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Zhu Y, Zhang W, Hu J, Luo S, Zhou Y, Tang X, Yan R, Deng X, He H. Seroprevalence of IgG antibodies against pertussis toxin in the Chinese population: A systematic review and meta-analysis. Hum Vaccin Immunother 2024; 20:2341454. [PMID: 38695296 PMCID: PMC11067989 DOI: 10.1080/21645515.2024.2341454] [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: 01/05/2024] [Accepted: 04/06/2024] [Indexed: 05/05/2024] Open
Abstract
Pertussis is a vaccine-preventable infectious disease; however, data on pertussis antibody levels in a nationwide population are still limited in China. We aimed to pool the seropositivity rates of IgG antibodies against pertussis toxin (PT-IgG) across the country. We systematically searched PubMed, Web of Science, Embase, and the China National Knowledge Infrastructure Database for studies published between January 1, 2010, and June 30, 2023. Studies reporting the seroprevalence of PT-IgG among a healthy Chinese population were included. Pooled estimates were obtained using random-effects meta-analyzes. The meta-analysis included 39 studies (47,778 participants) reporting anti-PT IgG seropositivity rates. The pooled rate for all ages was 7.06% (95% CI, 5.50%-9.07%). Subgroup analyzes showed rates ranging from 6.36% to 12.50% across different age groups. This meta-analysis indicated a low anti-PT IgG seropositivity rate in the Chinese population, particularly among school-aged children and young adults. This finding underscores the urgent need to refine immunization strategies.
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Affiliation(s)
- Yao Zhu
- Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Wanting Zhang
- Jiaxing Center for Disease Control and Prevention, Jiaxing, China
| | - Jie Hu
- Jiaxing Center for Disease Control and Prevention, Jiaxing, China
| | - Shuying Luo
- Department of Immunization Program, Yiwu District Center for Disease Control and Prevention, Yiwu, China
| | - Yang Zhou
- Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xuewen Tang
- Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Rui Yan
- Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xuan Deng
- Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Hanqing He
- Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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Shi W, Wang B, Meng Q, Zhang X, Li Z, He F, Ying F, Cong L, Yao K. Seroprevalence of tetanus and pertussis antibodies among health care workers in Wuhu, China. Hum Vaccin Immunother 2024; 20:2318892. [PMID: 38465707 PMCID: PMC10936590 DOI: 10.1080/21645515.2024.2318892] [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: 11/07/2023] [Accepted: 02/12/2024] [Indexed: 03/12/2024] Open
Abstract
This study aimed to elucidate the seroprevalence of antibodies to tetanus and pertussis among Chinese health care workers. Blood specimens from health care workers were collected during the 2021 annual medical examination at the First People's Hospital of Wuhu. Commercial ELISA kits were employed to quantify serum IgG antibodies against tetanus toxin (anti-TT IgG) and both IgG and IgA antibodies against pertussis toxin (anti-PT IgG, anti-PT IgA). A concentration of anti-TT IgG exceeding 0.1 IU/ml was deemed seroprotective against tetanus, while concentrations of anti-PT IgG ≥ 50 IU/ml or anti-PT IgA ≥ 15 IU/ml were indicative of a prior pertussis infection. The overall seroprotective rate for anti-TT IgG stood at 10.43% (92/882), with the highest seroprotective rate (13.91%) in the 20-29 age group, followed by the 30-39 age group (10.57%), 40-49 age group (5.80%), and 50-59 age group (5.63%). Eighteen (2.04%) of the studied subjects were positive to anti-PT IgG, and the positive rate in 20-39 age group and 40-59 age group was 1.19% (8/673) and 4.78% (10/209), respectively. Thirty (3.40%) subjects displayed anti-PT IgG levels ≥100 IU/ml and/or anti-PT IgA ≥ 15 IU/ml, suggesting a recent pertussis infection within the preceding year. Over half (503/882, 57.03%) had undetectable anti-PT IgG antibodies. The majority of health care workers in China appear susceptible to tetanus and pertussis, and a significant subset has experienced pertussis infection. The implementation of booster vaccinations against these diseases for Chinese health care workers is recommended.
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Affiliation(s)
- Wei Shi
- MOE Key Laboratory of Major Diseases in Children,National Key Discipline of Pediatrics, National Clinical Research Center for Respiratory Diseases, Beijing Pediatric Research Institute, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
| | - Bingsong Wang
- MOE Key Laboratory of Major Diseases in Children,National Key Discipline of Pediatrics, National Clinical Research Center for Respiratory Diseases, Beijing Pediatric Research Institute, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
| | - Qinghong Meng
- MOE Key Laboratory of Major Diseases in Children,National Key Discipline of Pediatrics, National Clinical Research Center for Respiratory Diseases, Beijing Pediatric Research Institute, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
| | - Xianlai Zhang
- Pediatric Respiratory Department, The First People’s Hospital of Wuhu, Wuhu, China
| | - Zhen Li
- Department of Laboratory Medicine, The First People’s Hospital of Wuhu, Wuhu, China
| | - Fang He
- Medical Centre, The First People’s Hospital of Wuhu, Wuhu, China
| | - Fei Ying
- Department of Laboratory Medicine, The First People’s Hospital of Wuhu, Wuhu, China
| | - Linyan Cong
- Pediatric Respiratory Department, The First People’s Hospital of Wuhu, Wuhu, China
| | - Kaihu Yao
- MOE Key Laboratory of Major Diseases in Children,National Key Discipline of Pediatrics, National Clinical Research Center for Respiratory Diseases, Beijing Pediatric Research Institute, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
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Sun X, Zhang T, Sun J, Zhou J, Chen Q, Jia C, Xu Y, Wu Y, Wang Z, Wang W. The seroepidemiology of immunoglobulin G antibodies against pertussis toxin and filamentous hemagglutinin in the east of China during the COVID-19 pandemic. Hum Vaccin Immunother 2024; 20:2331438. [PMID: 38517269 PMCID: PMC10962620 DOI: 10.1080/21645515.2024.2331438] [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: 12/22/2023] [Accepted: 03/13/2024] [Indexed: 03/23/2024] Open
Abstract
This study employed sero-epidemiological methods to estimate the incidence of pertussis within a healthy population located in eastern China. The aim was to gain deeper insights into the epidemiological characteristics and burden of pertussis within the country. Blood samples were collected from healthy individuals in Jiangsu Province between June 2019 and December 2022. The levels of IgG antibodies against pertussis toxin (anti-PT) and filamentous hemagglutinin (anti-FHA) in the serum were quantitatively measured using enzyme-linked immunosorbent assay (ELISA). Additionally, pertussis case data reported in Jiangsu Province were collected from the China Information System for Disease Control and Prevention and compared with the results of this study. In 2022, the reported incidence of pertussis stood at 1.0 per 100,000 individuals, marking the highest rate observed in the past two decades. Among 1,909 patients examined, the geometric mean concentration (GMC) of anti-PT IgG antibody was 20.2 (18.5-21.9) IU/ml, while that of anti-FHA IgG antibody was 27.0 (25.4-28.7) IU/ml. The IgG-PT and IgG-FHA seropositivity rate (>20.0 IU/ml) was highest in the 1 ~ 2 y old group and decreased rapidly to the lowest in the 3 ~ 4 y old group and then increased gradually with age. The estimated rate of pertussis infection based on seroprevalence was approximately 25,625-fold higher than the reported notification rate in the ≥15 year age group. Our findings highlight decreased immunity post-vaccination, stressing the importance of additional booster shots for adolescents and adults to maintain immunity and reduce severe illness. Additionally, they offer vital guidance for policymakers to enhance immunization strategies.
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Affiliation(s)
- Xiang Sun
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Tingting Zhang
- Medical Record Office, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Jinning Sun
- Department of Expanded Program on Immunization, Nanjing Center for Disease Control and Prevention, Nanjing, China
| | - Juan Zhou
- Department of Expanded Program on Immunization, Gaogang Center for Disease Control and Prevention, Taizhou, China
| | - Qiang Chen
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Chengmei Jia
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yan Xu
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yun Wu
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Zhiguo Wang
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Wen Wang
- Department of Rheumatology and Immunology, The Affiliated Suqian First People’s Hospital of Nanjing Medical University, Suqian, China
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Reicherz F, Li S, Watts AA, Goldfarb DM, Lavoie PM, Abu-Raya B. Bordetella pertussis infection following relaxation of COVID-19 non-pharmaceutical interventions in 2021-2023 in Vancouver metropolitan area, British Columbia, Canada. Vaccine 2024:S0264-410X(24)00620-0. [PMID: 38797627 DOI: 10.1016/j.vaccine.2024.05.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 05/07/2024] [Accepted: 05/21/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND We recently reported a near disappearance of B. pertussis and a decline in anti-B. pertussis antibodies during the peak implementation of Coronavirus disease 2019 (COVID-19) non-pharmaceutical interventions (NPI) in 2021 in British Columbia (BC), Canada. During 2021-2023, incidence of reported B. pertussis cases remained low in BC at < 1/100,000 population. This study determined how serological evidence of B. pertussis changed after the gradual relaxation of NPI between 2021-2023. METHODS Randomly selected blood samples from school staff 25-51 years old (n = 65) were collected yearly between 2021-2023 in the Vancouver metropolitan area, BC, Canada, and tested for anti-pertussis toxin (PT) IgG levels. Serological evidence of B. pertussis infection (thereafter "seroconversion") was defined as a quantifiable anti-PT IgG levels in subjects with anti-PT IgG levels below lower limit of quantification in the preceding year or a > 4-fold increase in anti-PT IgG levels between two subsequent years. Samples were also tested for anti-diphtheria toxoid (DT) IgG, and similar seroconversion criteria were applied to exclude seroconversion due to vaccination with tetanus-diphtheria-acellular-pertussis (Tdap). RESULTS Three subjects met seroconversion criteria for anti-PT IgG between 2021 and 2022 and 9 between 2022 and 2023, yielding a seroconversion rate of 4.6 /100 person-years and 14.9/100 person-years, P = 0.127, respectively. None of the subjects met the criteria for vaccination with Tdap. The geometric mean concentration of anti-PT IgG showed a statistically significant decrease in 2022 compared with 2021, 4.8 IU/mL IU/ml (95 % confidence interval [CI], 3.8-5.9) vs. 6.4 IU/ml (95 % CI, 4.9-8.2; p = 0.001), followed by a statistically significant increase in 2023 compared with 2022 6.5 IU/ml (95 % CI, 4.9-8.5) vs. 4.8 IU/ml (95 % CI, 3.8-5.9; p = 0.0006), respectively. DISCUSSION Serological evidence of B. pertussis increased between 2022 and 2023 despite low reported cases, which suggests that B. pertussis circulation resumed after relaxing of COVID-19 NPI.
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Affiliation(s)
- Frederic Reicherz
- BC Children's Hospital Research Institute, Vancouver, Canada; Department of Pediatrics, University of British Columbia, Vancouver, Canada; Department of Pediatrics, Children's Hospital Datteln, University of Witten/Herdecke, Germany
| | - Sirui Li
- BC Children's Hospital Research Institute, Vancouver, Canada
| | - Allison A Watts
- BC Children's Hospital Research Institute, Vancouver, Canada; Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - David M Goldfarb
- BC Children's Hospital Research Institute, Vancouver, Canada; Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Pascal M Lavoie
- BC Children's Hospital Research Institute, Vancouver, Canada; Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Bahaa Abu-Raya
- Department of Pediatrics, University of British Columbia, Vancouver, Canada; Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre and the Nova Scotia Health Authority, Canada; Departments of Pediatrics, Dalhousie University, Nova Scotia, Canada; Microbiology and Immunology, Dalhousie University, Nova Scotia, Canada.
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Liu Y, Zhang C, Wang Y, Luo X, Liu G, Zhang Z, Shen J. Seroepidemiology of pertussis in Huzhou: A population-based, cross-sectional study. PLoS One 2024; 19:e0303508. [PMID: 38768133 PMCID: PMC11104605 DOI: 10.1371/journal.pone.0303508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 04/25/2024] [Indexed: 05/22/2024] Open
Abstract
PURPOSE The resurgence of pertussis has occurred around the world. However, the epidemiological profiles of pertussis cannot be well understood by current diseases surveillance. This study was designed to understand the seroepidemiological characteristics of pertussis infection in the general population of Huzhou City, evaluate the prevalence infection of pertussis in the population, and offer insights to inform adjustments in pertussis prevention and control strategies. METHODS From September to October 2023, a cross-sectional serosurvey was conducted in Huzhou City, involving 1015 permanent residents. Serum samples were collected from the study subjects, and pertussis toxin IgG antibodies (Anti-PT-IgG) were quantitatively measured using enzyme-linked immunosorbent assay (ELISA). The analysis included the geometric mean concentration (GMC) of Anti-PT-IgG, rates of GMC≥40IU/mL, ≥100IU/mL, and <5IU/mL. Stratified comparisons were made based on age, vaccination history, and human categories. RESULTS Among the 1015 surveyed individuals, the geometric mean concentration (GMC) of Anti-PT-IgG was 10.52 (95% CI: 9.96-11.11) IU/mL, with a recent infection rate of 1.58%, a serum positivity rate of 11.43%, and a proportion with <5IU/mL of 40.49%. Among 357 children with clear vaccination history, susceptibility decreased with an increasing number of vaccine doses (Z = -6.793, P < 0.001). The concentration of Anti-PT-IgG exhibited a significant post-vaccination decline over time (Z = -5.143, P < 0.001). In women of childbearing age, the GMC of Anti-PT-IgG was 7.71 (95% CI: 6.90-8.62) IU/mL, with no significant difference in susceptibility among different age groups (χ2 = 0.545, P = 0.909). The annual pertussis infection rate in individuals aged ≥3 years was 9321 (95%CI: 3336-16039) per 100,000, with peak infection rates in the 20-29, 40-49, and 5-9 age groups at 34363 (95%CI: 6327-66918) per 100,000, 22307.72 (95%CI: 1380-47442) per 100,000, and 18020(95%CI: 1093-37266) per 100,000, respectively. CONCLUSIONS In 2023, the actual pertussis infection rate in the population of Huzhou City was relatively high. Vaccine-induced antibodies exhibit a rapid decay, and the estimated serum infection rate increases rapidly from post-school age, peaking in the 20-29 age group. It is recommended to enhance pertussis monitoring in adolescents and adults and refine vaccine immunization strategies.
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Affiliation(s)
- Yan Liu
- Huzhou Center for Disease Control and Prevention, Huzhou, China
| | - Chao Zhang
- Huzhou Center for Disease Control and Prevention, Huzhou, China
| | - Yuda Wang
- Huzhou Center for Disease Control and Prevention, Huzhou, China
| | - Xiaofu Luo
- Huzhou Center for Disease Control and Prevention, Huzhou, China
| | - Guangtao Liu
- Huzhou Center for Disease Control and Prevention, Huzhou, China
| | - Zizhe Zhang
- Huzhou Center for Disease Control and Prevention, Huzhou, China
| | - Jianyong Shen
- Huzhou Center for Disease Control and Prevention, Huzhou, China
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Natrajan MS, Hall JM, Weigand MR, Peng Y, Williams MM, Momin M, Damron FH, Dubey P, Tondella ML, Pawloski LC. Genome-based prediction of cross-protective, HLA-DR-presented epitopes as putative vaccine antigens for multiple Bordetella species. Microbiol Spectr 2024; 12:e0352723. [PMID: 38054724 PMCID: PMC10783135 DOI: 10.1128/spectrum.03527-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 11/07/2023] [Indexed: 12/07/2023] Open
Abstract
IMPORTANCE Pertussis, caused by Bordetella pertussis, can cause debilitating respiratory symptoms, so whole-cell pertussis vaccines (wPVs) were introduced in the 1940s. However, reactogenicity of wPV necessitated the development of acellular pertussis vaccines (aPVs) that were introduced in the 1990s. Since then, until the COVID-19 pandemic began, reported pertussis incidence was increasing, suggesting that aPVs do not induce long-lasting immunity and may not effectively prevent transmission. Additionally, aPVs do not provide protection against other Bordetella species that are observed during outbreaks. The significance of this work is in determining potential new vaccine antigens for multiple Bordetella species that are predicted to elicit long-term immune responses. Genome-based approaches have aided the development of novel vaccines; here, these methods identified Bordetella vaccine candidates that may be cross-protective and predicted to induce strong memory responses. These targets can lead to an improved vaccine with a strong safety profile while also strengthening the longevity of the immune response.
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Affiliation(s)
- Muktha S. Natrajan
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Laboratory Leadership Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jesse M. Hall
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Michael R. Weigand
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Yanhui Peng
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Margaret M. Williams
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mohamed Momin
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Frederick Heath Damron
- Department of Microbiology, Immunology, and Cell Biology, West Virginia University, Morgantown, West Virginia, USA
| | - Purnima Dubey
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Maria Lucia Tondella
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lucia C. Pawloski
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Wang W, Wang Z, Chen Q, Li M, Jia C, Xu Y, Wu Y, Sun X, Sun H. The Decay of Pertussis Antibodies in Children Aged 0-14 Years in Jiangsu Province, China. Vaccines (Basel) 2023; 11:1336. [PMID: 37631904 PMCID: PMC10458620 DOI: 10.3390/vaccines11081336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/29/2023] [Accepted: 07/31/2023] [Indexed: 08/29/2023] Open
Abstract
The purpose of this study was to investigate possible influencing factors based on the distribution of the pertussis toxin (PT) and filamentous hemagglutinin (FHA) antibody levels in 0-14-year-old children in Jiangsu Province, China, and to analyze changes in IgG antibody levels after pertussis vaccination in children over time via a restricted cubic spline (RCS)-fitted binary logistic regression model. We collected surveillance data on pertussis through the National Notifiable Disease Reporting System (NNDRS). Serum samples were collected, and PT IgG/FHA IgG antibody levels were determined via an enzyme-linked immunosorbent assay (ELISA). A binary logistic regression model was fitted with an RCS. Peak incidence occurred in children aged 0-1 years from 2007 to 2022, and a second peak emerged in children aged 5 years and older from 2018 onwards which shifted towards older age groups. The geometric mean concentrations (GMC) of the anti-PT IgG antibody and anti-FHA IgG antibody in 1129 patients were 15.13 (13.49-16.76) IU/mL and 22.99 (21.17-24.81) IU/mL, respectively. The seropositivity rates of the anti-PT IgG and anti-FHA IgG antibodies in the group receiving a full vaccination course (four doses) were significantly higher than those of other groups (24.6% vs. 43.3%). The RCS fitting model showed a non-linear relationship between the duration after immunization and the odds ratio (OR) of having PT-IgG and FHA-IgG antibody concentrations ≥20 IU/mL in children with documented immunization histories (1-4 doses) (Poverall < 0. 001; Pnonlinear ≤ 0.001). The children with histories of immunization demonstrated antibody levels that decreased to very low levels around 17 months after the last dose of the vaccine. Therefore, it is recommended that pertussis-containing vaccines be administered as booster immunizations for older children.
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Affiliation(s)
- Wen Wang
- Department of Rheumatology and Immunology, The Affiliated Suqian First People’s Hospital of Nanjing Medical University, Suqian 223800, China
| | - Zhiguo Wang
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China; (Z.W.)
| | - Qiang Chen
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China; (Z.W.)
| | - Mei Li
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China; (Z.W.)
| | - Chengmei Jia
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China; (Z.W.)
| | - Yan Xu
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China; (Z.W.)
| | - Yun Wu
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China; (Z.W.)
| | - Xiang Sun
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China; (Z.W.)
| | - Hui Sun
- Medical Department, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing 210000, China
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Chen Z, Liu X, Zhang Y, Peng X, Zhang N, Chen N, Li Y, He Q. Evaluation of serum anti-pertussis toxin IgA antibodies for the diagnosis of Bordetella pertussis infection in young children. J Infect Public Health 2023; 16:1167-1173. [PMID: 37269695 DOI: 10.1016/j.jiph.2023.05.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 05/02/2023] [Accepted: 05/22/2023] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND The determination of serum anti-pertussis toxin (PT) IgG antibodies is recommended for the diagnosis and surveillance of pertussis. However, the diagnostic power of anti-PT IgG can be hampered by possible interference from previous vaccinations. We aim to assess if anti-PT IgA antibodies can be well induced by Bordetella pertussis (B. pertussis) infections in children, and their capacity to improve pertussis serodiagnosis. METHODS Serum samples from 172 hospitalized children younger than 10 years old with confirmed pertussis were tested. Pertussis was confirmed by culture, PCR and/or serology. Anti-PT IgA antibodies were determined with commercial ELISA kits. RESULTS Sixty-four (37.2 %) subjects had anti-PT IgA antibodies greater than or equal to 15 IU/ml, and 52 (30.2 %) of them had anti-PT IgA antibodies greater than or equal to 20 IU/ml. No children with negative anti-PT IgG (less than 40 IU/ml) were observed to have anti-PT IgA antibodies greater than or equal to 15 IU/ml. Of patients younger than one year of age, about 50 % had an IgA antibody response. Moreover, the proportion of subjects with anti-PT IgA antibodies greater than or equal to 15 IU/ml among PCR negative subjects was significantly higher than that among PCR positive subjects (76.9 % vs 35.5 %). CONCLUSIONS The determination of anti-PT IgA antibodies does not seem to have added value for the serodiagnosis of pertussis in children older than one year of age. However, for infants, determination of serum anti-PT IgA antibodies appears to be useful for the diagnosis of pertussis especially when PCR and culture are negative. The results should be interpreted with caution as the number of subjects included in this study was limited.
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Affiliation(s)
- Zhiyun Chen
- Department of Medical Microbiology, Capital Medical University, Beijing, China
| | - Xiaoguai Liu
- The Third Department, Xi'an Children's Hospital, Xi'an, China
| | - Yuxiao Zhang
- Medical Research & Laboratory Diagnostic Center, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xiaokang Peng
- The Third Department, Xi'an Children's Hospital, Xi'an, China
| | - Nan Zhang
- Department of Medical Microbiology, Capital Medical University, Beijing, China
| | - Ning Chen
- Department of Medical Microbiology, Capital Medical University, Beijing, China; Center for adverse drug reactions monitoring of Beijing, Beijing, China
| | - Yarong Li
- The Third Department, Xi'an Children's Hospital, Xi'an, China.
| | - Qiushui He
- Department of Medical Microbiology, Capital Medical University, Beijing, China; Institute of Biomedicine, Research Center for Infections and Immunity, University of Turku, Turku, Finland.
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The decline in immunity and circulation of pertussis among Chinese population during the COVID-19 pandemic: A cross-sectional sero-epidemiological study. Vaccine 2022; 40:6956-6962. [PMID: 36283895 PMCID: PMC9581792 DOI: 10.1016/j.vaccine.2022.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/04/2022] [Accepted: 10/07/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND In recent years, the resurgence of pertussis has posed a public health challenge in many countries. This study aimed to evaluate the immunity levels against pertussis among populations of different ages in China. METHODS We conducted a cross-sectional serological survey in Zhejiang Province, China in 2020. Serum IgG antibodies against pertussis toxin (anti-PT), filamentous hemagglutinin (anti-FHA), and pertactin (anti-PRN) were quantitatively measured. The geometric mean concentration (GMC) of three antibodies was calculated. An anti-PT level < 5 IU/mL was considered undetectable, ≥20 IU/mL as seropositive and ≥80 IU/mL as an indicator of recent infection. Mathematical models were fitted for anti-PT concentrations over time in children after four doses of the pertussis vaccination. RESULTS A total of 4459 participants aged 0-59 years were included in the analyses. The overall positivity rate of anti-PT was 29.80% with the highest (81.44%) rate in the 1-2 years old and the lowest (4.72%) in 10-14 years old. The GMCs of anti-PT, anti-FHA and anti-PRN for the whole participants were 9.67 (95%CI: 9.25-10.10),18.93 (18.24-19.67), and 8.99 (8.61-9.38) IU/mL, respectively. Over 50% of subjects aged ≥ 7 years had undetectable anti-PT IgG antibodies (<5IU/mL). The proportions of the populations with anti-PT IgG ≥ 80 IU/mL were approximately 0.9%, 0.3% and 1.1% among the 10-14, 15-29, and 40-59 years old groups, respectively. The power regression equation of the attenuation model after last dose of pertussis vaccine was y = 41.088x-1.238 (R2 = 0.935, p < 0.001). The fitted anti-PT concentrations was only 5.60 IU/mL at 5 years following the last vaccination dose. CONCLUSION The prevalence of pertussis decreased during the study period in the COVID-19 pandemic; however, there was still a certain proportion of adolescents and adults with evidence of recent infection. The decline in antibody levels after pertussis vaccination was observed, and booster doses are in urgent need in China.
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Pertussis Prevalence in Adult Population in Greece: A Seroprevalence Nationwide Study. Vaccines (Basel) 2022; 10:vaccines10091511. [PMID: 36146589 PMCID: PMC9502282 DOI: 10.3390/vaccines10091511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022] Open
Abstract
The reported cases of pertussis vary considerably globally. In the present nationwide study, we aimed to record the Bordetella pertussis prevalence in Greece by measuring serum IgG specific antibody levels to pertussis toxin (anti-PT IgG). General practitioners and laboratories participated in this study from 12 regions of Greece. A geographically stratified sampling plan based on regional units (NUTS level 2) was applied in order to produce a representative sample, taking into consideration age group (30−39, 40−49, 50−59, 60−69, 70−79 and 80+) and sex. In total, 1169 subjects participated in the study. The percentage of participants with anti-PT IgG antibodies higher than 50 IU/mL was 3.7%. The levels of anti-PT IgG antibodies of total sample ranged between 1.46 IU/mL to 126.60 IU/mL, with mean 17.74 IU/mL and standard deviation 14.03 U/mL (p-value < 0.001). The total seroprevalence of Greek regions for pertussis disease varied significantly among prefectures. The region with the highest seroprevalence was Peloponnese 21.3%, followed by the region of Central Greece 15.3%. The proportion of adults who have pertussis specific antibodies <50 IU/mL has been >90%, suggesting that a large number of adults may be vulnerable to infection of pertussis despite well-established vaccination programs in Greece. Despite the fact that vaccination reduced the number of reported pertussis cases in the last decades in Greece, our seroprevalence study may indicate that the herd immunity level among Greek adults is suboptimal.
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