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Niinikoski V, Barkoff AM, Mertsola J, He Q. Bordetella pertussis isolates in Finland after acellular vaccination: serotype change and biofilm formation. Clin Microbiol Infect 2024; 30:683.e1-683.e3. [PMID: 38310999 DOI: 10.1016/j.cmi.2024.01.021] [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: 11/08/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/06/2024]
Abstract
OBJECTIVES In Finland, whole cell pertussis vaccine (wP) was introduced in 1952 and was replaced by acellular pertussis vaccine (aP) without fimbrial (FIM) antigen in 2005. We aimed to analyse the changes in serotypes of circulating Bordetella pertussis before and after acellular vaccination and to explore the relationship between biofilm formation and serotype diversity after the introduction of aP vaccine. METHODS Serotyping of 1399 B. pertussis isolates collected at the Finnish National Reference Laboratory for Pertussis and Diphtheria in Turku, Finland, from 1974 to 2023 was performed by slide agglutination or indirect ELISA. Of 278 isolates collected after 2005, 53 were selected, genotyped for fim3 and fim2 alleles, and tested for biofilm formation. The selection criteria included maintaining a relatively equal distribution of isolates per time interval, ensuring approximately a 50:50 ratio of FIM2 (N = 26) and FIM3 (N = 27) serotypes. The reference strain Tohama I was used as a control. RESULTS During the wP era, the majority of circulating B. pertussis exhibited the FIM2 serotype. However, FIM3 strains have appeared since 1999 and become prevalent. After the implementation of aP vaccines, the distribution of serotypes has exhibited substantial variability. FIM3 isolates displayed an enhanced biofilm formation compared to FIM2 isolates (Geometric mean value (95% CI): 0.90 (0.79-1.03) vs. 0.75 (0.65-0.85); p < 0.05). Of the 27 FIM3 isolates, 8 harboured fim3-1 and 19 fim3-2 alleles. FIM3 isolates with fim3-2 allele were significantly associated with increased biofilm formation when compared to those with fim3-1 (1.07 (0.96-1.19) vs. 0.61 (0.52-0.72); p < 0.0001). CONCLUSION Following the implementation of aP vaccines, the distribution of serotypes in Finland has exhibited substantial variability. FIM3 isolates with the fim3-2 allele displayed an enhanced biofilm formation capability compared to FIM2 isolates.
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Affiliation(s)
- Vili Niinikoski
- Finnish Reference Laboratory for Pertussis and Diphtheria, Institute of Biomedicine, University of Turku, Turku, Finland; InFLAMES Research Flagship Center, University of Turku, Turku, Finland
| | - Alex-Mikael Barkoff
- Finnish Reference Laboratory for Pertussis and Diphtheria, Institute of Biomedicine, University of Turku, Turku, Finland; InFLAMES Research Flagship Center, University of Turku, Turku, Finland
| | - Jussi Mertsola
- Finnish Reference Laboratory for Pertussis and Diphtheria, Institute of Biomedicine, University of Turku, Turku, Finland; InFLAMES Research Flagship Center, University of Turku, Turku, Finland
| | - Qiushui He
- Finnish Reference Laboratory for Pertussis and Diphtheria, Institute of Biomedicine, University of Turku, Turku, Finland; InFLAMES Research Flagship Center, University of Turku, Turku, Finland.
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Lecorvaisier F. [Impact of vaccination on the evolution of Bordetella pertussis]. Med Sci (Paris) 2024; 40:161-166. [PMID: 38411424 DOI: 10.1051/medsci/2023219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024] Open
Abstract
Vaccines against pertussis, or whooping cough, have been commercialized and used in most countries worldwide for decades. The history of these vaccines is distinctive, marked by the transition from whole-cell vaccines to acellular vaccines in many developed countries over the last two decades. This particular history has had a significant impact on the evolution of Bordetella pertussis, the etiological agent of whooping cough. Both genetic and phenotypic changes appeared, with the emergence of novel alleles for antigens targeted by the vaccines and changes in the expression of these antigens. The main consequence of these changes is the resurgence of whooping cough in many countries and the appearance of strains capable of evading vaccine-induced immunity. The emergence of novel strains under vaccine pressure underscores the importance of considering biological evolution in the conception of new vaccines and vaccine strategies.
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Affiliation(s)
- Florian Lecorvaisier
- Université Claude Bernard Lyon 1 LBBE, UMR 5558, CNRS, VAS, Villeurbanne, France
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Fu P, Zhou J, Yang C, Nijiati Y, Zhou L, Yan G, Lu G, Zhai X, Wang C. Molecular Evolution and Increasing Macrolide Resistance of Bordetella pertussis, Shanghai, China, 2016-2022. Emerg Infect Dis 2023; 30:29-38. [PMID: 38146984 PMCID: PMC10756392 DOI: 10.3201/eid3001.221588] [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] [Indexed: 12/27/2023] Open
Abstract
Resurgence and spread of macrolide-resistant Bordetella pertussis (MRBP) threaten global public health. We collected 283 B. pertussis isolates during 2016-2022 in Shanghai, China, and conducted 23S rRNA gene A2047G mutation detection, multilocus variable-number tandem-repeat analysis, and virulence genotyping analysis. We performed whole-genome sequencing on representative strains. We detected pertussis primarily in infants (0-1 years of age) before 2020 and older children (>5-10 years of age) after 2020. The major genotypes were ptxP1/prn1/fhaB3/ptxA1/ptxC1/fim2-1/fim3-1 (48.7%) and ptxP3/prn2/fhaB1/ptxA1/ptxC2/fim2-1/fim3-1 (47.7%). MRBP increased remarkably from 2016 (36.4%) to 2022 (97.2%). All MRBPs before 2020 harbored ptxP1, and 51.4% belonged to multilocus variable-number tandem-repeat analysis type (MT) 195, whereas ptxP3-MRBP increased from 0% before 2020 to 66.7% after 2020, and all belonged to MT28. MT28 ptxP3-MRBP emerged only after 2020 and replaced the resident MT195 ptxP1-MRBP, revealing that 2020 was a watershed in the transformation of MRBP.
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Affiliation(s)
| | | | - Chao Yang
- National Children's Medical Center, Shanghai, China (P. Fu, J. Zhou, Y. Nijiati, L. Zhou, G. Yan, G. Lu, X. Zhai, C. Wang)
- Chinese Academy of Sciences, Shanghai (C. Yang)
| | - Yaxier Nijiati
- National Children's Medical Center, Shanghai, China (P. Fu, J. Zhou, Y. Nijiati, L. Zhou, G. Yan, G. Lu, X. Zhai, C. Wang)
- Chinese Academy of Sciences, Shanghai (C. Yang)
| | - Lijun Zhou
- National Children's Medical Center, Shanghai, China (P. Fu, J. Zhou, Y. Nijiati, L. Zhou, G. Yan, G. Lu, X. Zhai, C. Wang)
- Chinese Academy of Sciences, Shanghai (C. Yang)
| | - Gangfen Yan
- National Children's Medical Center, Shanghai, China (P. Fu, J. Zhou, Y. Nijiati, L. Zhou, G. Yan, G. Lu, X. Zhai, C. Wang)
- Chinese Academy of Sciences, Shanghai (C. Yang)
| | - Guoping Lu
- National Children's Medical Center, Shanghai, China (P. Fu, J. Zhou, Y. Nijiati, L. Zhou, G. Yan, G. Lu, X. Zhai, C. Wang)
- Chinese Academy of Sciences, Shanghai (C. Yang)
| | - Xiaowen Zhai
- National Children's Medical Center, Shanghai, China (P. Fu, J. Zhou, Y. Nijiati, L. Zhou, G. Yan, G. Lu, X. Zhai, C. Wang)
- Chinese Academy of Sciences, Shanghai (C. Yang)
| | - Chuanqing Wang
- National Children's Medical Center, Shanghai, China (P. Fu, J. Zhou, Y. Nijiati, L. Zhou, G. Yan, G. Lu, X. Zhai, C. Wang)
- Chinese Academy of Sciences, Shanghai (C. Yang)
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Mir-Cros A, Moreno-Mingorance A, Martín-Gómez MT, Abad R, Bloise I, Campins M, González-Praetorius A, Gutiérrez MN, Martín-González H, Muñoz-Almagro C, Orellana MÁ, de Pablos M, Roca-Grande J, Rodrigo C, Rodríguez ME, Uriona S, Vidal MJ, Pumarola T, Larrosa MN, González-López JJ. Pertactin-Deficient Bordetella pertussis with Unusual Mechanism of Pertactin Disruption, Spain, 1986-2018. Emerg Infect Dis 2022; 28:967-976. [PMID: 35447067 PMCID: PMC9045434 DOI: 10.3201/eid2805.211958] [Citation(s) in RCA: 3] [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] [Indexed: 12/03/2022] Open
Abstract
Bordetella pertussis not expressing pertactin has increased in countries using acellular pertussis vaccines (ACV). The deficiency is mostly caused by pertactin gene disruption by IS481. To assess the effect of the transition from whole-cell vaccine to ACV on the emergence of B. pertussis not expressing pertactin in Spain, we studied 342 isolates collected during 1986–2018. We identified 93 pertactin-deficient isolates. All were detected after introduction of ACV and represented 38% of isolates collected during the ACV period; 58.1% belonged to a genetic cluster of isolates carrying the unusual prn::del(–292, 1340) mutation. Pertactin inactivation by IS481 insertion was identified in 23.7% of pertactin-deficient isolates, arising independently multiple times and in different phylogenetic branches. Our findings support the emergence and dissemination of a cluster of B. pertussis with an infrequent mechanism of pertactin disruption in Spain, probably resulting from introduction of ACV.
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Ahvenainen N, Dub T, Knuutila A, Barkoff AM, Sane J, He Q. Widespread circulation of pertussis in Finland during 1968-1972 when the whole cell vaccine was in use. Clin Microbiol Infect 2021; 27:1526-1528. [PMID: 34153458 DOI: 10.1016/j.cmi.2021.06.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/04/2021] [Accepted: 06/10/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Niina Ahvenainen
- Research Centre for Infection and Immunity, Institute of Biomedicine, University of Turku, Turku, Finland
| | - Timothée Dub
- Infectious Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Aapo Knuutila
- Research Centre for Infection and Immunity, Institute of Biomedicine, University of Turku, Turku, Finland
| | - Alex-Mikael Barkoff
- Research Centre for Infection and Immunity, Institute of Biomedicine, University of Turku, Turku, Finland
| | - Jussi Sane
- Infectious Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Qiushui He
- Research Centre for Infection and Immunity, Institute of Biomedicine, University of Turku, Turku, Finland; Department of Medical Microbiology, Capital Medical University, Beijing, China.
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6
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Versteegen P, Valente Pinto M, Barkoff AM, van Gageldonk PGM, van de Kassteele J, van Houten MA, Sanders EAM, de Groot R, Diavatopoulos DA, Bibi S, Luoto R, He Q, Buisman AM, Kelly DF, Mertsola J, Berbers GAM. Responses to an acellular pertussis booster vaccination in children, adolescents, and young and older adults: A collaborative study in Finland, the Netherlands, and the United Kingdom. EBioMedicine 2021; 65:103247. [PMID: 33647770 PMCID: PMC7920834 DOI: 10.1016/j.ebiom.2021.103247] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/02/2021] [Accepted: 02/02/2021] [Indexed: 01/08/2023] Open
Abstract
Background Pertussis can lead to serious disease and even death
in infants. Older adults are more vulnerable to complications as well. In
high-income countries, acellular pertussis vaccines are used for priming
vaccination. In the administration of booster vaccinations to different age
groups and target populations there is a substantial between-country variation.
We investigated the effect of age on the response to acellular pertussis booster
vaccination in three European countries. Methods This phase IV longitudinal intervention study
performed in Finland, the Netherlands and the United Kingdom between October
2017 and January 2019 compared the vaccine responses between healthy
participants of four age groups: children (7–10y), adolescents (11–15y), young
adults (20–34y), and older adults (60–70y). All participants received a
three-component acellular pertussis vaccine. Serum IgG and IgA antibody
concentrations to pertussis antigens at day 0, 28, and 1 year were measured with
a multiplex immunoassay, using pertussis toxin concentrations at day 28 as
primary outcome. This trial is registered with ClinicalTrialsRegister.eu
(2016–003,678–42). Findings Children (n = 109), adolescents
(n = 121), young adults
(n = 74), and older adults
(n = 75) showed high IgG antibody concentrations to
pertussis toxin at day 28 with GMCs of 147 (95% CI 120–181), 161 (95% CI
132–196), 103 (95% CI 80–133), and 121 IU/ml (95% CI 94–155), respectively. A
significant increase in GMCs for vaccine antigens in all age groups by 28 days
was found which had decreased by 1 year. Differences in patterns of IgG GMCs at
28 days and 1 year post-vaccination did not have a consistent relationship to
age. In contrast, IgA antibodies for all antigens increased with age at all
timepoints. Interpretation Acellular pertussis booster vaccination induces
significant serum IgG responses to pertussis antigens across the age range which
are not uniformly less in older adults. Acellular boosters could be considered
for older adults to reduce the health and economic burden of
pertussis.
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Affiliation(s)
- Pauline Versteegen
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Antonie van Leeuwenhoeklaan 9, Bilthoven 3720 BA, Netherlands
| | - Marta Valente Pinto
- University of Oxford, Department of Paediatrics, Oxford Vaccine Group, Oxford OX3 7LE, United Kingdom
| | - Alex M Barkoff
- University of Turku, Institute of Biomedicine, Microbiology, Virology and Immunology, and Turku University Hospital, Turku 20500, Finland
| | - Pieter G M van Gageldonk
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Antonie van Leeuwenhoeklaan 9, Bilthoven 3720 BA, Netherlands
| | - Jan van de Kassteele
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Antonie van Leeuwenhoeklaan 9, Bilthoven 3720 BA, Netherlands
| | | | - Elisabeth A M Sanders
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Antonie van Leeuwenhoeklaan 9, Bilthoven 3720 BA, Netherlands; Wilhelmina Children's Hospital, Department of Paediatric Immunology and Infectious Diseases, Lundlaan 6, 3584 EA Utrecht, Netherlands
| | - Ronald de Groot
- Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine, Nijmegen 6525 GA, Netherlands
| | - Dimitri A Diavatopoulos
- Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine, Nijmegen 6525 GA, Netherlands
| | - Sagida Bibi
- University of Oxford, Department of Paediatrics, Oxford Vaccine Group, Oxford OX3 7LE, United Kingdom
| | - Raakel Luoto
- University of Turku, Institute of Biomedicine, Microbiology, Virology and Immunology, and Turku University Hospital, Turku 20500, Finland
| | - Qiushui He
- University of Turku, Institute of Biomedicine, Microbiology, Virology and Immunology, and Turku University Hospital, Turku 20500, Finland
| | - Anne-Marie Buisman
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Antonie van Leeuwenhoeklaan 9, Bilthoven 3720 BA, Netherlands
| | - Dominic F Kelly
- University of Oxford, Department of Paediatrics, Oxford Vaccine Group, Oxford OX3 7LE, United Kingdom; Oxford University Hospitals NHS Foundation Trust, Headington, Oxford OX3 9DU, United Kingdom
| | - Jussi Mertsola
- University of Turku, Institute of Biomedicine, Microbiology, Virology and Immunology, and Turku University Hospital, Turku 20500, Finland
| | - Guy A M Berbers
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Antonie van Leeuwenhoeklaan 9, Bilthoven 3720 BA, Netherlands.
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Bahmanjeh A, Noofeli M, Khaki P, Hassanzadeh SM. Genetic analysis of clinical and vaccine strains of Bordetella pertussis by Pulsed-Field Gel Electrophoresis (PFGE), Multi Locus Sequence Typing (MLST) and serotyping. Comp Immunol Microbiol Infect Dis 2019; 64:168-175. [PMID: 31174694 DOI: 10.1016/j.cimid.2019.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 03/10/2019] [Accepted: 03/11/2019] [Indexed: 11/17/2022]
Abstract
In spite of high vaccination coverage in the Expanded Program of Immunization (EPI), pertussis has not been eradicated yet and the re-emergence of the disease is still reported worldwide. The genetic divergence study of circulating clinical strains of Bordetella pertussis among the population with high vaccination coverage is a useful tool to have an insight in the understanding of genetic patterns of this bacterium and deviation of them from vaccine strains. Different methods are accessible for studying of Bordetella pertussis that can perform appropriate assessment between populations. Strains used in this study were a collection of two pertussis vaccine strains used to create killed pertussis vaccine over years at Razi Vaccine and Serum Research Institute, 10 clinical and 2 reference strains (ATCC9797 and Tohama I) in Multilocus Sequence Typing (MLST), Pulsed-Field Gel Electrophoresis (PFGE), and serotyping. The genetic profiles of vaccine working and master seeds showed no important change(s) in frequencies of fingerprint types investigated in the vaccine strains and had homogeneity in PFGE method where the clinical isolates showed diversity in genetic profile. Serotyping method showed that all of 10 clinical strains expressing Fim 3. In MLST study, seven housekeeping genes including adk, pgm, fum C, tyr B, gly A, pep A and icd were analyzed which showed no changes in the sequence of clinical and vaccine strains with 100% homology. The genes that cause pathogenicity like ptxC, tcfA and fhaB were also evaluated and the results illustrated heterogeneity in the vaccine and circulating strains.
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Affiliation(s)
- Anahita Bahmanjeh
- Vaccine Production Unit, Research & Production Complex, Pasteur Institute of Iran, Karaj, Iran
| | - Mojtaba Noofeli
- Human Bacterial Vaccines Production & Research Dept, Razi Vaccine Serum Research Institute (RVSRI), Agricultural Research, Education Extension Organisation (AREEO), Karaj, Tehran, Iran.
| | - Pejvak Khaki
- Human Bacterial Vaccines Production & Research Dept, Razi Vaccine Serum Research Institute (RVSRI), Agricultural Research, Education Extension Organisation (AREEO), Karaj, Tehran, Iran
| | - Seyed Mehdi Hassanzadeh
- Vaccine Production Unit, Research & Production Complex, Pasteur Institute of Iran, Karaj, Iran.
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Non-Vaccine-Type Human Papillomavirus Prevalence After Vaccine Introduction: No Evidence for Type Replacement but Evidence for Cross-Protection. Sex Transm Dis 2019; 45:260-265. [PMID: 29465705 DOI: 10.1097/olq.0000000000000731] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND We examined non-vaccine-type human papillomavirus (HPV) prevalence in a community before and during the first 8 years after vaccine introduction, to assess for (1) type replacement with any non-vaccine-type HPV and (2) cross-protection with non-vaccine types genetically related to vaccine-type HPV. METHODS Sexually experienced 13- to- 26-year-old women were recruited for 3 cross-sectional studies from 2006 to 2014 (N = 1180). Outcome variables were as follows: (1) prevalence of at least 1 of 32 anogenital non-vaccine-type HPVs and (2) prevalence of at least 1 HPV type genetically related to HPV-16 and HPV-18. We determined changes in proportions of non-vaccine-type HPV prevalence across the study waves using logistic regression with propensity score inverse probability weighting. RESULTS Vaccine initiation rates increased from 0% to 71.3%. Logistic regression demonstrated that from 2006 to 2014, there was no increase in non-vaccine-type HPV among vaccinated women (adjusted odds ratio [AOR], 1.02; 95% confidence interval [CI], 0.73-1.42), but an increase among unvaccinated women (AOR, 1.88; 95% CI, 1.16-3.04). Conversely, there was a decrease in types genetically related to HPV-16 among vaccinated (AOR, 0.57; 95% CI, 0.38-0.88) but not unvaccinated women (AOR, 1.33; 95% CI, 0.81-2.17). CONCLUSIONS We did not find evidence of type replacement, but did find evidence of cross-protection against types genetically related to HPV-16. These findings have implications for cost-effectiveness analyses, which may impact vaccine-related policies, and provide information to assess the differential risk for cervical cancer in unvaccinated and vaccinated women, which may influence clinical screening recommendations. The findings also have implications for public health programs, such as health messaging for adolescents, parents, and clinicians about HPV vaccination.
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Molecular Epidemiology of Bordetella pertussis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1183:19-33. [PMID: 31342459 DOI: 10.1007/5584_2019_402] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Although vaccination has been effective, Bordetella pertussis is increasingly causing epidemics, especially in industrialized countries using acellular vaccines (aPs). One factor behind the increased circulation is the molecular changes on the pathogen level. After pertussis vaccinations were introduced, changes in the fimbrial (Fim) serotype of the circulating strains was observed. When bacterial typing methods improved, further changes between the vaccine and circulating strains, especially among the common virulence genes including pertussis toxin (PT) and pertactin (PRN) were noticed. Moreover, development of genome based techniques including pulsed-field gel electrophoresis (PFGE), multiple-locus variable number tandem repeat analysis (MLVA) and whole-genome sequencing (WGS) have offered a better resolution to monitor B. pertussis strains. After the introduction of aP vaccines, B. pertussis strains that are deficient to vaccine antigens, especially PRN, have appeared widely. On the other hand, antimicrobial resistance to first line drugs (macrolides) against B. pertussis is still low in many countries and therefore no globally evaluated antimicrobial susceptibility test values have been recommended. In this review, we focus on the molecular changes in the bacteria, which have or may have affected the past and current epidemiology of pertussis.
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Dias WDO, Prestes AFR, Cunegundes PS, Silva EP, Raw I. Immunization against Pertussis: An Almost Solved Problem or a Headache in Public Health. Vaccines (Basel) 2017. [DOI: 10.5772/intechopen.69283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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The characterization of Bordetella pertussis strains isolated in the Central-Western region of Brazil suggests the selection of a specific genetic profile during 2012-2014 outbreaks. Epidemiol Infect 2017; 145:1392-1397. [PMID: 28219454 DOI: 10.1017/s0950268816003332] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Pertussis is a worldwide acute respiratory disease caused by the bacterium Bordetella pertussis. Despite high vaccine coverage, the bacterium continues to circulate in populations and is still one of the most common vaccine-preventable diseases. In Brazil, pertussis incidence has presented a significant decrease since 1990 but since 2011 a sudden increase in incidence has been observed. Thus, the aim of this study was to perform a molecular epidemiological characterization of B. pertussis strains isolated in the Central-Western region (specifically in Distrito Federal) of Brazil from August 2012 to August 2014. During this period, 92 B. pertussis strains were isolated from the outbreaks. All strains were characterized by serotyping and XbaI pulsed-field gel electrophoresis profiles. From August to December 2012, the most prevalent serotype observed was 1,3 (13/17). During 2013 the prevalence of serotype 1,3 decreased (13/30) and from January 2014 to August 2014 the most prevalent serotype was 1,2 (33/45). Fourteen PFGE profiles were identified. Of these, BP-XbaI0039 prevalence increased from 3/17 in 2012 to 10/30 in 2013, and 35/45 in 2014. These results evidence the selection of a specific genetic profile during this period, suggesting the occurrence of a bacterial genomic profile with high circulation potential.
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Cassiday PK, Skoff TH, Jawahir S, Tondella ML. Changes in Predominance of Pulsed-Field Gel Electrophoresis Profiles of Bordetella pertussis Isolates, United States, 2000-2012. Emerg Infect Dis 2016; 22:442-8. [PMID: 26886905 PMCID: PMC4766905 DOI: 10.3201/eid2203.151136] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
These changes are concurrrent with other recent molecular changes and may be contributing to US pertussis reemergence. To clarify the characteristics of circulating Bordetella pertussis isolates, we used pulsed-field gel electrophoresis (PFGE) to analyze 5,262 isolates collected in the United States during 2000–2012. We found 199 PFGE profiles; 5 profiles accounted for 72% of isolates. The most common profile, CDC013, accounted for 35%–46% of isolates tested from 2000–2009; however, the proportion of isolates of this profile rapidly decreased in 2010. Profile CDC237, first seen in 2009, increased rapidly and accounted for 29% of 2012 isolates. No location bias was observed among profiles during 2000–2010, but differences were observed among isolates from different states during 2012. Predominant profiles match those observed in recent European PFGE studies. PFGE profile changes are concurrent with other recent molecular changes in B. pertussis and may be contributing to the reemergence of pertussis in the United States. Continued PFGE monitoring is critical for understanding the changing epidemiology of pertussis.
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13
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Xu Y, Zhang L, Tan Y, Wang L, Zhang S, Wang J. Genetic diversity and population dynamics of Bordetella pertussis in China between 1950–2007. Vaccine 2015; 33:6327-31. [DOI: 10.1016/j.vaccine.2015.09.040] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 08/26/2015] [Accepted: 09/15/2015] [Indexed: 10/23/2022]
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14
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Xu Y, Liu B, Gröndahl-Yli-Hannuksila K, Tan Y, Feng L, Kallonen T, Wang L, Peng D, He Q, Wang L, Zhang S. Whole-genome sequencing reveals the effect of vaccination on the evolution of Bordetella pertussis. Sci Rep 2015; 5:12888. [PMID: 26283022 PMCID: PMC4539551 DOI: 10.1038/srep12888] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 07/10/2015] [Indexed: 12/11/2022] Open
Abstract
Herd immunity can potentially induce a change of circulating viruses. However, it remains largely unknown that how bacterial pathogens adapt to vaccination. In this study, Bordetella pertussis, the causative agent of whooping cough, was selected as an example to explore possible effect of vaccination on the bacterial pathogen. We sequenced and analysed the complete genomes of 40 B. pertussis strains from Finland and China, as well as 11 previously sequenced strains from the Netherlands, where different vaccination strategies have been used over the past 50 years. The results showed that the molecular clock moved at different rates in these countries and in distinct periods, which suggested that evolution of the B. pertussis population was closely associated with the country vaccination coverage. Comparative whole-genome analyses indicated that evolution in this human-restricted pathogen was mainly characterised by ongoing genetic shift and gene loss. Furthermore, 116 SNPs were specifically detected in currently circulating ptxP3-containing strains. The finding might explain the successful emergence of this lineage and its spread worldwide. Collectively, our results suggest that the immune pressure of vaccination is one major driving force for the evolution of B. pertussis, which facilitates further exploration of the pathogenicity of B. pertussis.
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Affiliation(s)
- Yinghua Xu
- Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products, National Institutes of Food and Drug Control, Beijing 100050, P. R. China
| | - Bin Liu
- 1] TEDA School of Biological Sciences and Biotechnology, Nankai University, Tianjin 300457, P.R. China [2] Key Laboratory of Molecular Microbiology and Technology, Ministry of Education, 23 Hongda Street, Tianjin 300457, P. R. China
| | | | - Yajun Tan
- Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products, National Institutes of Food and Drug Control, Beijing 100050, P. R. China
| | - Lu Feng
- 1] TEDA School of Biological Sciences and Biotechnology, Nankai University, Tianjin 300457, P.R. China [2] Key Laboratory of Molecular Microbiology and Technology, Ministry of Education, 23 Hongda Street, Tianjin 300457, P. R. China
| | - Teemu Kallonen
- Department of Medical Microbiology and Immunology, Turku University, Turku 20520, Finland
| | - Lichan Wang
- Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products, National Institutes of Food and Drug Control, Beijing 100050, P. R. China
| | - Ding Peng
- 1] TEDA School of Biological Sciences and Biotechnology, Nankai University, Tianjin 300457, P.R. China [2] Key Laboratory of Molecular Microbiology and Technology, Ministry of Education, 23 Hongda Street, Tianjin 300457, P. R. China
| | - Qiushui He
- 1] Department of Medical Microbiology and Immunology, Turku University, Turku 20520, Finland [2] Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Turku 20520, Finland [3] Department of Medical Microbiology, Capital Medical University, Beijing 100069, P. R. China
| | - Lei Wang
- 1] TEDA School of Biological Sciences and Biotechnology, Nankai University, Tianjin 300457, P.R. China [2] Key Laboratory of Molecular Microbiology and Technology, Ministry of Education, 23 Hongda Street, Tianjin 300457, P. R. China [3] State Key Laboratory of Medicinal Chemical Biology, Nankai University 300457, Tianjin, P. R. China
| | - Shumin Zhang
- Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products, National Institutes of Food and Drug Control, Beijing 100050, P. R. China
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Abstract
Bordetella pertussis produces two serologically distinct fimbriae, Fim2 and Fim3. Expression of these antigens is governed by the BvgA/S system and by the length of a poly(C) tract in the promoter of each gene. Fim2 and Fim3 are important antigens for whole cell pertussis vaccines as clinical trials have shown an association of anti-fimbriae antibody-mediated agglutination and protection. The current five component acellular pertussis vaccine contains co-purified Fim2/3 and provided good efficacy in clinical trials with the anti-Fim antibody response correlating with protection when pre and post exposure antibody levels were analysed. The predominant serotype of B. pertussis isolates has changed over time in most countries but it is not understood whether this is vaccine-driven or whether serotype is linked to the prevailing predominant genotype. Recent studies have shown that both Fim2 and Fim3 are expressed during infection and that Fim2 is more immunogenic than Fim3 in the acellular vaccine.
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Immunization with the recombinant Cholera toxin B fused to Fimbria 2 protein protects against Bordetella pertussis infection. BIOMED RESEARCH INTERNATIONAL 2014; 2014:421486. [PMID: 24982881 PMCID: PMC4052895 DOI: 10.1155/2014/421486] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Revised: 04/14/2014] [Accepted: 04/22/2014] [Indexed: 11/18/2022]
Abstract
This study examined the immunogenic properties of the fusion protein fimbria 2 of Bordetella pertussis (Fim2)—cholera toxin B subunit (CTB) in the intranasal murine model of infection. To this end B. pertussis Fim2 coding sequence was cloned downstream of the cholera toxin B subunit coding sequence. The expression and assembly of the fusion protein into pentameric structures (CTB-Fim2) were evaluated by SDS-PAGE and monosialotetrahexosylgaglioside (GM1-ganglioside) enzyme-linked immunosorbent assay (ELISA). To evaluate the protective capacity of CTB-Fim2, an intraperitoneal or intranasal mouse immunization schedule was performed with 50 μg of CTB-Fim2. Recombinant (rFim2) or purified (BpFim2) Fim2, CTB, and phosphate-buffered saline (PBS) were used as controls. The results showed that mice immunized with BpFim2 or CTB-Fim2 intraperitoneally or intranasally presented a significant reduction in bacterial lung counts compared to control groups (P < 0.01 or P < 0.001 , resp.). Moreover, intranasal immunization with CTB-Fim2 induced significant levels of Fim2-specific IgG in serum and bronchoalveolar lavage (BAL) and Fim2-specific IgA in BAL. Analysis of IgG isotypes and cytokines mRNA levels showed that CTB-Fim2 results in a mixed Th1/Th2 (T-helper) response. The data presented here provide support for CTB-Fim2 as a promising recombinant antigen against Bordetella pertussis infection.
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Kim SH, Lee J, Sung HY, Yu JY, Kim SH, Park MS, Jung SO. Recent trends of antigenic variation in Bordetella pertussis isolates in Korea. J Korean Med Sci 2014; 29:328-33. [PMID: 24616579 PMCID: PMC3945125 DOI: 10.3346/jkms.2014.29.3.328] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 01/08/2014] [Indexed: 01/26/2023] Open
Abstract
Pertussis is a representative vaccine-preventable disease. However, there have been recent outbreaks in countries where even higher vaccination against the disease. One reason is the emergence of antigenic variants, which are different to vaccine type. In Korea, reported cases have rapidly increased since 2009. Therefore, we analyzed genotype of strains isolated in 2011-2012 by multilocus sequence typing method. As expected, the genotype profiles of tested genes dramatically changed. The major sequence type changed from ST1 to ST2, and new sequence type (ST8) appeared. In the minimum spanning tree, recent isolates belonging to the ACC-I-ST3 subgroup were detected that were composed of ST2, ST3, and ST6. In particular, the ST2 frequency increased to 81%. The novel ST8 was linked to the increased frequency of ST2. In addition, toxic strains carrying the ptxP3 promoter type were confirmed. This ptxP3 type emerged from 2009 and its frequency had increased to 100% in 2012. Based on these results, it can be inferred that the genotypic changes in the currently circulating strains are strongly associated with the recent increasing of pertussis in Korea. Therefore, the surveillance system should be strengthened, and genetic characterization of the isolates should be expanded to the whole genome sequence level.
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Affiliation(s)
- So-Hyun Kim
- Division of Bacterial Respiratory Infections, Korea National Institute of Health, Osong, Korea
| | - Jin Lee
- Division of Bacterial Respiratory Infections, Korea National Institute of Health, Osong, Korea
| | - Hwa Young Sung
- Pathogen Resource TF, Korea National Institute of Health, Osong, Korea
| | - Jae Yon Yu
- Division of Antimicrobial Resistance, Korea National Institute of Health, Osong, Korea
| | - Seong Han Kim
- Division of Bacterial Respiratory Infections, Korea National Institute of Health, Osong, Korea
| | - Mi Sun Park
- Division of Bacterial Respiratory Infections, Korea National Institute of Health, Osong, Korea
| | - Sang-Oun Jung
- Division of Bacterial Respiratory Infections, Korea National Institute of Health, Osong, Korea
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18
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Ulloa-Gutierrez R, Avila-Aguero ML. Pertussis in Latin America: current situation and future vaccination challenges. Expert Rev Vaccines 2014; 7:1569-80. [DOI: 10.1586/14760584.7.10.1569] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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19
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Kallonen T, He Q. Bordetella pertussisstrain variation and evolution postvaccination. Expert Rev Vaccines 2014; 8:863-75. [DOI: 10.1586/erv.09.46] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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20
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Poolman JT, Hallander HO. Acellular pertussis vaccines and the role of pertactin and fimbriae. Expert Rev Vaccines 2014; 6:47-56. [PMID: 17280478 DOI: 10.1586/14760584.6.1.47] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The introduction of acellular pertussis (Pa) vaccines in countries with a low uptake of whole-cell pertussis (Pw) vaccines has led to a dramatic reduction in pertussis disease. Diphtheria-tetanus-acellular pertussis (DTPa) vaccines have also ensured continued high level disease protection in these countries following the shift from Pw- to Pa-containing vaccines, and allowed pertussis booster programs to be implemented. Vaccines containing between one and five components have been licensed and implemented. Those with three or more components consisting of filamentous hemagglutinin (FHA), pertussis toxin (PT) and pertactin (PRN) are considered to be more effective than one/two-component Pa vaccines that contain only PT or both PT and FHA. Changes in circulating Bordetella pertussis strains may impact vaccine efficacy and, thus, incidence and transmission of pertussis and deserve to be followed carefully. To date, vaccine-induced shifts among fimbriae (FIM) are reported and this could impact the efficacy of FIM-containing vaccines. Currently, FIM3 appears to be dominant in most European countries, Canada and Australia. Data obtained from a DTPa5 vaccine containing FIM2 and FIM3 have indicated a shift towards an increase in FIM3-expressing B. pertussis clinical breakthrough cases when compared with control vaccine. By contrast, relatively minor PT and PRN sequence polymorphisms have been identified without demonstrable association with vaccination programs. Adsorption of PRN to aluminum salt appears critical for optimal protective capacity in murine pertussis lung challenge. In addition, clinical studies have shown anti-PRN antibody levels to be higher when PRN is adsorbed at a 8-microg dosage versus non-adsorbed PRN at a 3-microg dosage. The available data, therefore, demonstrate that appropriately formulated acellular vaccines containing PT and PRN are the preferred option for pertussis immunization.
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Affiliation(s)
- Jan T Poolman
- Head of Bacterial Vaccines, R&D Bacterial Vaccine Program, GlaxoSmithKline Biologicals, Rixensart, Belgium.
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21
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Nikbin VS, Shahcheraghi F, Lotfi MN, Zahraei SM, Parzadeh M. Comparison of culture and real-time PCR for detection of Bordetella pertussis isolated from patients in Iran. IRANIAN JOURNAL OF MICROBIOLOGY 2013; 5:209-14. [PMID: 24475325 PMCID: PMC3895556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVE Due to contagiousness of pertussis, a rapid and sensitive method for diagnosis is required to initiate the treatment and interrupt its transmission. MATERIALS AND METHODS To detect B. pertussis strains, we used two real-time PCR targeting IS481 and BP283 sequences and compared factors influencing culture and real-time PCR results. RESULTS Totally, 779 specimens were collected from patients among which 11 (1.4%) were culture positive. Using IS481 and BP283 primers, 122 (15.6%) and 100 (12.8%) were diagnosed as infected specimens respectively. There were significant relationships between the real-time PCR method for diagnosis of B. pertussis and age, sex and vaccination of patients before sampling. CONCLUSION The real-time PCR is superior and much more sensitive than culture for diagnosis of B. pertussis. However, the sensitivity was improved when both IS481 and BP283 were used. Correct sampling and transportation of specimen also improved the detection rate in our research.
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Affiliation(s)
- Vajiheh Sadat Nikbin
- Pertussis Reference Laboratory, Department of Bacteriology, Pasteur Institute of Iran, Tehran
| | - Fereshteh Shahcheraghi
- Pertussis Reference Laboratory, Department of Bacteriology, Pasteur Institute of Iran, Tehran, Corresponding author: Fereshteh Shahcheraghi, Ph.D, Address: Pertussis Reference Laboratory, Department of Bacteriology and Microbiology Research Center, Pasteur Institute of Iran, Pasteur St., Tehran, Iran. Tel & Fax: +98-21-66405535. E-mail:
| | - Masoumeh Nakhost Lotfi
- Pertussis Reference Laboratory, Department of Bacteriology, Pasteur Institute of Iran, Tehran
| | | | - Masoumeh Parzadeh
- Pertussis Reference Laboratory, Department of Bacteriology, Pasteur Institute of Iran, Tehran
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22
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Zhang Q, Li M, Wang L, Xin T, He Q. High-resolution melting analysis for the detection of two erythromycin-resistant Bordetella pertussis strains carried by healthy schoolchildren in China. Clin Microbiol Infect 2013; 19:E260-2. [DOI: 10.1111/1469-0691.12161] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Revised: 12/10/2012] [Accepted: 01/10/2013] [Indexed: 11/30/2022]
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23
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Pulsed-field gel electrophoresis analysis of Bordetella pertussis isolates circulating in Europe from 1998 to 2009. J Clin Microbiol 2012; 51:422-8. [PMID: 23175253 DOI: 10.1128/jcm.02036-12] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Between 1998 and 2009, Bordetella pertussis clinical isolates were collected during three periods, i.e., 1998 to 2001 (n = 102), 2004 to 2005 (n = 154), and 2007 to 2009 (n = 140), from nine countries with distinct vaccination programs, i.e., Denmark, Finland, France, Germany, The Netherlands, Norway, Poland, Sweden, and the United Kingdom. Pulsed-field gel electrophoresis (PFGE) analysis was performed according to standardized recommendations for epidemiological typing of B. pertussis. There were 81 different PFGE profiles, five of which (BpSR3, BpSR5, BpSR10, BpSR11, and BpSR12) were observed in 61% of the 396 isolates and shown to be predominant in almost all countries. The major profile, BpSR11, showed a decreasing trend from 25% to 30% in 1998 to 2005 to 13% in 2007 to 2009, and there were increases in BpSR3 and BpSR10 from 0% and 8% to 21% and 22%, respectively. One difference between these profiles is that BpSR11 contains isolates harboring the fim3-2 allele and BpSR3 and BpSR10 contain isolates harboring the fim3-1 allele. The total proportion of the five predominant profiles increased from 44% in 1998 to 2001 to 63% in 2004 to 2005 to 70% in 2007 to 2009. In conclusion, common PFGE profiles were identified in B. pertussis populations circulating in European countries with different vaccination programs and different vaccine coverages. These prevalent isolates contain the novel pertussis toxin promoter ptxP3 allele. However, there is evidence for diversifying selection between ptxP3 strains characterized by distinct PFGE profiles. This work shows that, even within a relatively short time span of 10 years, successful isolates which spread through Europe and cause large shifts in B. pertussis populations may emerge.
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Pertussis Epidemiology in Greece and Emerging Risk Groups during the Vaccination Era (1980-2008). Adv Prev Med 2012; 2012:303846. [PMID: 23019527 PMCID: PMC3457588 DOI: 10.1155/2012/303846] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 08/09/2012] [Accepted: 08/23/2012] [Indexed: 11/18/2022] Open
Abstract
To study the epidemiology of pertussis in Greece and epidemiologic changes throughout a period of twenty-nine years, we conducted a retrospective analysis of available data of pertussis cases for the past twenty-nine years (1980-2008) and a prospective analysis of hospitalized pertussis cases from a children's hospital in Athens for eight years (2001-2008). From 1980 through 2008, the incidence of pertussis in Greece declined from 11.2 to 0.05 cases per 100,000. Epidemic cycles occurring every 3 to 5 years were observed. Since pertussis circulation cannot be fully controlled by present immunization programs, efforts should be made to vaccinate infants at the recommended age, early diagnose, treatment as well as contact tracing of pertussis cases. Control of pertussis in social susceptible populations is necessary. A national program with adolescent and adult booster could decrease the circulation of B. pertussis. Despite an overall decrease for pertussis cases, pertussis is still a present and future challenge of public health service in Greece.
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Gröndahl-Yli-Hannuksela K, Viander M, Mertsola J, He Q. Increased risk of pertussis in adult patients with mannose-binding lectin deficiency. APMIS 2012; 121:311-5. [PMID: 23030784 DOI: 10.1111/apm.12000] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 08/19/2012] [Indexed: 11/28/2022]
Abstract
Mannose-binding lectin (MBL) is an important molecule of the innate immunity. The low level of MBL in the serum is associated with increased susceptibility to respiratory infections. In this study, MBL concentrations were determined from the sera of 125 Finnish pertussis patients and from 430 control subjects. Severe MBL deficiency (<50 ng/mL) was found more often in the patients than in the controls (11.2% vs 5.8%, p = 0.038). Moreover, the deficiency was detected more frequently in the adult patients than in the controls [20.4% vs 8.6%, p = 0.021; odds ratio 2.7 (95% confidence interval 1.1-6.5)]. Our findings suggest, for the first time, that MBL deficiency predisposes to pertussis infection, at least in adults.
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Affiliation(s)
- Kirsi Gröndahl-Yli-Hannuksela
- Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Turku, Finland
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26
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Mughal A, Kazi Y, Bukhari H, Ali M. Pertussis resurgence among vaccinated children in Khairpur, Sindh, Pakistan. Public Health 2012; 126:518-22. [DOI: 10.1016/j.puhe.2012.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Revised: 09/26/2011] [Accepted: 02/01/2012] [Indexed: 10/28/2022]
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Differences in the genomic content of Bordetella pertussis isolates before and after introduction of pertussis vaccines in four European countries. INFECTION GENETICS AND EVOLUTION 2011; 11:2034-42. [PMID: 21964035 DOI: 10.1016/j.meegid.2011.09.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Revised: 09/12/2011] [Accepted: 09/14/2011] [Indexed: 11/20/2022]
Abstract
Resurgence of pertussis has been observed in many countries with high vaccination coverage and clonal expansion of certain Bordetella pertussis strains has been associated with recent epidemics in Europe. It is known that vaccinations have selected strains which are different from those used for vaccine production. However, little is known about the differences in genomic content of strains circulating before the vaccination was introduced. In this study, we compared the genomes of 39 vaccine strains and old clinical isolates (isolated 1941-1984) collected from Finland (n = 5), Poland (n = 14), Serbia (n = 10) and the UK (n = 10). The analysis included genotyping, pulsed-field gel electrophoresis (PFGE) and comparative genomic hybridisation (CGH). Compared to the strain Tohama I, the European isolates analyzed have lost three major regions of difference (RD3, 5 and 29). However, difference in frequency of the absent RDs 3 (BP0910A-BP0934), 5 (BP1135-BP1141) or 29 (BP1225) was observed among isolates from the four countries. Of the isolates with absent RD5, half had also a duplicated region in the genome. All four RDs (RD22 (BB0535-BB0541), 23 (BB0916-BB0921), 24 (BB1140-BB1158) and 26 (BB4880-BB4888)) absent in Tohama I were present in majority of the tested isolates. Results obtained from PFGE analysis correlated well with those of CGH. Recently a novel pertussis toxin promoter allele (ptxP3) was described. Isolates with ptxP3 have replaced resident ptxP1 isolates in the countries where this was investigated. When the recent isolates, collected in 2000-2004, selected from the four countries were examined, the ptxP3 allele was found in all countries except Poland. Our result indicates that at least three clusters of B. pertussis circulated in Europe in pre- and early vaccine era and their genomes were distinct from that of the reference strain Tohama I. Although progressive gene loss occurs in B. pertussis population with time, difference in frequency of the lost genes were observed among isolates from the four countries. The observed differences in genomic content might be vaccine-driven.
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28
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Jung SO, Moon YM, Kim SH, Sung HY, Kwon SJ, Kang YH, Yu JY. Multilocus Sequence Analysis of Housekeeping Genes and Antigenic Determinant Genes in Bordetella pertussis Strains Isolated in Korea. Osong Public Health Res Perspect 2011; 2:115-26. [PMID: 24159461 PMCID: PMC3766922 DOI: 10.1016/j.phrp.2011.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2011] [Revised: 06/16/2011] [Accepted: 07/06/2011] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES To confirm genotype diversities of clinical isolates of Bordetella pertussis and to evaluate the risk of pertussis outbreak in Korea. METHODS Seven housekeeping genes and 10 antigenic determinant genes from clinical B. pertussis isolates were analyzed by Multilocus sequence typing (MLST). RESULTS More variant pattern was observed in antigenic determinant genes. Especially, PtxS1 gene was the most variant gene; five genotypes were observed from eight global genotypes. In the bacterial type, the number of observed sequence types in the isolates was seven and the most frequent form was type 1 (79.6%). This major sequence type also showed a time-dependent transition pattern. Older isolates (1968 and 1975) showed type 1 and 6 in housekeeping genes and antigenic determinant genes, respectively. However, these were changed to type 2 and 1 in isolates 1999-2008. This transition was mainly attributed to genotype change of PtxS1 and Fim3 gene; the tendency of genotype change was to avoid vaccine-derived genotype. In addition, there was second transition in 2009. In this period, only the sequence type of antigenic determinant genes was changed to type 2. Based Upon Related Sequence Types (BURST) analysis confirmed that there were two clonal complexes (ACCI and ACCII) in the Korean isolates. Moreover, the recently increased sequence type was revealed as AST2 derived from AST 3 in ACCI. CONCLUSIONS Genotype changes in Korean distributing strains are still progressing and there was a specific driving force in antigenic determinant genes. Therefore continuous surveillance of genotype change of the distributing strains should be performed to confirm interrelationship of genotype change with vaccine immunity.
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Affiliation(s)
- Sang-Oun Jung
- Division of Bacterial Respiratory Infections, Korea National Institute of Health, Osong, Korea
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29
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Pulsed-field gel electrophoresis characterization of Bordetella pertussis clinical isolates circulating in Turkey in 2001–2009. Eur J Clin Microbiol Infect Dis 2011; 30:1229-36. [DOI: 10.1007/s10096-011-1217-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Accepted: 03/03/2011] [Indexed: 10/18/2022]
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30
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Mosiej E, Augustynowicz E, Zawadka M, Dąbrowski W, Lutyńska A. Strain variation among Bordetella pertussis isolates circulating in Poland after 50 years of whole-cell pertussis vaccine use. J Clin Microbiol 2011; 49:1452-7. [PMID: 21307213 PMCID: PMC3122874 DOI: 10.1128/jcm.01487-10] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Accepted: 02/01/2011] [Indexed: 11/20/2022] Open
Abstract
In the present study, clinical isolates of Bordetella pertussis collected in Poland from 1960 to 2005 were analyzed by pulsed-field gel electrophoresis (PFGE) according to protocols recommended in previous studies. Among the 110 isolates from 1995 to 2005, 59 PFGE patterns were found, most of which were different from those currently circulating in other European Union (EU) countries for which data are available. The PFGE patterns of currently disseminating B. pertussis clones were found within PFGE groups III and IV, as elsewhere in the EU, and in newly identified clusters A and C. Up to 70, 26, and 4%, respectively, of the currently isolated strains in Poland harbored ptxA1-prn1, ptxA1-prn2, and ptxA1-prn3 allele combinations, and most (82%) were found to be of the Fim2 phenotype. Differences in the extent of heterogeneity estimated by PFGE typing in B. pertussis populations circulating in Poland in comparison to other EU countries may be due to the different vaccine composition strategy, since routine pertussis vaccination was initiated in Poland in 1960.
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Affiliation(s)
- Ewa Mosiej
- Department of Sera and Vaccines Evaluation, National Institute of Public Health–National Institute of Hygiene, Warsaw, Poland
| | - Ewa Augustynowicz
- Department of Sera and Vaccines Evaluation, National Institute of Public Health–National Institute of Hygiene, Warsaw, Poland
| | - Monika Zawadka
- Department of Sera and Vaccines Evaluation, National Institute of Public Health–National Institute of Hygiene, Warsaw, Poland
| | - Waldemar Dąbrowski
- Department of Food Microbiology, West Pomeranian University, Szczecin, Poland
| | - Anna Lutyńska
- Department of Sera and Vaccines Evaluation, National Institute of Public Health–National Institute of Hygiene, Warsaw, Poland
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Studies on Prn variation in the mouse model and comparison with epidemiological data. PLoS One 2011; 6:e18014. [PMID: 21464955 PMCID: PMC3064647 DOI: 10.1371/journal.pone.0018014] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Accepted: 02/21/2011] [Indexed: 11/19/2022] Open
Abstract
The virulence factor pertactin (Prn) is a component of pertussis vaccines and one
of the most polymorphic Bordetella pertussis antigens. After
the introduction of vaccination shifts in predominant Prn types were observed
and strains with the Prn vaccine type (Prn1) were replaced by strains carrying
non-vaccine types (Prn2 and Prn3), suggesting vaccine-driven selection. The aim
of this study was to elucidate the shifts observed in Prn variants. We show
that, although Prn2 and Prn3 circulated in similar frequencies in the 1970s and
1980s, in the 1990s Prn2 strains expanded and Prn3 strains disappeared,
suggesting that in vaccinated populations Prn2 strains are fitter than Prn3
strains. We established a role for Prn in the mouse model by showing that a Prn
knock-out (Prn-ko) mutation reduced colonization in trachea and lungs.
Restoration of the mutation resulted in a significant increase in colonization
compared to the knock-out mutant. The ability of clinical isolates with
different Prn variants to colonize the mouse lung was compared. Although these
isolates were also polymorphic at other loci, only variation in the promoter for
pertussis toxin (ptxP) and Prn were found to contribute
significantly to differences in colonization. Analysis of a subset of strains
with the same ptxP allele revealed that the ability to colonize
mice decreased in the order Prn1>Prn2 and Prn3. Our results are consistent
with the predominance of Prn1 strains in unvaccinated populations. Our results
show that ability to colonize mice is practically the same for Prn2 and Prn3.
Therefore other factors may have contributed to the predominance of Prn2 in
vaccinated populations. The mouse model may be useful to assess and predict
changes in the B. pertussis population due to vaccination.
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Zhang L, Xu Y, Zhao J, Kallonen T, Cui S, Xu Y, Hou Q, Li F, Wang J, He Q, Zhang S. Effect of vaccination on Bordetella pertussis strains, China. Emerg Infect Dis 2011; 16:1695-701. [PMID: 21029526 PMCID: PMC3294513 DOI: 10.3201/eid1611.100401] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Strains in China may differ from those in countries that have long histories of high vaccination coverage. Whole-cell pertussis vaccine was introduced in China in the early 1960s. We used standard typing methods to compare 96 Bordetella pertussis isolates collected before and after introduction of vaccination, during 1953–2005. The following vaccine-type alleles of the pertussis toxin (ptx) gene were characteristic for all prevaccination strains: ptxA2, ptxA3, and ptxA4. The shift to ptxA1 occurred since 1963. All isolates collected since 1983 contained ptxA1. Pertactin (prn) allele 1, prn1, was predominant, although prn2 and prn3 have been detected since 2000. Serotypes fimbriae (Fim) 2 and Fim2,3 were found in all isolates collected before 1986. During 1997–2005, Fim3 became prevalent. Although changes in electrophoresis profiles over time were observed, the predominant profiles during 1997–2005 resembled those during the prevaccine era and those found in Europe before the 1990s. B. pertussis strains in China may differ from those in countries that have a long history of high vaccine coverage.
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Affiliation(s)
- Liu Zhang
- National Institute for the Control of Pharmaceutical and Biological Products, Beijing, People's Republic of China
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Synergic effect of genotype changes in pertussis toxin and pertactin on adaptation to an acellular pertussis vaccine in the murine intranasal challenge model. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2010; 17:807-12. [PMID: 20357056 DOI: 10.1128/cvi.00449-09] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The Bordetella pertussis pertussis toxin and pertactin (Prn) are protective antigens and are contained in acellular pertussis vaccines. Polymorphisms in the A subunit of pertussis toxin (PtxA) and pertactin have been proposed to mediate vaccine resistance and contribute to pertussis reemergence. To test this hypothesis, previous studies compared clinical isolates expressing different alleles for the proteins. However, other virulence factors or virulence factor expression levels also may vary, confounding the analysis. To overcome these limitations, we constructed isogenic mutants of B. pertussis Tohama expressing the alleles ptxA1 or ptxA2 and prn1 or prn2 and compared the efficacies of an acellular pertussis vaccine against the mutants in a mouse model. While the vaccine was effective against all of the B. pertussis strains regardless of the allele expression pattern, the strain expressing ptxA1 and prn2 displayed a survival advantage over the other strains. These results suggest that an allele shift to the ptxA1 prn2 genotype may play a role in the emergence of pertussis in vaccinated populations.
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Long GH, Karanikas AT, Harvill ET, Read AF, Hudson PJ. Acellular pertussis vaccination facilitates Bordetella parapertussis infection in a rodent model of bordetellosis. Proc Biol Sci 2010; 277:2017-25. [PMID: 20200027 DOI: 10.1098/rspb.2010.0010] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Despite over 50 years of population-wide vaccination, whooping cough incidence is on the rise. Although Bordetella pertussis is considered the main causative agent of whooping cough in humans, Bordetella parapertussis infections are not uncommon. The widely used acellular whooping cough vaccines (aP) are comprised solely of B. pertussis antigens that hold little or no efficacy against B. parapertussis. Here, we ask how aP vaccination affects competitive interactions between Bordetella species within co-infected rodent hosts and thus the aP-driven strength and direction of in-host selection. We show that aP vaccination helped clear B. pertussis but resulted in an approximately 40-fold increase in B. parapertussis lung colony-forming units (CFUs). Such vaccine-mediated facilitation of B. parapertussis did not arise as a result of competitive release; B. parapertussis CFUs were higher in aP-relative to sham-vaccinated hosts regardless of whether infections were single or mixed. Further, we show that aP vaccination impedes host immunity against B. parapertussis-measured as reduced lung inflammatory and neutrophil responses. Thus, we conclude that aP vaccination interferes with the optimal clearance of B. parapertussis and enhances the performance of this pathogen. Our data raise the possibility that widespread aP vaccination can create hosts more susceptible to B. parapertussis infection.
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Affiliation(s)
- Gráinne H Long
- Center for Infectious Disease Dynamics, Department of Biology, The Pennsylvania State University, University Park, PA 16802, USA.
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King AJ, van Gorkom T, van der Heide HGJ, Advani A, van der Lee S. Changes in the genomic content of circulating Bordetella pertussis strains isolated from the Netherlands, Sweden, Japan and Australia: adaptive evolution or drift? BMC Genomics 2010; 11:64. [PMID: 20102608 PMCID: PMC2834637 DOI: 10.1186/1471-2164-11-64] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Accepted: 01/26/2010] [Indexed: 11/17/2022] Open
Abstract
Background Bordetella pertussis is the causative agent of human whooping cough (pertussis) and is particularly severe in infants. Despite worldwide vaccinations, whooping cough remains a public health problem. A significant increase in the incidence of whooping cough has been observed in many countries since the 1990s. Several reasons for the re-emergence of this highly contagious disease have been suggested. A particularly intriguing possibility is based on evidence indicating that pathogen adaptation may play a role in this process. In an attempt to gain insight into the genomic make-up of B. pertussis over the last 60 years, we used an oligonucleotide DNA microarray to compare the genomic contents of a collection of 171 strains of B. pertussis isolates from different countries. Results The CGH microarray analysis estimated the core genome of B. pertussis, to consist of 3,281 CDSs that are conserved among all B. pertussis strains, and represent 84.8% of all CDSs found in the 171 B. pertussis strains. A total of 64 regions of difference consisting of one or more contiguous CDSs were identified among the variable genes. CGH data also revealed that the genome size of B. pertussis strains is decreasing progressively over the past 60 years. Phylogenetic analysis of microarray data generated a minimum spanning tree that depicted the phylogenetic structure of the strains. B. pertussis strains with the same gene content were found in several different countries. However, geographic specificity of the B. pertussis strains was not observed. The gene content was determined to highly correlate with the ptxP-type of the strains. Conclusions An overview of genomic contents of a large collection of isolates from different countries allowed us to derive a core genome and a phylogenetic structure of B. pertussis. Our results show that B. pertussis is a dynamic organism that continues to evolve.
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Affiliation(s)
- Audrey J King
- Laboratory for Infectious Diseases and Screening (LIS) Centre for Infectious Disease Control, National Institute for Public Health and the Environment - RIVM - Netherlands, 3720 BA Bilthoven, The Netherlands.
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Dakic G, Kallonen T, Elomaa A, Pljesa T, Vignjevic-Krastavcevic M, He Q. Bordetella pertussis vaccine strains and circulating isolates in Serbia. Vaccine 2009; 28:1188-92. [PMID: 19945417 DOI: 10.1016/j.vaccine.2009.11.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Revised: 11/11/2009] [Accepted: 11/11/2009] [Indexed: 11/16/2022]
Abstract
In Serbia, whole cell pertussis vaccine was introduced in 1957. Current composition of the vaccine has been used since 1985 and contains four autochthonous strains of Bordetella pertussis isolated from 1957 to 1984. To monitor changes in bacterial population, 70 isolates collected from 1953 to 2000 were studied together with the vaccine strains. The methods included serotyping of fimbriae (Fim), genotyping of pertactin (prn) and pertussis toxin S1 subunit (ptxA), and pulsed-field gel electrophoresis analysis. Shift from ptxA2 to ptxA1 has been observed in isolates since the late of 1960s. All isolates from 1980 to 1984 harbored ptxA1. Re-appearance of the ptxA2 allele followed an addition of the two strains harboring ptxA1 in the vaccine in 1985. The allele prn1 was predominant among the Serbian isolates, though prn3 and prn11 have been detected since 1981 and 1984. The allele prn2 was found only in two strains isolated in 2000. Serotype Fim2.3 disappeared before 1980 and serotype Fim2 became predominant since then. The Serbian vaccine strains showed differences in ptxA and prn. The results of this present study indicate that the B. pertussis population in Serbia is different from other vaccinated populations and that this difference may be related to the vaccine used.
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Affiliation(s)
- Gordana Dakic
- Institute of Virology, Vaccine and Sera Torlak, Belgrade, Serbia
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Mooi FR. Bordetella pertussis and vaccination: the persistence of a genetically monomorphic pathogen. INFECTION GENETICS AND EVOLUTION 2009; 10:36-49. [PMID: 19879977 DOI: 10.1016/j.meegid.2009.10.007] [Citation(s) in RCA: 135] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2009] [Revised: 10/11/2009] [Accepted: 10/20/2009] [Indexed: 01/08/2023]
Abstract
Before childhood vaccination was introduced in the 1950s, pertussis or whooping cough was a major cause of infant death worldwide. Widespread vaccination of children was successful in significantly reducing morbidity and mortality. However, despite vaccination, pertussis has persisted and, in the 1990s, resurged in a number of countries with highly vaccinated populations. Indeed, pertussis has become the most prevalent vaccine-preventable disease in developed countries with estimated infection frequencies of 1-6%. Recently vaccinated children are well protected against pertussis disease and its increase is mainly seen in adolescents and adults in which disease symptoms are often mild. The etiologic agent of pertussis, Bordetella pertussis, is extremely monomorphic and its ability to persist in the face of intensive vaccination is intriguing. Numerous studies have shown that B. pertussis populations changed after the introduction of vaccination suggesting adaptation. These adaptations did not involve the acquisition of novel genes but small genetic changes, mainly SNPs, and occurred in successive steps in a period of 40 years. The earliest adaptations resulted in antigenic divergence with vaccine strains. More recently, strains emerged with increased pertussis toxin (Ptx) production. Here I argue that the resurgence of pertussis is the compound effect of pathogen adaptation and waning immunity. I propose that the removal by vaccination of naïve infants as the major source for transmission was the crucial event which has driven the changes in B. pertussis populations. This has selected for strains which are more efficiently transmitted by primed hosts in which immunity has waned. The adaptation of B. pertussis to primed hosts involved delaying an effective immune response by antigenic divergence with vaccine strains and by increasing immune suppression through higher levels of Ptx production. Higher levels of Ptx may also benefit transmission by enhancing clinical symptoms. The study of B. pertussis populations has not only increased our understanding of pathogen evolution, but also suggests way to improve pertussis vaccines, underlining the public health significance of population-based studies of pathogens.
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Affiliation(s)
- Frits R Mooi
- Lab for Infectious Diseases and Screening, Netherlands Centre for Infectious Diseases Control, Natl Institute for Public Health and the Environment, RIVM, PO Box 1, 3720 BA Bilthoven, Netherlands.
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Pertussis before and after the introduction of acellular pertussis vaccines in Finland. Vaccine 2009; 27:5443-9. [DOI: 10.1016/j.vaccine.2009.07.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2009] [Revised: 07/01/2009] [Accepted: 07/06/2009] [Indexed: 11/18/2022]
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Analysis of Swedish Bordetella pertussis isolates with three typing methods: characterization of an epidemic lineage. J Microbiol Methods 2009; 78:297-301. [PMID: 19577594 DOI: 10.1016/j.mimet.2009.06.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Revised: 06/23/2009] [Accepted: 06/24/2009] [Indexed: 11/24/2022]
Abstract
Three Bordetella pertussis typing methods, pulsed-field gel electrophoresis (PFGE), multi-locus sequence typing (MLST), and multi-locus variable number tandem repeat analysis (MLVA) were compared using a collection of Swedish strains. Of the three typing methods used, PFGE was found to be the most discriminatory. MLVA and MLST were less discriminatory, but may be valuable for strain discrimination when culture is not possible as they are based on PCR. The combination of MLVA/MLST was found to be equally discriminatory as PFGE and should therefore also be considered. The relationship between predominant lineages in Sweden and The Netherlands, characterized by the PFGE type BpSR11 and the allele for the pertussis toxin promoter ptxP3, respectively, was investigated. Linkage was found between the PFGE type BpSR11 and ptxP3 in that all BpSR11 strains carried ptxP3. On the other hand ptxP3 was found in several other PFGE-types. The presence of the ptxP3 allele in different genetic backgrounds may indicate horizontal gene transfer within B. pertussis or homoplasy. Alternatively, this observation may be due to convergence of PFGE types.
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Changes in genetic diversity of the Bordetella pertussis population in the United Kingdom between 1920 and 2006 reflect vaccination coverage and emergence of a single dominant clonal type. J Clin Microbiol 2009; 47:680-8. [PMID: 19158267 DOI: 10.1128/jcm.01838-08] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Pertussis (whooping cough) is a potentially fatal respiratory disease caused by the bacterium Bordetella pertussis. Despite effective vaccination programs, there has been concern in some developed countries that pertussis cases are on the increase. We characterized 703 clinical B. pertussis isolates collected in the United Kingdom between 1920 and 2006 using multilocus variable-number tandem repeat analysis (MLVA), pertactin (prnA) and pertussis toxin (ptxA) genotyping, and serotyping. The results showed that the genetic diversity of the bacterial population decreased during periods of high vaccine coverage. However, it was elevated between 1977 and 1986, when vaccine coverage in the United Kingdom was low and epidemics occurred. A high proportion of MLVA types during this epidemic period were novel, and the prnA(2) and prnA(3) alleles were seen for the first time in the United Kingdom. MLVA-27 appeared in 1982, was codominant during the 1998-to-2001 period, and comprised approximately 70% of isolates during both the 2002-to-2004 and the 2005-to-2006 periods. The United Kingdom is dominated currently by an MLVA-27 prnA(2) ptxA(1) serotype Fim3 clonal type. Even during recent periods dominated by MLVA-27, many novel types were found at low frequencies, suggesting that either there are a large number of uncommon MLVA types circulating at low frequencies or new types are constantly arising. This supports a hypothesis that MLVA-27 is under some form of positive selection conferring increased survival in a highly vaccinated population. There has been no significant change to the bacterial population in the first 2 years since the United Kingdom switched from a whole-cell to an acellular vaccine.
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Heikkinen E, Xing DK, Olander RM, Hytönen J, Viljanen MK, Mertsola J, He Q. Bordetella pertussis isolates in Finland: serotype and fimbrial expression. BMC Microbiol 2008; 8:162. [PMID: 18816412 PMCID: PMC2562373 DOI: 10.1186/1471-2180-8-162] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2008] [Accepted: 09/25/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bordetella pertussis causes whooping cough or pertussis in humans. It produces several virulence factors, of which the fimbriae are considered adhesins and elicit immune responses in the host. B. pertussis has three distinct serotypes Fim2, Fim3 or Fim2,3. Generally, B. pertussis Fim2 strains predominate in unvaccinated populations, whereas Fim3 strains are often isolated in vaccinated populations. In Finland, pertussis vaccination was introduced in 1952. The whole-cell vaccine contained two strains, 18530 (Fim3) since 1962 and strain 1772 (Fim2,3) added in 1976. After that the vaccine has remained the same until 2005 when the whole-cell vaccine was replaced by the acellular vaccine containing pertussis toxin and filamentous hemagglutinin. Our aims were to study serotypes of Finnish B. pertussis isolates from 1974 to 2006 in a population with > 90% vaccination coverage and fimbrial expression of the isolates during infection. Serotyping was done by agglutination and serotype-specific antibody responses were determined by blocking ELISA. RESULTS Altogether, 1,109 isolates were serotyped. Before 1976, serotype distributions of Fim2, Fim3 and Fim2,3 were 67%, 19% and 10%, respectively. From 1976 to 1998, 94% of the isolates were Fim2 serotype. Since 1999, the frequency of Fim3 strains started to increase and reached 83% during a nationwide epidemic in 2003. A significant increase in level of serum IgG antibodies against purified fimbriae was observed between paired sera of 37 patients. The patients infected by Fim3 strains had antibodies which blocked the binding of monoclonal antibodies to Fim3 but not to Fim2. Moreover, about one third of the Fim2 strain infected patients developed antibodies capable of blocking of binding of both anti-Fim2 and Fim3 monoclonal antibodies. CONCLUSION Despite extensive vaccinations in Finland, B. pertussis Fim2 strains were the most common serotype. Emergence of Fim3 strains started in 1999 and coincided with nationwide epidemics. Results of serotype-specific antibody responses suggest that Fim2 strains could express Fim3 during infection, showing a difference in fimbrial expression between in vivo and in vitro.
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Affiliation(s)
- Eriikka Heikkinen
- Pertussis Reference Laboratory, National Public Health Institute, Kiinamyllynkatu 13, 20520 Turku, Finland.
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Abstract
Despite extensive immunization, the disease pertussis remains one of the world’s leading causes of vaccine-preventable deaths. An estimated 50 million cases and 300,000 deaths occur every year. A resurgence of pertussis is observed in highly immunized populations. Increasing numbers of pertussis are reported in adolescents and adults who transmit bacteria to newborns and infants to whom pertussis may be a life-threatening disease. Many studies have shown that the causes for the resurgence are multiple, such as increased awareness of disease, use of better diagnostic tools, improved surveillance methods and waning vaccine-induced immunity. Recently, antigenic divergence has been found between vaccine strains and clinical isolates in many countries with high vaccination coverage. Here, we summarize these findings and discuss the factors contributing to pertussis resurgence in immunized populations.
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Affiliation(s)
- Qiushui He
- Pertussis Reference Laboratory, National Public Health Institute, Kiinamyllynkatu 13, 20520 Turku, Finland
| | - Jussi Mertsola
- Department of Pediatrics, Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland
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André P, Caro V, Njamkepo E, Wendelboe AM, Van Rie A, Guiso N. Comparison of serological and real-time PCR assays to diagnose Bordetella pertussis infection in 2007. J Clin Microbiol 2008; 46:1672-7. [PMID: 18367565 PMCID: PMC2395107 DOI: 10.1128/jcm.02187-07] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2007] [Revised: 12/17/2007] [Accepted: 03/18/2008] [Indexed: 11/20/2022] Open
Abstract
Bacterial culture for diagnosing pertussis infection has high specificity but poor sensitivity and is slow. Highly sensitive real-time PCR assays and single-serum pertussis serology have been developed to overcome these limitations, but there are few data available on the relative sensitivities and specificities of such assays for pertussis diagnosis. Using data on 195 participants (>or=7 years old) from an epidemiological study, we assessed the sensitivity, specificity, and performance (Youden index) for pertussis diagnosis of the pertussis toxin enzyme-linked immunosorbent assay (using single and paired serology) and of real-time PCR assays (using the IS481 and ptxA-Pr targets). All available diagnostic information (clinical and laboratory) was pooled to serve as the gold standard. Single serology was the most efficient diagnostic test (Youden index, 0.57 to 0.58), with relatively high sensitivity (>64%) and high specificity (>90%), independent of the cutoff level. IS481 PCR performance was superior to that of ptxA-Pr PCR, and it was the second-most-efficient tool (Youden index, 0.30). Performing both ptxA-Pr and IS481 PCRs did not improve diagnostic performance. The greatest test efficiency (Youden index, 0.69 to 0.74) was achieved when single-serum serology was used in combination with IS481 or ptxA-Pr PCR or paired serology. Combining single serology with one PCR or paired serology increased the sensitivity with an associated limited decrease in specificity. The most specific tests for diagnosis of pertussis were single serology and ptxA-Pr PCR, and the most sensitive diagnostic tool was the combination of IS481 PCR with single serology.
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Affiliation(s)
- Philippe André
- Sanofi Pasteur, 2 Avenue Pont Pasteur, 69367 Lyon Cedex 07, France
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Heikkinen E, Kallonen T, Saarinen L, Sara R, King AJ, Mooi FR, Soini JT, Mertsola J, He Q. Comparative genomics of Bordetella pertussis reveals progressive gene loss in Finnish strains. PLoS One 2007; 2:e904. [PMID: 17878939 PMCID: PMC1975675 DOI: 10.1371/journal.pone.0000904] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2007] [Accepted: 08/23/2007] [Indexed: 11/18/2022] Open
Abstract
Background Bordetella pertussis is a Gram-negative bacterium that infects the human respiratory tract and causes pertussis or whooping cough. The disease has resurged in many countries including Finland where the whole-cell pertussis vaccine has been used for more than 50 years. Antigenic divergence has been observed between vaccine strains and clinical isolates in Finland. To better understand genome evolution in B. pertussis circulating in the immunized population, we developed an oligonucleotide-based microarray for comparative genomic analysis of Finnish strains isolated during the period of 50 years. Methodology/Principal Findings The microarray consisted of 3,582 oligonucleotides (70-mer) and covered 94% of 3,816 ORFs of Tohama I, the strain of which the genome has been sequenced [1]. Twenty isolates from 1953 to 2004 were studied together with two Finnish vaccine strains and two international reference strains. The isolates were selected according to their characteristics, e.g. the year and place of isolation and pulsed-field gel electrophoresis profiles. Genomic DNA of the tested strains, along with reference DNA of Tohama I strain, was labelled and hybridized. The absence of genes as established with microarrays, was confirmed by PCR. Compared with the Tohama I strain, Finnish isolates lost 7 (8.6 kb) to 49 (55.3 kb) genes, clustered in one to four distinct loci. The number of lost genes increased with time, and one third of lost genes had functions related to inorganic ion transport and metabolism, or energy production and conversion. All four loci of lost genes were flanked by the insertion sequence element IS481. Conclusion/Significance Our results showed that the progressive gene loss occurred in Finnish B. pertussis strains isolated during a period of 50 years and confirmed that B. pertussis is dynamic and is continuously evolving, suggesting that the bacterium may use gene loss as one strategy to adapt to highly immunized populations.
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Affiliation(s)
- Eriikka Heikkinen
- Pertussis Reference Laboratory, National Public Health Institute, Turku, Finland
| | - Teemu Kallonen
- Pertussis Reference Laboratory, National Public Health Institute, Turku, Finland
- Turku Graduate School of Biomedical Sciences, University of Turku, Turku, Finland
| | - Lilli Saarinen
- Finnish DNA Microarray Centre, Turku Centre for Biotechnology, University of Turku, Åbo Akademi University, Turku, Finland
| | - Rolf Sara
- Finnish DNA Microarray Centre, Turku Centre for Biotechnology, University of Turku, Åbo Akademi University, Turku, Finland
| | - Audrey J. King
- Laboratory for Infectious Diseases and Screening, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | - Frits R. Mooi
- Laboratory for Infectious Diseases and Screening, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | - Juhani T. Soini
- Finnish DNA Microarray Centre, Turku Centre for Biotechnology, University of Turku, Åbo Akademi University, Turku, Finland
| | - Jussi Mertsola
- Department of Pediatrics, Turku University Hospital, Turku, Finland
| | - Qiushui He
- Pertussis Reference Laboratory, National Public Health Institute, Turku, Finland
- * To whom correspondence should be addressed. E-mail:
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Bottero D, Gaillard ME, Fingermann M, Weltman G, Fernández J, Sisti F, Graieb A, Roberts R, Rico O, Ríos G, Regueira M, Binsztein N, Hozbor D. Pulsed-field gel electrophoresis, pertactin, pertussis toxin S1 subunit polymorphisms, and surfaceome analysis of vaccine and clinical Bordetella pertussis strains. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2007; 14:1490-8. [PMID: 17699837 PMCID: PMC2168178 DOI: 10.1128/cvi.00177-07] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
To add new insight to our previous work on the molecular epidemiology of Bordetella pertussis in Argentina, the prn and ptxS1 gene sequences and pulsed-field gel electrophoresis (PFGE) profiles of 57 clinical isolates obtained during two periods, 1969 to 1989 and 1997 to 2006, were analyzed. Non-vaccine-type ptxS1A was detected in isolates obtained since 1969. From 1989 on, a shift of predominance from the vaccine prn1 type to the nonvaccine prn2 type was observed. This was also reflected in a transition of PFGE group IV to group VI. These results show that nonvaccine B. pertussis strains are currently circulating. To analyze whether the observed genomic divergences between vaccine strains and clinical isolates have functional implications, protection assays using the intranasal mouse challenge model were performed. For such experiments, the clinical isolate B. pertussis 106 was selected as representative of circulating bacteria, since it came from the major group of the PFGE dendrogram (PFGE group VI). Groups of mice were immunized either with diphtheria-tetanus-whole-cell pertussis vaccine (ptxS1B prn1) or a vaccine prepared by us containing B. pertussis 106. Immunized mice were then challenged with a B. pertussis vaccine strain (Tohama, harboring ptxS1B and prn1) or the clinical isolate B. pertussis 106 (ptxS1A prn2). An adequate bacterial-elimination rate was observed only when mice were immunized and challenged with the same kind of strain. For further characterization, comparative proteomic profiling of enriched membrane proteins was done using three vaccine strains and the selected B. pertussis 106 clinical isolate. By matrix-assisted laser desorption ionization-time of flight mass spectrometry analysis, a total of 54 proteins were identified. This methodology allowed us to detect differing proteins among the four strains studied and, in particular, to distinguish the three vaccine strains from each other, as well as the vaccine strains from the clinical isolate. The differing proteins observed have cellular roles associated with amino acid and carbohydrate transport and metabolism. Some of them have been proposed as novel vaccine candidate proteins for other pathogens. Overall, the global strategy described here is presented as a good tool for the development of next-generation acellular vaccines.
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Affiliation(s)
- Daniela Bottero
- Instituto de Bioquímica y Biología Molecular, Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, Calles 47 y 115 (1900), La Plata, República Argentina
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Gagneux S, Small PM. Global phylogeography of Mycobacterium tuberculosis and implications for tuberculosis product development. THE LANCET. INFECTIOUS DISEASES 2007; 7:328-37. [PMID: 17448936 DOI: 10.1016/s1473-3099(07)70108-1] [Citation(s) in RCA: 509] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
New tools for controlling tuberculosis are urgently needed. Despite our emerging understanding of the biogeography of Mycobacterium tuberculosis, the implications for development of new diagnostics, drugs, and vaccines is unknown. M tuberculosis has a clonal genetic population structure that is geographically constrained. Evidence suggests strain-specific differences in virulence and immunogenicity in light of this global phylogeography. We propose a strain selection framework, based on robust phylogenetic markers, which will allow for systematic and comprehensive evaluation of new tools for tuberculosis control.
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Phase variation and microevolution at homopolymeric tracts in Bordetella pertussis. BMC Genomics 2007; 8:122. [PMID: 17509142 PMCID: PMC1891110 DOI: 10.1186/1471-2164-8-122] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2006] [Accepted: 05/17/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bordetella pertussis, the causative agent of whooping cough, is a highly clonal pathogen of the respiratory tract. Its lack of genetic diversity, relative to many bacterial pathogens, could limit its ability to adapt to a hostile and changing host environment. This limitation might be overcome by phase variation, as observed for other mucosal pathogens. One of the most common mechanisms of phase variation is reversible expansion or contraction of homopolymeric tracts (HPTs). RESULTS The genomes of B. pertussis and the two closely related species, B. bronchiseptica and B. parapertussis, were screened for homopolymeric tracts longer than expected on the basis of chance, given their nucleotide compositions. Sixty-nine such HPTs were found in total among the three genomes, 74% of which were polymorphic among the three species. Nine HPTs were genotyped in a collection of 90 geographically and temporally diverse B. pertussis strains using the polymerase chain reaction/ligase detection reaction (PCR/LDR) assay. Six HPTs were polymorphic in this collection of B. pertussis strains. Of note, one of these polymorphic HPTs was found in the fimX promoter, where a single base insertion variant was present in seven strains, all of which were isolated prior to introduction of the pertussis vaccine. Transcript abundance of fimX was found to be 3.8-fold lower in strains carrying the longer allele. HPTs in three other genes, tcfA, bapC, and BP3651, varied widely in composition across the strain collection and displayed allelic polymorphism within single cultures. CONCLUSION Allelic polymorphism at homopolymeric tracts is common within the B. pertussis genome. Phase variability may be an important mechanism in B. pertussis for evasion of the immune system and adaptation to different niches in the human host. High sensitivity and specificity make the PCR/LDR assay a powerful tool for investigating allelic variation at HPTs. Using this method, allelic diversity and phase variation were demonstrated at several B. pertussis loci.
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Caro V, Bouchez V, Guiso N, Gatti B, Agosti MR, Ayala SEG. Pertussis in Argentina and France. Vaccine 2007; 25:4335-9. [PMID: 17229502 DOI: 10.1016/j.vaccine.2006.08.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2006] [Revised: 08/11/2006] [Accepted: 08/16/2006] [Indexed: 10/24/2022]
Abstract
We have studied the epidemiology of pertussis in two countries, Argentina and France, which have similar histories of long-term mass vaccination with a whole-cell vaccine. Both countries display a comparable epidemiology, with an increase of the incidence of the disease in non-vaccinated newborns. We used pulsed-field gel electrophoresis (PFGE) analysis and genotyping to compare Bordetella pertussis clinical isolates recovered in Argentina and France in 2001-2004. The majority of the isolates harbors prn2 allele and belongs to PFGE IVbeta group. Isolates were found to be very similar genetically suggesting a common evolution of the disease in these two countries using the same vaccine.
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Abstract
Vaccines exert strong selective pressures on pathogens, favouring the spread of antigenic variants. We propose a simple mathematical model to investigate the dynamics of a novel pathogenic strain that emerges in a population where a previous strain is maintained at low endemic level by a vaccine. We compare three methods to assess the ability of the novel strain to invade and persist: algebraic rate of invasion; deterministic dynamics; and stochastic dynamics. These three techniques provide complementary predictions on the fate of the system. In particular, we emphasize the importance of stochastic simulations, which account for the possibility of extinctions of either strain. More specifically, our model suggests that the probability of persistence of an invasive strain (i) can be minimized for intermediate levels of vaccine cross-protection (i.e. immune protection against the novel strain) and (ii) is lower if cross-immunity acts through a reduced infectious period rather than through reduced susceptibility.
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Affiliation(s)
- Olivier Restif
- Department of Veterinary Medicine, University of Cambridge, Cambridge Infectious Diseases Consortium, Madingley Road, Cambridge CB3 0ES, UK.
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Elomaa A, Advani A, Donnelly D, Antila M, Mertsola J, He Q, Hallander H. Population dynamics of Bordetella pertussis in Finland and Sweden, neighbouring countries with different vaccination histories. Vaccine 2006; 25:918-26. [PMID: 17030495 DOI: 10.1016/j.vaccine.2006.09.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2005] [Revised: 04/25/2006] [Accepted: 09/04/2006] [Indexed: 10/24/2022]
Abstract
Pertussis is an infectious disease of the respiratory tract in humans caused by Bordetella pertussis. Despite extensive vaccinations, pertussis has remained endemic and re-emerged. In Finland, a whole-cell pertussis vaccine has been used since 1952 with high coverage. In Sweden, whole-cell vaccinations were introduced in 1953 but ceased in 1979, and pertussis vaccinations with acellular vaccines were introduced in 1996. Two epidemic peaks occurred in Sweden in 1999 and 2002 and in Finland in 1999 and 2003. We compared Finnish (N=193) and Swedish (N=455) B. pertussis isolates circulating in 1998-2003 together with vaccine strains used in these neighbouring countries with different vaccination histories. The isolates were analysed by serotyping, genotyping of pertussis toxin S1 subunit and pertactin, and pulsed-field gel electrophoresis. The results suggest that the sequential epidemics were caused by clonal expansion of a certain B. pertussis strain possibly transmitted from Sweden to Finland. The roles of antigenic variation in immunity-driven evolution of B. pertussis in both countries are discussed.
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Affiliation(s)
- Annika Elomaa
- Pertussis Reference Laboratory, National Public Health Institute, Turku, Finland.
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