISEASES 2022; 22:21-22. [PMID: 34953548 DOI: 10.1016/s1473-3099(21)00752-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 11/23/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Jiaosheng Zhang
- Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen 518038, China
| | - Jikui Deng
- Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen 518038, China
| | - Yonghong Yang
- Microbiology Laboratory, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
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Zhang JS, Wang HM, Yao KH, Liu Y, Lei YL, Deng JK, Yang YH. Clinical characteristics, molecular epidemiology and antimicrobial susceptibility of pertussis among children in southern China. World J Pediatr 2020; 16:185-192. [PMID: 31493136 DOI: 10.1007/s12519-019-00308-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 08/22/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Increasing numbers of pertussis cases have been reported in recent years. The reported cases from Shenzhen Children's Hospital were close to one tenth of all cases in China. The epidemiology of antigenic genotype and antibiotic resistance of circulating strains in children have been unknown in Shenzhen, southern China. The aim of this study was to describe the clinical features and explore the genotypes and antimicrobial susceptibility of circulating Bordetella pertussis among children in Shenzhen. METHODS Data of hospitalized children with pertussis in Shenzhen Children's Hospital from August 2015 to April 2017 were collected. The genetic variability of isolates was investigated and Etest was performed for phenotypic susceptibility to erythromycin, azithromycin, clarithromycin, clindamycin, and trimethoprim/sulfamethoxazole. RESULTS 469 children with pertussis confirmed by real-time quantitative polymerase chain reaction were hospitalized and strains were isolated from 105 patients. White blood cell count ≥ 20 × 109/L and lymphocyte proportion ≥ 60% were observed in 39.29% of infants younger than 3 months. The two predominant profiles of virulence-associated allelic genes were ptxA1/ptxC1/ptxP1/prn1 (48.6%) and ptxA1/ptxC2/ptxP3/prn2 (44.8%). Among the isolates, 48.6% (51/105) were found resistant to macrolides. CONCLUSIONS These findings indicate that leukocytosis is not a sensitive indicator of pertussis. Isolates with the gene profile ptxP3/prn2 were highly circulating in Shenzhen and less resistant to macrolides, different from patterns observed in other parts of China.
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Affiliation(s)
- Jiao-Sheng Zhang
- Laboratory of Microbiology and Immunology, Beijing Children's Hospital Affiliated to Capital Medical University, 56 Nanlishi Road, Beijing, 100045, China.,Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, 518038, China
| | - Hong-Mei Wang
- Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, 518038, China
| | - Kai-Hu Yao
- Laboratory of Microbiology and Immunology, Beijing Children's Hospital Affiliated to Capital Medical University, 56 Nanlishi Road, Beijing, 100045, China
| | - Ying Liu
- Laboratory of Microbiology and Immunology, Beijing Children's Hospital Affiliated to Capital Medical University, 56 Nanlishi Road, Beijing, 100045, China
| | - Yan-Ling Lei
- Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, 518038, China
| | - Ji-Kui Deng
- Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, 518038, China
| | - Yong-Hong Yang
- Laboratory of Microbiology and Immunology, Beijing Children's Hospital Affiliated to Capital Medical University, 56 Nanlishi Road, Beijing, 100045, China. .,Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, 518038, China.
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Meng Q, Qian Q, Li L, Liu D, Gao W, Yuan L, Yao K. The maternal antibody against diphtheria, tetanus and pertussis showed distinct regional difference in China. BMC Pediatr 2019; 19:480. [PMID: 31810436 PMCID: PMC6898916 DOI: 10.1186/s12887-019-1860-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 11/28/2019] [Indexed: 01/05/2023] Open
Abstract
Background Passive transferred antibodies to the fetus play an essential role on protecting neonates and young infants until infant vaccination is more efficacious. However, very little is known about the discrepancy of DTP vaccine associated antibodies level in neonates from different economic areas in China. Methods In 2018, 200 neonates hospitalized in Shunyi Women and Children’s Hospital in Beijing, and 238 neonates hospitalized in Qianjiang Central Hospital located in the southwestern mountainous areas were included in this study. Antibodies specific for the antigens covered by DTP vaccine were determined using ELISA Kits (Euroimmun, Lübeck, Germany). The cut off value of ≥0.1 IU/ml (anti-diphtheria, anti-Dtx), > 0.1 IU/ml (anti-tetanus, anti-Ttx) and > 40 IU/ml (anti-pertussis toxin, anti-Ptx) were used to assess the percentage of protected neonates, respectively. Results The antibody levels in the neonates from Qianjiang (0.04 IU/ml for anti-Dtx IgG and 0.07 IU/ml for anti-Ttx IgG) were significantly lower than those from Shunyi (0.12 IU/ml for anti-Dtx IgG and 0.18 IU/ml for anti-Ttx IgG). The prevalence of protective anti-Dtx and anti-Ttx IgG were lower in the neonates from Qianjiang (7.1% for anti-Dtx IgG and 7.6% for anti-Ttx IgG) than in those from Shunyi (30.5% for anti-Dtx and 38.5% for anti-Ttx). The neonates from Qianjiang also had lower detectable rate of anti-Dtx (57.5%) and anti-Ttx IgG (55.8%) than neonates from Shunyi (97.5% for anti-Dtx and 71.0% for anti-Ttx). However, the detectable rate of anti-Ptx IgG in neonates from Qianjiang (39.9%) was higher significantly than in those from Shunyi (30.5%). Two neonates from Qianjiang have anti-PT IgG ≥100.0 IU/ml, which suggested that their mothers have a recent pertussis course. Conclusions The regional discrepancy of the protective antibody rates might be caused by different vaccine coverage and pertussis exposure, which suggested the importance of Tdap booster immunization for pregnant women or women at childbearing age, those living undeveloped areas in particular.
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Affiliation(s)
- Qinghong Meng
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Qinghui Qian
- Department of Pediatrics, Qianjiang Central Hospital, Chongqing, 409000, China
| | - Li Li
- Department of Neonatology, Shunyi Women and Children's Hospital of Beijing Children's Hospital, Beijing, 101320, China
| | - Dandan Liu
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Wei Gao
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Lin Yuan
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Kaihu Yao
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
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Brillo E, Tosto V, Giardina I, Buonomo E. Maternal tetanus, diphtheria, and acellular pertussis (Tdap) and influenza immunization: an overview. J Matern Fetal Neonatal Med 2019; 34:3415-3444. [PMID: 31645152 DOI: 10.1080/14767058.2019.1680633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Maternal tetanus, diphtheria, and acellular pertussis (Tdap) and influenza immunization for women during pregnancy (the so-called "maternal immunization") has been introduced in several countries, and recently also in Italy, to protect mother and fetus during pregnancy, infant in his first months of life and mother during postpartum period. However, very low vaccination coverage rates have been reached due to several variables. METHODS A literature search was conducted on PubMed and Embase, including any experimental or observational studies, to assesses existing evidence on the effectiveness, efficacy, safety and optimal timing of administration of Tdap and influenza immunization in pregnancy for mothers and their infants. The search was finalized in August 2019. RESULTS Reviewing the literature, we identified only a few studies that, among several maternal and infant outcomes, found sporadic significant associations with maternal influenza immunization and even less with Tdap immunization. Moreover, most of the authors of these studies explained these findings as a result of residual confounding effect. The effectiveness of maternal influenza immunization is more complicated to prove than the effectiveness of Tdap immunization because of several reasons. Not all nations recommend and offer vaccines in the same weeks of pregnancy and this one manifests the complexity in defining the best timing for Tdap or influenza immunization. CONCLUSIONS The safety of maternal Tdap or influenza immunization is supported by the evidence so far, however, regular surveillance should be maintained, especially with regard to the influenza vaccine that changes in formulation each year. There is a need to optimize the timing of vaccination in pregnancy and to have a national system of detection of maternal immunization in each country.
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Affiliation(s)
- Eleonora Brillo
- Center for Research in Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy.,Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Valentina Tosto
- Department of Obstetrics and Gynecology, University Hospital of Perugia, Perugia, Italy
| | - Irene Giardina
- Center for Research in Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy.,Department of Obstetrics and Gynecology, University Hospital of Perugia, Perugia, Italy
| | - Ersilia Buonomo
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
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Narchi H, Osman W, George JA, Almekhaini LA, Souid AK, Alsuwaidi AR. Pertussis seronegativity in pregnant women in the city of Al Ain, United Arab Emirates. Int J Infect Dis 2019; 89:96-101. [PMID: 31493522 DOI: 10.1016/j.ijid.2019.08.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 08/21/2019] [Accepted: 08/29/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE As the current recommendation of administering Tdap (tetanus-diphtheria-acellular pertussis) to all pregnant women has not been widely implemented in the United Arab Emirates (UAE), we aimed to ascertain the prevalence of pertussis seronegativity during pregnancy. METHODS IgG antibodies against Bordetella pertussis toxin (PT) were measured in 213 women attending the antenatal clinic at Oasis hospital, Al Ain, UAE. Results were compared by maternal age, nationality and gestational age with the Kruskal-Wallis test for IgG-PT levels and the Chi-squared test for serology status. RESULTS The mean age±SD of the participants was 30.4±5.6 years, mean gestational age±SD of 25.5±3.3 weeks. Serum concentration of IgG-PT <10IU/ml were found in 160 out of 213 women (75%; 95% confidence interval 69%, 81%). There was no significant difference in the geometric mean of serum IgG-PT concentration across maternal age (P=0.80) or nationality (P=0.90). There were no differences in the prevalence of seronegativity with maternal age (P=0.65) or nationality (P=0.90). CONCLUSION With a high prevalence of pertussis seronegativity in pregnant women, there is a potential benefit of introducing pertussis vaccination during pregnancy into our national immunization program.
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Affiliation(s)
- Hassib Narchi
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates.
| | - Wafa Osman
- Department of Obstetrics and Gynecology, Oasis Hospital, Al Ain, United Arab Emirates.
| | - Junu A George
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates.
| | - Lolowa A Almekhaini
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates.
| | - Abdul-Kader Souid
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates.
| | - Ahmed R Alsuwaidi
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates.
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