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Hara M, Fukuoka M, Tashiro K, Ozaki I, Ohfuji S, Okada K, Nakano T, Fukushima W, Hirota Y. Pertussis outbreak in university students and evaluation of acellular pertussis vaccine effectiveness in Japan. BMC Infect Dis 2015; 15:45. [PMID: 25656486 PMCID: PMC4323135 DOI: 10.1186/s12879-015-0777-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 01/21/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recent studies worldwide have reported increasing numbers of adults diagnosed with Bordetella pertussis despite receiving childhood vaccinations. This study describes a pertussis outbreak at a university medical faculty campus and examines the effectiveness of diphtheria, tetanus, and pertussis (DTaP) vaccination completed during infancy in Japan. METHODS After the outbreak, self-administered questionnaires and serum samples were collected from students on campus to determine the incidence of pertussis and underlying diseases. Pertussis was diagnosed on the basis of clinical criteria and serum anti-pertussis toxin antibody levels. Using data collected from 248 first and second grade students who had submitted copies of their vaccination records, we evaluated the effectiveness of DTaP vaccination in infancy against adult pertussis. RESULTS Questionnaire responses were obtained from 636 students (of 671 registered students; 95% response rate). Of 245 students who reported a continuous cough during the outbreak period, 84 (attack rate: 13.2%) were considered "probable" pertussis cases that met clinical criteria. The outbreak occurred mainly in first and second grade students in the Faculty of Medicine. Of 248 students who provided vaccination records, 225 had received 4 DTaP doses (coverage: 90.7%); the relative risk of the complete vaccination series compared to those with fewer than 4 doses or no doses for probable cases was 0.48 (95% confidence interval: 0.24-0.97). CONCLUSIONS Waning protection was suspected due to over time. Booster vaccination for teenagers and development of highly efficacious pertussis vaccines are needed.
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Affiliation(s)
- Megumi Hara
- Department of Preventive Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga City, Saga, 849-8501, Japan.
| | - Mami Fukuoka
- Department of Infection Control, Saga-ken Medical Centre Koseikan, 400 Nakahara, Kase, Saga City, Saga, 840-8571, Japan.
| | - Katsuya Tashiro
- Department of Pediatrics, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga City, Saga, 849-8501, Japan.
| | - Iwata Ozaki
- Health Care Center, Saga University, 5-1-1 Nabeshima, Saga City, Saga, 849-8501, Japan.
| | - Satoko Ohfuji
- Department of Public Health, Faculty of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
| | - Kenji Okada
- Department of Pediatrics, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka City, Fukuoka, 814-0193, Japan.
| | - Takashi Nakano
- Department of Pediatrics, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, 701-0192, Japan.
| | - Wakaba Fukushima
- Department of Public Health, Faculty of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
| | - Yoshio Hirota
- Department of Public Health, Faculty of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan. .,Clinical Epidemiology Research Center, Medical Co. LTA, 6-18, Ten-ya-machi, Hakata-ku, Fukuoka, 812-0025, Japan.
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Storsaeter J, Olin P. Relative efficacy of two acellular pertussis vaccines during three years of passive surveillance. Vaccine 1992; 10:142-4. [PMID: 1557928 DOI: 10.1016/0264-410x(92)90002-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Prolonged unblinded passive surveillance of the trial cohort from the Swedish 1986-87 pertussis vaccine efficacy trial indicates that a two-component vaccine, containing pertussis toxoid and filamentous haemagglutinin, provided better long-term protection against pertussis than a monocomponent pertussis toxoid vaccine. The relative risk (RR) for culture-confirmed pertussis was 1.5 (95% confidence interval (CI) 1.0-2.4), and RR for pertussis according to parents' diagnoses was also 1.5 (95% CI 1.1-2.1), for the monocomponent vaccine compared with the two-component vaccine.
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Affiliation(s)
- J Storsaeter
- Department of Paediatrics, Sachs' Children's Hospital, Karolinska Institute, Stockholm, Sweden
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