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Sedney CJ, Harvill ET. The Neonatal Immune System and Respiratory Pathogens. Microorganisms 2023; 11:1597. [PMID: 37375099 PMCID: PMC10301501 DOI: 10.3390/microorganisms11061597] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/02/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Neonates are more susceptible to some pathogens, particularly those that cause infection in the respiratory tract. This is often attributed to an incompletely developed immune system, but recent work demonstrates effective neonatal immune responses to some infection. The emerging view is that neonates have a distinctly different immune response that is well-adapted to deal with unique immunological challenges of the transition from a relatively sterile uterus to a microbe-rich world, tending to suppress potentially dangerous inflammatory responses. Problematically, few animal models allow a mechanistic examination of the roles and effects of various immune functions in this critical transition period. This limits our understanding of neonatal immunity, and therefore our ability to rationally design and develop vaccines and therapeutics to best protect newborns. This review summarizes what is known of the neonatal immune system, focusing on protection against respiratory pathogens and describes challenges of various animal models. Highlighting recent advances in the mouse model, we identify knowledge gaps to be addressed.
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Affiliation(s)
| | - Eric T. Harvill
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA;
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2
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Jiang F, Tang N, Gao Y, Feng J, Wang Y, Qu B. Knowledge and Willingness toward Vaccination among Pregnant Women: Comparison between Pertussis and Influenza. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14082. [PMID: 36360959 PMCID: PMC9658401 DOI: 10.3390/ijerph192114082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/24/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Our study sought to characterize the knowledge and willingness levels regarding vaccinations against pertussis and seasonal influenza (influenza) among pregnant women in Guizhou province, China, which have previously been unclear. METHODS In total, 11 hospitals that carried out obstetrics and antenatal examination services were randomly included in the target organizations, and 564 questionnaires completed by the pregnant women were collected and analyzed in Guizhou province. The questionnaires contained questions addressing awareness and knowledge of pertussis and influenza, willingness to be vaccinated at different life stages, and the basic statuses of subjects. A two-paired McNemar test was used to compare the knowledge levels on pertussis and influenza. A Friedman test was used to compare the willingness to be vaccinated at different life stages. To explore the factors influencing knowledge levels, a chi-square test and binary logistic regression were used with stepwise backward regression. RESULTS In total, 11.9 percent of the pregnant women had received influenza vaccines in the year prior to their pregnancy in Guizhou province. The pregnant women had poorer knowledge of pertussis than of influenza. Given a vaccine was available, the willingness of pregnant women to partake in the following vaccination-related actions could be ranked, from highest to lowest: free vaccination of babies, recommend vaccination to family members, postpartum vaccination, vaccination of babies at mothers' expense, and vaccination during pregnancy. Knowledge levels played different roles in the women's willingness to receive vaccinations at different life stages. Common knowledge of pertussis and influenza played a limited role in the willingness to receive maternal vaccinations. Among the pregnant women, the factors influencing the low levels of pertussis knowledge were occupation as nonmedical-institution staff, lower educational level, pregnancy stage past the first trimester, and not bearing children; for influenza, the factors were occupation as nonmedical-institution staff, lower educational level, denial of pregnancy-induced disease, and lower monthly household income per capita. CONCLUSIONS Pregnant women have poorer levels of knowledge on pertussis than influenza, whereas there was no significant difference in their willingness to be vaccinated against these conditions. Health education on pertussis should be strengthened and we called for vaccines given at birth.
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Affiliation(s)
- Feng Jiang
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, China
| | - Ning Tang
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, China
| | - Yuanxue Gao
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, China
| | - Jun Feng
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, China
| | - Ying Wang
- School of Public Health, Fudan University, Shanghai 200032, China
| | - Bin Qu
- Zunyi Prefectural Center for Disease Control and Prevention, Zunyi 563000, China
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Dienstbier A, Amman F, Petráčková D, Štipl D, Čapek J, Zavadilová J, Fabiánová K, Držmíšek J, Kumar D, Wildung M, Pouchnik D, Večerek B. Comparative Omics Analysis of Historic and Recent Isolates of Bordetella pertussis and Effects of Genome Rearrangements on Evolution. Emerg Infect Dis 2021; 27:57-68. [PMID: 33350934 PMCID: PMC7774529 DOI: 10.3201/eid2701.191541] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Despite high vaccination coverage, pertussis is increasing in many industrialized countries, including the Czech Republic. To better understand Bordetella pertussis resurgence, we analyzed historic strains and recent clinical isolates by using a comparative omics approach. Whole-genome sequencing showed that historic and recent isolates of B. pertussis have substantial variation in genome organization and form separate phylogenetic clusters. Subsequent RNA sequence analysis and liquid chromatography with mass tandem spectrometry analyses showed that these variations translated into discretely separated transcriptomic and proteomic profiles. When compared with historic strains, recent isolates showed increased expression of flagellar genes and genes involved in lipopolysaccharide biosynthesis and decreased expression of polysaccharide capsule genes. Compared with reference strain Tohama I, all strains had increased expression and production of the type III secretion system apparatus. We detected the potential link between observed effects and insertion sequence element–induced changes in gene context only for a few genes.
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Petráčková D, Farman MR, Amman F, Linhartová I, Dienstbier A, Kumar D, Držmíšek J, Hofacker I, Rodriguez ME, Večerek B. Transcriptional profiling of human macrophages during infection with Bordetella pertussis. RNA Biol 2020; 17:731-742. [PMID: 32070192 PMCID: PMC7237194 DOI: 10.1080/15476286.2020.1727694] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 02/01/2020] [Accepted: 12/12/2019] [Indexed: 12/14/2022] Open
Abstract
Bordetella pertussis, a strictly human re-emerging pathogen and the causative agent of whooping cough, exploits a broad variety of virulence factors to establish efficient infection. Here, we used RNA sequencing to analyse the changes in gene expression profiles of human THP-1 macrophages resulting from B. pertussis infection. In parallel, we attempted to determine the changes in intracellular B. pertussis-specific transcriptomic profiles resulting from interaction with macrophages. Our analysis revealed that global gene expression profiles in THP-1 macrophages are extensively rewired 6 h post-infection. Among the highly expressed genes, we identified those encoding cytokines, chemokines, and transcription regulators involved in the induction of the M1 and M2 macrophage polarization programmes. Notably, several host genes involved in the control of apoptosis and inflammation which are known to be hijacked by intracellular bacterial pathogens were overexpressed upon infection. Furthermore, in silico analyses identified large temporal changes in expression of specific gene subsets involved in signalling and metabolic pathways. Despite limited numbers of the bacterial reads, we observed reduced expression of majority of virulence factors and upregulation of several transcriptional regulators during infection suggesting that intracellular B. pertussis cells switch from virulent to avirulent phase and actively adapt to intracellular environment, respectively.
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Affiliation(s)
- Denisa Petráčková
- Institute of Microbiology of the Czech Academy of Sciences, Laboratory of Post-transcriptional Control of Gene Expression, Prague, Czech Republic
| | - Mariam R. Farman
- Institute for Theoretical Chemistry, University of Vienna, Vienna, Austria
| | - Fabian Amman
- Institute for Theoretical Chemistry, University of Vienna, Vienna, Austria
- Division of Cell and Developmental Biology, Medical University of Vienna, Vienna, Austria
| | - Irena Linhartová
- Institute of Microbiology of the Czech Academy of Sciences, Laboratory of Molecular Biology of Bacterial Pathogens, Prague, Czech Republic
| | - Ana Dienstbier
- Institute of Microbiology of the Czech Academy of Sciences, Laboratory of Post-transcriptional Control of Gene Expression, Prague, Czech Republic
| | - Dilip Kumar
- Institute of Microbiology of the Czech Academy of Sciences, Laboratory of Post-transcriptional Control of Gene Expression, Prague, Czech Republic
| | - Jakub Držmíšek
- Institute of Microbiology of the Czech Academy of Sciences, Laboratory of Post-transcriptional Control of Gene Expression, Prague, Czech Republic
| | - Ivo Hofacker
- Institute for Theoretical Chemistry, University of Vienna, Vienna, Austria
- Faculty of Computer Science, Research Group Bioinformatics and Computational Biology, University of Vienna, Vienna, Austria
| | - Maria Eugenia Rodriguez
- Facultad de Ciencias Exactas, Universidad Nacional de La Plata, CINDEFI (UNLP CONICET La Plata), La Plata, Argentina
| | - Branislav Večerek
- Institute of Microbiology of the Czech Academy of Sciences, Laboratory of Post-transcriptional Control of Gene Expression, Prague, Czech Republic
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5
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McGirr A, Fisman DN, Tuite AR. The health and economic burden of pertussis in Canada: A microsimulation study. Vaccine 2019; 37:7240-7247. [PMID: 31585727 DOI: 10.1016/j.vaccine.2019.09.070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 09/18/2019] [Accepted: 09/20/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Despite excellent vaccine coverage, pertussis persists in Canada, with high incidence during recent outbreaks and non-negligible incidence in non-outbreak years. While Canadian pertussis incidence is well-characterized, the full health and economic impact of pertussis have not been examined in Canada. We estimated age-specific life years (LYs) and quality-adjusted life years (QALYs) lost, and costs due to pertussis in Ontario, Canada, using a model-based approach. METHODS We developed a microsimulation model to simulate pertussis natural history. Daily probabilities of pertussis complications, hospitalizations, and disease sequelae as well as utilities and costs for health states were literature-derived. A healthcare payer perspective was used with a lifetime time horizon. Model outcomes were compared to those from a model with no pertussis health states. Probabilistic sensitivity analyses were used to generate distributions for estimates. Economic burden was estimated by multiplying case cost estimates by annual age-specific incidence. RESULTS Overall, LYs lost per pertussis case was low, with negligible LYs lost in those aged >4 years. Infants (<6 months) had the greatest mean QALY loss per case (0.58), while adults lost only 0.05 QALYs per case. Infants experienced the greatest mean cost per case of $22,768 (95% CI: 21,144-23,406). Case costs generally declined with age, but increased in seniors (aged 65+) with mean cost of $1920 (95% CI: 1800-2033). Based on historic age-specific incidence, pertussis costs the Ontario healthcare system approximately $7.6-$21.5 M annually. In total economic cost estimates with QALYs valued at 1xGDP (3xGDP) per capita, the net impact of pertussis in Ontario was estimated at $21.7-$66.5 M annually ($50.0-$156.3 M). For all of Canada, total economic costs were estimated at $79.6-$241.3 M ($187.5-$580.5 M) annually. CONCLUSION The health and economic consequences of pertussis persistence are substantial and highlight the need for improved control strategies.
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Affiliation(s)
- Ashleigh McGirr
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - David N Fisman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Ashleigh R Tuite
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Dienstbier A, Amman F, Štipl D, Petráčková D, Večerek B. Comparative Integrated Omics Analysis of the Hfq Regulon in Bordetella pertussis. Int J Mol Sci 2019; 20:ijms20123073. [PMID: 31238496 PMCID: PMC6627887 DOI: 10.3390/ijms20123073] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 06/19/2019] [Accepted: 06/19/2019] [Indexed: 12/21/2022] Open
Abstract
Bordetella pertussis is a Gram-negative strictly human pathogen of the respiratory tract and the etiological agent of whooping cough (pertussis). Previously, we have shown that RNA chaperone Hfq is required for virulence of B. pertussis. Furthermore, microarray analysis revealed that a large number of genes are affected by the lack of Hfq. This study represents the first attempt to characterize the Hfq regulon in bacterial pathogen using an integrative omics approach. Gene expression profiles were analyzed by RNA-seq and protein amounts in cell-associated and cell-free fractions were determined by LC-MS/MS technique. Comparative analysis of transcriptomic and proteomic data revealed solid correlation (r2 = 0.4) considering the role of Hfq in post-transcriptional control of gene expression. Importantly, our study confirms and further enlightens the role of Hfq in pathogenicity of B. pertussis as it shows that Δhfq strain displays strongly impaired secretion of substrates of Type III secretion system (T3SS) and substantially reduced resistance to serum killing. On the other hand, significantly increased production of proteins implicated in transport of important metabolites and essential nutrients observed in the mutant seems to compensate for the physiological defect introduced by the deletion of the hfq gene.
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Affiliation(s)
- Ana Dienstbier
- Institute of Microbiology v.v.i., Laboratory of post-transcriptional control of gene expression, 14220 Prague, Czech Republic.
| | - Fabian Amman
- University of Vienna, Institute for Theoretical Chemistry, Währinger Straße 17, A-1090 Vienna, Austria.
- Medical University of Vienna, Division of Cell and Developmental Biology, Schwarzspanierstraße 17, A-1090 Vienna, Austria.
| | - Daniel Štipl
- Institute of Microbiology v.v.i., Laboratory of post-transcriptional control of gene expression, 14220 Prague, Czech Republic.
| | - Denisa Petráčková
- Institute of Microbiology v.v.i., Laboratory of post-transcriptional control of gene expression, 14220 Prague, Czech Republic.
| | - Branislav Večerek
- Institute of Microbiology v.v.i., Laboratory of post-transcriptional control of gene expression, 14220 Prague, Czech Republic.
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Akinola F, Muloiwa R, Hussey GD, Dirix V, Kagina B, Amponsah-Dacosta E. Assessment of humoral and cell-mediated immune responses to pertussis vaccination: a systematic review protocol. BMJ Open 2019; 9:e028109. [PMID: 31182449 PMCID: PMC6561409 DOI: 10.1136/bmjopen-2018-028109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 04/23/2019] [Accepted: 05/17/2019] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Globally, some studies show a resurgence of pertussis. The risks and benefits of using whole-cell pertussis (wP) or acellular pertussis (aP) vaccines in the control of the disease have been widely debated. Better control of pertussis will require improved understanding of the immune response to pertussis vaccines. Improved understanding and assessment of the immunity induced by pertussis vaccines is thus imperative. Several studies have documented different immunological outcomes to pertussis vaccination from an array of assays. We propose to conduct a systematic review of the different immunological assays and outcomes used in the assessment of the humoraland cell-mediated immune response following pertussis vaccination. METHODS AND ANALYSIS The primary outcomes for consideration are quality and quantity of immune responses (humoral and cell-mediated) post-pertussis vaccination. Of interest as secondary outcomes are types of immunoassays used in assessing immune responses post-pertussis vaccination, types of biological samples used in assessing immune responses post-pertussis vaccination, as well as the types of antigens used to stimulate these samples during post-pertussis vaccination immune response assessments. Different electronic databases (including PubMed, Cochrane, EBSCO Host, Scopus and Web of Science) will be accessed for peer-reviewed published and grey literature evaluating immune responses to pertussis vaccines between 1990 and 2019. The quality of included articles will be assessed using standardised risk and quality assessment tools specific to the study design used in each article. Data extraction will be done using a data extraction form. The extracted data will be analysed using STATA V.14.0 and RevMan V.5.3 software. A subgroup analysis will be conducted based on the study population, type of vaccine (wP or aP) and type of immune response (cell-mediated or humoral). Guidelines for reporting systematic reviews in the revised 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement will be used in this study. ETHICS AND DISSEMINATION Ethics approval is not required for this study as it is a systematic review. We will only make use of data already available in the public space. Findings will be reported via publication in a peer-reviewed journal and presented at scientific meetings and workshops. TRIAL REGISTRATION NUMBER CRD42018102455.
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Affiliation(s)
- Funbi Akinola
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Vaccines for Africa Initiative, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Rudzani Muloiwa
- Vaccines for Africa Initiative, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Department of Paediatrics and Child Health, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Gregory D Hussey
- Vaccines for Africa Initiative, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Division of Medical Microbiology and Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Violette Dirix
- Laboratory of Vaccinology and Mucosal Immunity, Université Libre de Bruxelles, Brussels, Belgium
| | - Benjamin Kagina
- Vaccines for Africa Initiative, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Edina Amponsah-Dacosta
- Vaccines for Africa Initiative, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Keidel K, Amman F, Bibova I, Drzmisek J, Benes V, Hot D, Vecerek B. Signal transduction-dependent small regulatory RNA is involved in glutamate metabolism of the human pathogen Bordetella pertussis. RNA (NEW YORK, N.Y.) 2018; 24:1530-1541. [PMID: 30097543 PMCID: PMC6191719 DOI: 10.1261/rna.067306.118] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 08/01/2018] [Indexed: 06/08/2023]
Abstract
Bordetella pertussis is the causative agent of human whooping cough, a highly contagious respiratory disease which despite vaccination programs remains the major cause of infant morbidity and mortality. The requirement of the RNA chaperone Hfq for virulence of B. pertussis suggested that Hfq-dependent small regulatory RNAs are involved in the modulation of gene expression. High-throughput RNA sequencing revealed hundreds of putative noncoding RNAs including the RgtA sRNA. Abundance of RgtA is strongly decreased in the absence of the Hfq protein and its expression is modulated by the activities of the two-component regulatory system BvgAS and another response regulator RisA. Whereas RgtA levels were elevated under modulatory conditions or in the absence of bvg genes, deletion of the risA gene completely abolished RgtA expression. Profiling of the ΔrgtA mutant in the ΔbvgA genetic background identified the BP3831 gene encoding a periplasmic amino acid-binding protein of an ABC transporter as a possible target gene. The results of site-directed mutagenesis and in silico analysis indicate that RgtA base-pairs with the region upstream of the start codon of the BP3831 mRNA and thereby weakens the BP3831 protein production. Furthermore, our data suggest that the function of the BP3831 protein is related to transport of glutamate, an important metabolite in the B. pertussis physiology. We propose that the BvgAS/RisA interplay regulates the expression of RgtA which upon infection, when glutamate might be scarce, attenuates translation of the glutamate transporter and thereby assists in adaptation of the pathogen to other sources of energy.
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Affiliation(s)
- Kristina Keidel
- Institute of Microbiology v.v.i., Laboratory of post-transcriptional control of gene expression, 14220 Prague, Czech Republic
| | - Fabian Amman
- Institute for Theoretical Chemistry, University of Vienna, A-1090 Vienna, Austria
- Department of Chromosome Biology of the University of Vienna, A-1030 Vienna, Austria
| | - Ilona Bibova
- Institute of Microbiology v.v.i., Laboratory of post-transcriptional control of gene expression, 14220 Prague, Czech Republic
| | - Jakub Drzmisek
- Institute of Microbiology v.v.i., Laboratory of post-transcriptional control of gene expression, 14220 Prague, Czech Republic
| | - Vladimir Benes
- Genomics Core Facility, European Molecular Biology Laboratory, 69117 Heidelberg, Germany
| | - David Hot
- Université de Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR8204 - CIIL - Center for Infection and Immunity of Lille, F-59000 Lille, France
| | - Branislav Vecerek
- Institute of Microbiology v.v.i., Laboratory of post-transcriptional control of gene expression, 14220 Prague, Czech Republic
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9
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Dienstbier A, Pouchnik D, Wildung M, Amman F, Hofacker IL, Parkhill J, Holubova J, Sebo P, Vecerek B. Comparative genomics of Czech vaccine strains of Bordetella pertussis. Pathog Dis 2018; 76:5089975. [PMID: 30184175 DOI: 10.1093/femspd/fty071] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 08/30/2018] [Indexed: 11/13/2022] Open
Abstract
Bordetella pertussis is a strictly human pathogen causing the respiratory infectious disease called whooping cough or pertussis. B. pertussis adaptation to acellular pertussis vaccine pressure has been repeatedly highlighted, but recent data indicate that adaptation of circulating strains started already in the era of the whole cell pertussis vaccine (wP) use. We sequenced the genomes of five B. pertussis wP vaccine strains isolated in the former Czechoslovakia in the pre-wP (1954-1957) and early wP (1958-1965) eras, when only limited population travel into and out of the country was possible. Four isolates exhibit a similar genome organization and form a distinct phylogenetic cluster with a geographic signature. The fifth strain is rather distinct, both in genome organization and SNP-based phylogeny. Surprisingly, despite isolation of this strain before 1966, its closest sequenced relative appears to be a recent isolate from the US. On the genome content level, the five vaccine strains contained both new and already described regions of difference. One of the new regions contains duplicated genes potentially associated with transport across the membrane. The prevalence of this region in recent isolates indicates that its spread might be associated with selective advantage leading to increased strain fitness.
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Affiliation(s)
- Ana Dienstbier
- Institute of Microbiology v.v.i., Laboratory of post-transcriptional control of gene expression, 14220 Prague, Czech Republic
| | - Derek Pouchnik
- Laboratory for Biotechnology and Bioanalysis, Center for Reproductive Biology, Washington State University, Pullman, Washington 99164-7520
| | - Mark Wildung
- Laboratory for Biotechnology and Bioanalysis, Center for Reproductive Biology, Washington State University, Pullman, Washington 99164-7520
| | - Fabian Amman
- University of Vienna, Institute for Theoretical Chemistry, Währinger Straße 17, A-1090 Vienna, Austria
| | - Ivo L Hofacker
- University of Vienna, Institute for Theoretical Chemistry, Währinger Straße 17, A-1090 Vienna, Austria.,University of Vienna, Research group BCB, Faculty of Computer Science, Währinger Straße 24, 1090 Vienna, Austria
| | - Julian Parkhill
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, CB10 1SA Cambridge, UK
| | - Jana Holubova
- Institute of Microbiology v.v.i, Laboratory of molecular biology of bacterial pathogens, 14220 Prague, Czech Republic
| | - Peter Sebo
- Institute of Microbiology v.v.i, Laboratory of molecular biology of bacterial pathogens, 14220 Prague, Czech Republic
| | - Branislav Vecerek
- Institute of Microbiology v.v.i., Laboratory of post-transcriptional control of gene expression, 14220 Prague, Czech Republic
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10
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Bibova I, Hot D, Keidel K, Amman F, Slupek S, Cerny O, Gross R, Vecerek B. Transcriptional profiling of Bordetella pertussis reveals requirement of RNA chaperone Hfq for Type III secretion system functionality. RNA Biol 2015; 12:175-85. [PMID: 25674816 PMCID: PMC4615762 DOI: 10.1080/15476286.2015.1017237] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Bordetella pertussis, the causative agent of human whooping cough (pertussis) produces a complex array of virulence factors in order to establish efficient infection in the host. The RNA chaperone Hfq and small regulatory RNAs are key players in posttranscriptional regulation in bacteria and have been shown to play an essential role in virulence of a broad spectrum of bacterial pathogens. This study represents the first attempt to characterize the Hfq regulon of the human pathogen B. pertussis under laboratory conditions as well as upon passage in the host and indicates that loss of Hfq has a profound effect on gene expression in B. pertussis. Comparative transcriptional profiling revealed that Hfq is required for expression of several virulence factors in B. pertussis cells including the Type III secretion system (T3SS). In striking contrast to the wt strain, T3SS did not become operational in the hfq mutant passaged either through mice or macrophages thereby proving that Hfq is required for the functionality of the B. pertussis T3SS. Likewise, expression of virulence factors vag8 and tcfA encoding autotransporter and tracheal colonization factor, respectively, was strongly reduced in the hfq mutant. Importantly, for the first time we demonstrate that B. pertussis T3SS can be activated upon contact with macrophage cells in vitro.
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Affiliation(s)
- Ilona Bibova
- a Institute of Microbiology of the ASCR ; Prague , Czech Republic
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11
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Gambhir M, Clark TA, Cauchemez S, Tartof SY, Swerdlow DL, Ferguson NM. A change in vaccine efficacy and duration of protection explains recent rises in pertussis incidence in the United States. PLoS Comput Biol 2015; 11:e1004138. [PMID: 25906150 PMCID: PMC4408109 DOI: 10.1371/journal.pcbi.1004138] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 01/16/2015] [Indexed: 01/27/2023] Open
Abstract
Over the past ten years the incidence of pertussis in the United States (U.S.) has risen steadily, with 2012 seeing the highest case number since 1955. There has also been a shift over the same time period in the age group reporting the largest number of cases (aside from infants), from adolescents to 7–11 year olds. We use epidemiological modelling and a large case incidence dataset to explain the upsurge. We investigate several hypotheses for the upsurge in pertussis cases by fitting a suite of dynamic epidemiological models to incidence data from the National Notifiable Disease Surveillance System (NNDSS) between 1990–2009, as well as incidence data from a variety of sources from 1950–1989. We find that: the best-fitting model is one in which vaccine efficacy and duration of protection of the acellular pertussis (aP) vaccine is lower than that of the whole-cell (wP) vaccine, (efficacy of the first three doses 80% [95% CI: 78%, 82%] versus 90% [95% CI: 87%, 94%]), increasing the rate at which disease is reported to NNDSS is not sufficient to explain the upsurge and 3) 2010–2012 disease incidence is predicted well. In this study, we use all available U.S. surveillance data to: 1) fit a set of mathematical models and determine which best explains these data and 2) determine the epidemiological and vaccine-related parameter values of this model. We find evidence of a difference in efficacy and duration of protection between the two vaccine types, wP and aP (aP efficacy and duration lower than wP). Future refinement of the model presented here will allow for an exploration of alternative vaccination strategies such as different age-spacings, further booster doses, and cocooning. Over the past ten years the incidence of pertussis in the United States (U.S.) has risen steadily, with 2012 seeing the highest case number since 1955. There has also been a shift over the same time period in the age group reporting the largest number of cases (aside from infants), from adolescents to 7–11 year olds. We investigate several hypotheses for the upsurge in pertussis cases by fitting a suite of epidemiological models to incidence data from the National Notifiable Disease Surveillance System (NNDSS) between 1990–2009. We find that: 1) the best-fitting model is one in which the vaccine efficacy and duration of protection of the acellular pertussis vaccine is lower than that of the whole-cell vaccine, 2) increasing the rate at which disease is reported to NNDSS is not sufficient to explain the upsurge and 3) 2010–2012 disease incidence is predicted well. These results demonstrate that the resurgence in pertussis in the U.S. can be explained by past changes in vaccination policy. However, our findings suggest that the efficacy of the currently-used acellular vaccine is not much lower than that of the whole-cell vaccine, and booster doses may be sufficient to curtail epidemics while vaccine research continues.
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Affiliation(s)
- Manoj Gambhir
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
- Modeling Unit, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
- IHRC, Inc., Atlanta, Georgia, United States of America
- * E-mail:
| | - Thomas A. Clark
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, NCIRD, CDC, Atlanta, Georgia, United States of America
| | - Simon Cauchemez
- Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, London, United Kingdom
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Paris, France
| | - Sara Y. Tartof
- Kaiser Permanente Southern California, Kaiser Permanente Research, Department of Research & Evaluation, Pasadena, California, United States of America
| | - David L. Swerdlow
- Modeling Unit, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
- Office of Science and Integrative Programs, NCIRD, CDC, Atlanta, Georgia, United States of America
| | - Neil M. Ferguson
- Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, London, United Kingdom
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Abstract
BACKGROUND AND OBJECTIVES Pertussis incidence is increasing, possibly due to the introduction of acellular vaccines, which may have decreased the durability of immune response. We sought to evaluate and compare the duration of protective immunity conferred by a childhood immunization series with 3 or 5 doses of diphtheria-tetanus-acellular pertussis (DTaP). METHODS We searched Medline and Embase for articles published before October 10, 2013. Included studies contained a measure of long-term immunity to pertussis after 3 or 5 doses of DTaP. Twelve articles were eligible for inclusion; 11 of these were included in the meta-analysis. We assessed study quality and used meta-regression models to evaluate the relationship between the odds of pertussis and time since last dose of DTaP and to estimate the probability of vaccine failure through time. RESULTS We found no significant difference between the annual odds of pertussis for the 3- versus 5-dose DTaP regimens. For every additional year after the last dose of DTaP, the odds of pertussis increased by 1.33 times (95% confidence interval: 1.23-1.43). Assuming 85% vaccine efficacy, we estimated that 10% of children vaccinated with DTaP would be immune to pertussis 8.5 years after the last dose. Limitations included the statistical model extrapolated from data and the different study designs included, most of which were observational study designs. CONCLUSIONS Although acellular pertussis vaccines are considered safer, the adoption of these vaccines may necessitate earlier booster vaccination and repeated boosting strategies to achieve necessary "herd effects" to control the spread of pertussis.
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Affiliation(s)
- Ashleigh McGirr
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - David N Fisman
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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McGirr AA, Tuite AR, Fisman DN. Estimation of the underlying burden of pertussis in adolescents and adults in Southern Ontario, Canada. PLoS One 2013; 8:e83850. [PMID: 24376767 PMCID: PMC3871538 DOI: 10.1371/journal.pone.0083850] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Accepted: 11/17/2013] [Indexed: 01/16/2023] Open
Abstract
Despite highly successful vaccination programs and high vaccine uptake, both endemic pertussis and periodic pertussis outbreaks continue to occur. The under-recognized role of adolescents and adults in disease transmission, due to waning immunity following natural infection and vaccination, and reduced likelihood of correct diagnosis, may contribute to pertussis persistence. We constructed a mathematical model to describe the transmission of pertussis in Southern Ontario in both pre-vaccine and vaccine eras, to estimate the underlying burden of pertussis in the population. The model was well calibrated using the best available data on pertussis in the pre-vaccination (1880–1929) and vaccination (1993–2004) eras in Ontario. Pertussis under-reporting by age group was estimated by comparing model-projected incidence to reported laboratory-confirmed cases for Greater Toronto. Best-fit model estimates gave a basic reproductive number of approximately 10.6, (seasonal range 9.9 to 11.5). Under-reporting increased with age, and approximately >95% of infections in children were caused by infections in persons with waning immunity to pertussis following prior infection or vaccination. A well-calibrated model suggests that under-recognized cases of pertussis in older individuals are likely to be an important driver of ongoing pertussis outbreaks in children. Model projections strongly support enhancement of booster vaccination efforts in adults.
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Affiliation(s)
- Ashleigh A. McGirr
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Ashleigh R. Tuite
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - David N. Fisman
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- * E-mail:
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The Bordetella pertussis type III secretion system tip complex protein Bsp22 is not a protective antigen and fails to elicit serum antibody responses during infection of humans and mice. Infect Immun 2013; 81:2761-7. [PMID: 23690400 DOI: 10.1128/iai.00353-13] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The type III secretion system (T3SS) of pathogenic bordetellae employs a self-associating tip complex protein Bsp22. This protein is immunogenic during infections by Bordetella bronchiseptica and could be used as a protective antigen to immunize mice against B. bronchiseptica challenge. Since low-passage clinical isolates of the human pathogen Bordetella pertussis produce a highly homologous Bsp22 protein (97% homology), we examined its vaccine and diagnostic potential. No Bsp22-specific antibodies were, however, detected in serum samples from 36 patients with clinically and serologically confirmed whooping cough disease (pertussis syndrome). Moreover, although the induction of Bsp22 secretion by the laboratory-adapted 18323 strain in the course of mice lung infection was observed, the B. pertussis 18323-infected mice did not mount any detectable serum antibody response against Bsp22. Furthermore, immunization with recombinant Bsp22 protein yielded induction of high Bsp22-specific serum antibody titers but did not protect mice against an intranasal challenge with B. pertussis 18323. Unlike for B. bronchiseptica, hence, the Bsp22 protein is nonimmunogenic, and/or the serum antibody response to it is suppressed, during B. pertussis infections of humans and mice.
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Baron-Epel O, Madjar B, Grefat R, Rishpon S. Trust and the demand for autonomy may explain the low rates of immunizations among nurses. Hum Vaccin Immunother 2012; 9:100-7. [PMID: 23108353 DOI: 10.4161/hv.22503] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Rates of vaccinations of healthcare workers with recommended vaccines are generally low in the developed countries. Our goals were to identify attitudes associated with self-reported vaccinations against pertussis and seasonal influenza among Israeli nurses in Mother and Child Healthcare Centers (MCHC) in the Haifa District. Over 100 nurses answered a self-administered questionnaire. Forty two percent of the nurses reported receiving the pertussis vaccine in the last five years and 44% reported receiving the influenza vaccine during the previous year. Attitudes toward the importance of vaccinating nurses, trust in the public health authorities and demand for autonomy were associated with receiving the pertussis vaccine. Attitudes toward the importance of vaccinating nurses and trust were associated with receiving the influenza vaccine in a bivariant analysis. However, in the logistic regression models only attitudes toward the importance of vaccinating nurses were associated with vaccinations [odds ratio (OR)- 3.66, 95% confidence interval (CI)- 1.4-9.6 for pertussis and OR- 4.53, CI-1.6-13.0 for influenza]. Jewish nurses reported more often receiving the influenza vaccine compared with the Arab nurses, whereas there was no difference between them in receiving the pertussis vaccine. Low levels of positive attitudes toward the importance of vaccinating nurses may inhibit nurses in MCHC from receiving vaccines. The demand for autonomy and low levels of trust may, in part, form these low levels of positive attitudes toward the importance of vaccinating nurses.
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Affiliation(s)
- Orna Baron-Epel
- School of Public Health; Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
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Fisman DN, Tang P, Hauck T, Richardson S, Drews SJ, Low DE, Jamieson F. Pertussis resurgence in Toronto, Canada: a population-based study including test-incidence feedback modeling. BMC Public Health 2011; 11:694. [PMID: 21899765 PMCID: PMC3189138 DOI: 10.1186/1471-2458-11-694] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2011] [Accepted: 09/07/2011] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Pertussis continues to challenge medical professionals; recently described increases in incidence may be due to age-cohort effects, vaccine effectiveness, or changes in testing patterns. Toronto, Canada has recently experienced increases in pertussis incidence, and provides an ideal jurisdiction for evaluating pertussis epidemiology due to centralized testing. We evaluated pertussis trends in Toronto using all available specimen data, which allowed us to control for changing testing patterns and practices. METHODS Data included all pertussis culture and PCR test records for Greater Toronto from 1993 to 2007. We estimated incidence trends using Poisson regression models; complex relationships between disease incidence and test submission were explored with vector autoregressive models. RESULTS From 1993 to 2007, 26988 specimens were submitted for testing; 2545 (9.4%) were positive. Pertussis incidence was 2 per 100,000 from 1993 to 2004 and increased to 10 per 100,000 from 2005-2007, with a concomitant 6-fold surge in test specimen submissions after the introduction of a new, more sensitive PCR assay. The relative change in incidence was less marked after adjustment for testing volumes. Bidirectional feedbacks between test positivity and test submissions were identified. CONCLUSIONS Toronto's recent surge in pertussis reflects a true increase in local disease activity; the apparent size of the outbreak has likely been magnified by increasing use of pertussis testing by clinicians, and by improved test sensitivity since 2005. These findings may be applicable to changes in pertussis epidemiology that have been noted elsewhere in North America.
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Affiliation(s)
- David N Fisman
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, M5T 3M7, Canada
- Department of Health Policy, Evaluation and Management, University of Toronto, 155 College Street, Toronto, M5T 3M7, Canada
- Department of Medicine, University of Toronto, 1 Kings College Circle, Toronto, M5S 1A8, Canada
| | - Patrick Tang
- Public Health Laboratory--Toronto, Ontario Agency for Health Protection and Promotion, 81 Resources Road, Toronto, M9P 3V6, Canada
| | - Tanya Hauck
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, M5T 3M7, Canada
| | - Susan Richardson
- Department of Laboratory Medicine and Pathobiology, University of Toronto, 1 Kings College Circle, Toronto, M5S 1A8, Canada
- Department of Microbiology, Hospital for Sick Children, 555 University Avenue, Toronto M5G 1X5, Canada
| | - Steven J Drews
- Alberta Provincial Public Health Laboratory, 3030 Hospital Drive Northwest, Calgary, T2N 4W4, Canada
| | - Donald E Low
- Public Health Laboratory--Toronto, Ontario Agency for Health Protection and Promotion, 81 Resources Road, Toronto, M9P 3V6, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, 1 Kings College Circle, Toronto, M5S 1A8, Canada
- Department of Microbiology, Mount Sinai Hospital, 600 University Avenue, Toronto, M5G 1X5, Canada
| | - Frances Jamieson
- Public Health Laboratory--Toronto, Ontario Agency for Health Protection and Promotion, 81 Resources Road, Toronto, M9P 3V6, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, 1 Kings College Circle, Toronto, M5S 1A8, Canada
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Wallace SS, Cruz AT, Quinonez RA, Caviness AC. Risk factors for complications in hospitalized young infants presenting with uncomplicated pertussis. Hosp Pediatr 2011; 1:16-22. [PMID: 24510925 DOI: 10.1542/hpeds.2011-0007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE We sought to identify risk factors for complications in hospitalized young infants with uncomplicated pertussis. METHODS Retrospective cohort study of hospitalized infants 0 to 6 months of age with confirmed pertussis from 2005 to 2009. Subjects presenting without complications or need for initial intensive care admission were deemed to have uncomplicated pertussis. Complications during hospitalization were defined as apnea, pneumonia, seizures, or encephalopathy. Univariate analysis was performed by estimating odds ratios (OR) and 95% confidence intervals (CI) for the association between each variable and the occurrence of complications. Multivariable analysis was performed using logistic regression. Clinical variables included demographics, historical, laboratory, and imaging data. RESULTS Of 126 study subjects, 46 (36.5%) developed complications in the hospital: 43 with apnea (two required endotracheal intubation), seven with pneumonia, and three with seizures; there were no cases of encephalopathy and no deaths. Age less than 60 days (OR, 2.71; 95% CI, 1.08-6.82), cough duration less than 7 days (OR, 5.38; 95% CI, 1.79-16.18), history of color change (OR, 5.24; 95% CI, 1.14-24.07), parental intervention (OR, 10.05; 95% CI, 1.67-60.39), and need for oxygen in the emergency department (OR. 3.94; 95% CI. 1.37-11.36) were associated with development of complications. The median duration of cough at the time of complication was 9 days (range 2-30 days). Initial complete blood cell count and radiographic findings were not associated with complications. CONCLUSIONS Infants with uncomplicated pertussis may be at low risk for developing respiratory failure or death. Historical information may assist practitioners in determining risk for serious complications.
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Abstract
PURPOSE Does the literature support universal vaccination of adolescents and adults, reducing disease incidence in infants and young children? DESIGN & METHODS An extensive literature review and a meta-analysis of four case-control studies, evaluating effects of missed or late vaccine doses, was conducted. RESULTS The literature confirms (a) increasing pertussis rates; (b) adults and adolescents are the primary carriers; (c) vaccine effectiveness wanes over time; and (d) pertussis persists despite disease control efforts. PRACTICE IMPLICATIONS Missed or late doses mean an increase in likelihood of contracting pertussis, supporting full vaccination for children and boosters for adolescents/adults.
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Affiliation(s)
- Chad Rittle
- RN-BSN and MSN Programs, Nursing Department, Waynesburg University, Waynesburg, Pennsylvania, USA.
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Nagamatsu K, Kuwae A, Konaka T, Nagai S, Yoshida S, Eguchi M, Watanabe M, Mimuro H, Koyasu S, Abe A. Bordetella evades the host immune system by inducing IL-10 through a type III effector, BopN. ACTA ACUST UNITED AC 2009; 206:3073-88. [PMID: 20008527 PMCID: PMC2806459 DOI: 10.1084/jem.20090494] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The inflammatory response is one of several host alert mechanisms that recruit neutrophils from the circulation to the area of infection. We demonstrate that Bordetella, a bacterial pathogen, exploits an antiinflammatory cytokine, interleukin-10 (IL-10), to evade the host immune system. We identified a Bordetella effector, BopN, that is translocated into the host cell via the type III secretion system, where it induces enhanced production of IL-10. Interestingly, the BopN effector translocates itself into the nucleus and is involved in the down-regulation of mitogen-activated protein kinases. Using pharmacological blockade, we demonstrated that BopN-induced IL-10 production is mediated, at least in part, by its ability to block the extracellular signal-regulated kinase pathway. We also showed that BopN blocks nuclear translocation of nuclear factor κB p65 (NF-κBp65) but, in contrast, promotes nuclear translocation of NF-κBp50. A BopN-deficient strain was unable to induce IL-10 production in mice, resulting in the elimination of bacteria via neutrophil infiltration into the pulmonary alveoli. Furthermore, IL-10–deficient mice effectively eliminated wild-type as well as BopN mutant bacteria. Thus, Bordetella exploits BopN as a stealth strategy to shut off the host inflammatory reaction. These results explain the ability of Bordetella species to avoid induction of the inflammatory response.
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Affiliation(s)
- Kanna Nagamatsu
- Laboratory of Bacterial Infection, Graduate School of Infection Control Sciences, Kitasato University, Tokyo 108-8641, Japan
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Schneider F, Stánitz É, Kalácska J, Tompity T, Gábor B. Whooping cough in an urban high school in Hungary. Conclusions of a local pertussis outbreak. Orv Hetil 2009; 150:1557-61. [DOI: 10.1556/oh.2009.28655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A pertussis a védőoltás bevezetésével fokozatosan visszaszoruló fertőző betegség lett, de teljes eradikációja nem lehetséges. Ezt mutatják a nemzetközi és a hazai adatok is. Az ezredforduló után a pertussisos megbetegedések lassú növekedése figyelhető meg.
Célkitűzés:
Az adolescens pertussis klinikumának bemutatása egy helyi járvány kapcsán, ezzel egyidejűleg a pertussis jelenlétének demonstrálása a hazai populációban.
Módszer:
Az első felismert 18 éves beteg környezetében retrospektív adatgyűjtéssel felderített, tartósan köhögő betegektől vett vérmintából emelkedő pertussis-antitoxin-IgG meghatározásával igazolták a pertussisetiológiát.
Eredmények:
A járványügyi munka 17 további, szerológiai vizsgálattal megerősített megbetegedést derített fel a felismert beteg környezetében.
Következtetések:
Tartós köhögés hátterében pertussist kell keresni. A védőoltással szerzett pertussis elleni immunitás a gyermekkor végére kialszik, a kórokozó a hazai populációban is cirkulál, a pertussisemlékeztető oltás beillesztése a 11 éves korúak oltásába indokolt. Serdülő- és felnőttkorban a pertussis enyhébben és atípusosan zajlik, de elhúzódó köhögés esetén gondolni kell rá.
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Affiliation(s)
- Ferenc Schneider
- 1 Vas Megyei Markusovszky Kórház Nonprofit Zrt. Infektológiai Osztály Szombathely Markusovszky u. 3. 9700
| | - Éva Stánitz
- 2 ÁNTSZ Szombathelyi, Csepregi, Kőszegi Kistérségi Intézete Szombathely
| | - Judit Kalácska
- 3 Országos Epidemiológiai Intézet Bakteriológia II. Osztály Budapest
| | - Tünde Tompity
- 1 Vas Megyei Markusovszky Kórház Nonprofit Zrt. Infektológiai Osztály Szombathely Markusovszky u. 3. 9700
| | - Beáta Gábor
- 1 Vas Megyei Markusovszky Kórház Nonprofit Zrt. Infektológiai Osztály Szombathely Markusovszky u. 3. 9700
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Oliveira MLS, Arêas APM, Ho PL. Intranasal vaccines for protection against respiratory and systemic bacterial infections. Expert Rev Vaccines 2007; 6:419-29. [PMID: 17542756 DOI: 10.1586/14760584.6.3.419] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
More than 4 million deaths per year are due to respiratory diseases. Although licensed vaccines are available, bacteria, such as Streptococcus pneumoniae, Haemophilus influenzae, Mycobacterium tuberculosis, Bordetella pertussis and Neisseria meningiditis, among others, continue to be the major agents of diseases in young children, the elderly and/or immunocompromized individuals. Following respiratory tract infection, some microorganisms may also invade the epithelial tissue, achieving systemic circulation and/or other organs. Nasal administration of different antigen formulations has shown promising results in the induction of immune responses and the defeat of the pathogens at the site of infection. This review will focus on the main nasal vaccine strategies and technologies being investigated against the most common infections caused by respiratory bacteria.
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