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Rubis AB, Cole M, Tondella ML, Pawloski LC, Youngkin E, Firmender P, Aden V, Cruz V, Stanislawski E, Wester R, Cieslak PR, Acosta AM, Skoff TH. Assessing the Impact of the 2020 Council of State and Territorial Epidemiologists Case Definition for Pertussis on Reported Pertussis Cases. Clin Infect Dis 2024:ciae207. [PMID: 38607928 DOI: 10.1093/cid/ciae207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/27/2024] [Accepted: 04/10/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND In 2020, the Council of State and Territorial Epidemiologists (CSTE) pertussis case definition was modified; the main change was classifying PCR-positive cases as confirmed, regardless of cough duration. Pertussis data reported through Enhanced Pertussis Surveillance (EPS) in seven sites and the National Notifiable Diseases Surveillance System (NNDSS) were used to evaluate the impact of the new case definition. METHODS We compared the number of EPS cases with cough onset in 2020 to the number that would have been reported based on the prior (2014) CSTE case definition. To assess the impact of the change nationally, the proportion of EPS cases newly reportable under the 2020 CSTE case definition was applied to 2020 NNDSS data to estimate how many additional cases were captured nationally. RESULTS Among 442 confirmed and probable cases reported to EPS states in 2020, 42 (9.5%) were newly reportable according to the 2020 case definition. Applying this proportion to the 6,124 confirmed and probable cases reported nationally in 2020, we estimated that the new definition added 582 cases. Had the case definition not changed, reported cases in 2020 would have decreased by 70% from 2019; the observed decrease was 67%. CONCLUSIONS Despite a substantial decrease in reported pertussis cases in the setting of COVID-19, our data show that the 2020 pertussis case definition change resulted in additional case reporting compared with the previous case definition, providing greater opportunities for public health interventions such as prophylaxis of close contacts.
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Affiliation(s)
- Amy B Rubis
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Matthew Cole
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - M Lucia Tondella
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lucia C Pawloski
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Erin Youngkin
- Colorado Department of Public Health and Environment, Denver, CO, USA
| | | | - Vanessa Aden
- Georgia Department of Public Health, Atlanta, GA, USA
| | - Victor Cruz
- Minnesota Department of Public Health, St. Paul, MN, USA
| | | | - Rachel Wester
- New York State Department of Public Health, Albany, NY, USA
| | | | - Anna M Acosta
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA (now with GSK Vaccines)
| | - Tami H Skoff
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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3
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Xiaoli L, Peng Y, Williams MM, Lawrence M, Cassiday PK, Aneke JS, Pawloski LC, Shil SR, Rashid MO, Bhowmik P, Weil LM, Acosta AM, Shirin T, Habib ZH, Tondella ML, Weigand MR. Genomic characterization of cocirculating Corynebacterium diphtheriae and non-diphtheritic Corynebacterium species among forcibly displaced Myanmar nationals, 2017-2019. Microb Genom 2023; 9:001085. [PMID: 37712831 PMCID: PMC10569726 DOI: 10.1099/mgen.0.001085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 07/23/2023] [Indexed: 09/16/2023] Open
Abstract
Respiratory diphtheria is a serious infection caused by toxigenic Corynebacterium diphtheriae, and disease transmission mainly occurs through respiratory droplets. Between 2017 and 2019, a large diphtheria outbreak among forcibly displaced Myanmar nationals densely settled in Bangladesh was investigated. Here we utilized whole-genome sequencing (WGS) to characterize recovered isolates of C. diphtheriae and two co-circulating non-diphtheritic Corynebacterium (NDC) species - C. pseudodiphtheriticum and C. propinquum. C. diphtheriae isolates recovered from all 53 positive cases in this study were identified as toxigenic biovar mitis, exhibiting intermediate resistance to penicillin, and formed four phylogenetic clusters circulating among multiple refugee camps. Additional sequenced isolates collected from two patients showed co-colonization with non-toxigenic C. diphtheriae biovar gravis, one of which exhibited decreased susceptibility to the first-line antibiotics and harboured a novel 23-kb multidrug resistance plasmid. Results of phylogenetic reconstruction and virulence-related gene contents of the recovered NDC isolates indicated they were likely commensal organisms, though 80.4 %(45/56) were not susceptible to erythromycin, and most showed high minimum inhibition concentrations against azithromycin. These results demonstrate the high resolution with which WGS can aid molecular investigation of diphtheria outbreaks, through the quantification of bacterial genetic relatedness, as well as the detection of virulence factors and antibiotic resistance markers among case isolates.
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Affiliation(s)
- Lingzi Xiaoli
- ASRT, Inc, Atlanta, GA, USA
- Present address: Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Yanhui Peng
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Margaret M. Williams
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Present address: Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Marlon Lawrence
- Laboratory Leadership Service, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Present address: Public Health Laboratory, Virgin Islands Department of Health, US Virgin Islands, USA
| | - Pamela K. Cassiday
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Janessa S. Aneke
- IHRC, Inc., Atlanta, GA, USA
- Present address: Université de Paris Cité, Learning Planet Institute, Paris, France
| | - Lucia C. Pawloski
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sadhona Rani Shil
- Institute of Epidemiology, Disease Control & Research, National Influenza Center, Dhaka, Bangladesh
| | - Mamun Or Rashid
- Institute of Epidemiology, Disease Control & Research, National Influenza Center, Dhaka, Bangladesh
| | - Proshanta Bhowmik
- Institute of Epidemiology, Disease Control & Research, National Influenza Center, Dhaka, Bangladesh
| | - Lauren M. Weil
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Present address: Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Anna M. Acosta
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Present address: Director of Medical and Clinical Affairs, GSK Vaccines, USA
| | - Tahmina Shirin
- Institute of Epidemiology, Disease Control & Research, National Influenza Center, Dhaka, Bangladesh
| | - Zakir Hossain Habib
- Institute of Epidemiology, Disease Control & Research, National Influenza Center, Dhaka, Bangladesh
| | - M. Lucia Tondella
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Michael R. Weigand
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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4
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Vaz-de-Lima LR, Sato APS, Pawloski LC, Fernandes EG, Rajam G, Sato HK, Patel D, Li H, de Castilho EA, Tondella ML, Schiffer J. Effect of maternal Tdap on infant antibody response to a primary vaccination series with whole cell pertussis vaccine in São Paulo, Brazil. Vaccine X 2021; 7:100087. [PMID: 33817624 PMCID: PMC8010450 DOI: 10.1016/j.jvacx.2021.100087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 02/04/2021] [Accepted: 02/12/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Maternal Tetanus, diphtheria, and acellular pertussis (Tdap) vaccination provides antibody transfer to newborn infants and may affect their antibody response to the primary vaccination series. This study aimed to assess the effect of Tdap vaccination during pregnancy on infant antibody response to the whole cell pertussis (DTwP) primary series. METHODS Plasma from 318 pregnant women (243 Tdap-vaccinated and 75 unvaccinated) and their infants (cord blood) was collected at delivery; infant blood was again collected at 2 and 7 months, before and after their primary DTwP series. Anti-pertussis toxin (PT), pertactin (PRN), filamentous hemagglutinin (FHA), fimbriae 2/3 (FIM) and adenylate cyclase toxin (ACT) IgG antibodies were quantified by a microsphere-based multiplex antibody capture assay and anti-PT neutralizing antibodies by the Real Time Cell analysis system. RESULTS Infant geometric mean concentrations (GMCs) of IgG anti-Tdap antigens were significantly higher (p < 0.001) among the Tdap-vaccinated (PT: 57.22 IU/mL; PRN: 464.86 IU/mL; FHA: 424.0 IU/mL), versus the unvaccinated group (4 IU/mL, 15.43 IU/mL, 31.99 IU/mL, respectively) at delivery. Anti-FIM and ACT GMCs were similar between the two groups. At 2 months of age, anti-PT, PRN, and FHA GMCs remained higher (p < 0.001) in the Tdap-vaccinated group (12.64 IU/mL; 108.76 IU/mL; 87.41 IU/mL, respectively) than the unvaccinated group (1.02 IU/mL; 4.46 IU/mL; 6.89 IU/mL). However, at 7 months, after receiving the third DTwP dose, the anti-PT GMC was higher (p = 0.016) in the unvaccinated group (7.91 IU/mL) compared to the vaccinated group (2.27 IU/mL), but without differences for anti-PRN, FHA, FIM and ACT GMCs. CONCLUSION Elevated antibody levels suggest that maternal Tdap vaccination might protect infants until 2 months of age. Reduced anti-PT levels at 7 months indicate potential blunting of immune response in infants. Surveillance would help determine if blunting alters vaccine immunity and impacts pertussis prevention in infants.
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Affiliation(s)
- Lourdes R.A. Vaz-de-Lima
- Centro de Imunologia, Instituto Adolfo Lutz, Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde, São Paulo, Brazil
| | - Ana Paula S. Sato
- Departmento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo – USP, Brazil
| | - Lucia C. Pawloski
- Division of Bacterial Diseases, NCIRD, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eder G. Fernandes
- Divisão de Imunização, Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac, Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde SP, Brazil
| | - Gowrisankar Rajam
- Division of Bacterial Diseases, NCIRD, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Helena K. Sato
- Divisão de Imunização, Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac, Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde SP, Brazil
| | - Divya Patel
- Division of Bacterial Diseases, NCIRD, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Han Li
- Division of Bacterial Diseases, NCIRD, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Maria Lucia Tondella
- Division of Bacterial Diseases, NCIRD, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jarad Schiffer
- Division of Bacterial Diseases, NCIRD, Centers for Disease Control and Prevention, Atlanta, GA, USA
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5
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Abstract
We characterized 170 complete genome assemblies from clinical Bordetella pertussis isolates representing geographic and temporal diversity in the United States. These data capture genotypic shifts, including increased pertactin deficiency, occurring amid the current pertussis disease resurgence and provide a foundation for needed research to direct future public health control strategies.
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6
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Weil LM, Butler C, Howell KR, Sharr S, Paley GL, Huang AJW, Maamari RN, Pawloski LC, Cassiday PK, Acosta AM, Hariri S, Tiwari TSP. Notes from the Field: Conjunctivitis Caused by Toxigenic Corynebacterium ulcerans - Missouri, 2018. MMWR Morb Mortal Wkly Rep 2019; 68:615-616. [PMID: 31295230 PMCID: PMC6741855 DOI: 10.15585/mmwr.mm6827a3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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7
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Vaz-de-Lima LRA, Sato HK, Fernandes EG, Sato APS, Pawloski LC, Tondella ML, de Brito CA, Luna EJA, Carvalhanas TRMP, de Castilho EA. Association between the timing of maternal vaccination and newborns' anti-pertussis toxin antibody levels. Vaccine 2019; 37:5474-5480. [PMID: 31153689 DOI: 10.1016/j.vaccine.2019.04.079] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 04/03/2019] [Accepted: 04/25/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Pertussis remains an important global public health concern, despite the presence of extensive immunization programs. Incidence and severity of pertussis are typically higher in neonates and young infants. As a strategy to protect these young infants, maternal vaccination with Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) has been recommended in Brazil. The objective of this study was to evaluate the effects of Tdap vaccination during pregnancy on the anti-pertussis toxin (PT) IgG response in mothers and their infants at birth. MATERIAL AND METHODS Maternal and cord blood samples were collected from vaccinated (n = 243) and unvaccinated (n = 75) pregnant women, at the time of delivery, from July 2015 to August 2016 in São Paulo, Brazil. Anti-PT IgG antibodies were quantified by Enzyme-Linked Immunosorbent Assay (ELISA) and geometric mean concentrations (GMC) were calculated. Relationship between timing of vaccination and antibody concentrations were evaluated. RESULTS Maternal and cord blood GMCs among the vaccinated group were 5.4 and 5.6 fold higher [66.5 International Units (IU)/mL and 89.8 IU/mL] compared to the unvaccinated group (12.4 IU/mL and 16.1 IU/mL), respectively (p < 0.001). Higher anti-PT IgG GMCs were observed when vaccination occurred ≥60 days before delivery compared to <60 days, suggesting that vaccination early in the third trimester may be more effective than later in pregnancy. CONCLUSION Tdap maternal vaccination results in significantly higher anti-PT IgG in newborn infants and supports the current recommendation of the Brazilian Immunization Program.
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Affiliation(s)
| | - Helena Keico Sato
- Divisão de Imunização, Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac, Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde de São Paulo, Brazil
| | - Eder Gatti Fernandes
- Divisão de Imunização, Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac, Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde de São Paulo, Brazil
| | - Ana Paula Sayuri Sato
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, Brazil
| | - Lucia C Pawloski
- Pertussis and Diphtheria Laboratory, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, United States
| | - Maria Lucia Tondella
- Pertussis and Diphtheria Laboratory, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, United States
| | | | | | - Telma Regina M P Carvalhanas
- Divisão de Doenças de Transmissão Respiratória, Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac, Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde SP, Brazil
| | - Euclides A de Castilho
- Departamento de Medicina Preventiva, Faculdade de Medicina da Universidade de São Paulo, Brazil
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8
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Lee AD, Cassiday PK, Pawloski LC, Tatti KM, Martin MD, Briere EC, Tondella ML, Martin SW. Clinical evaluation and validation of laboratory methods for the diagnosis of Bordetella pertussis infection: Culture, polymerase chain reaction (PCR) and anti-pertussis toxin IgG serology (IgG-PT). PLoS One 2018; 13:e0195979. [PMID: 29652945 PMCID: PMC5898745 DOI: 10.1371/journal.pone.0195979] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 04/03/2018] [Indexed: 11/19/2022] Open
Abstract
Introduction The appropriate use of clinically accurate diagnostic tests is essential for the detection of pertussis, a poorly controlled vaccine-preventable disease. The purpose of this study was to estimate the sensitivity and specificity of different diagnostic criteria including culture, multi-target polymerase chain reaction (PCR), anti-pertussis toxin IgG (IgG-PT) serology, and the use of a clinical case definition. An additional objective was to describe the optimal timing of specimen collection for the various tests. Methods Clinical specimens were collected from patients with cough illness at seven locations across the United States between 2007 and 2011. Nasopharyngeal and blood specimens were collected from each patient during the enrollment visit. Patients who had been coughing for ≤ 2 weeks were asked to return in 2–4 weeks for collection of a second, convalescent blood specimen. Sensitivity and specificity of each diagnostic test were estimated using three methods—pertussis culture as the “gold standard,” composite reference standard analysis (CRS), and latent class analysis (LCA). Results Overall, 868 patients were enrolled and 13.6% were B. pertussis positive by at least one diagnostic test. In a sample of 545 participants with non-missing data on all four diagnostic criteria, culture was 64.0% sensitive, PCR was 90.6% sensitive, and both were 100% specific by LCA. CRS and LCA methods increased the sensitivity estimates for convalescent serology and the clinical case definition over the culture-based estimates. Culture and PCR were most sensitive when performed during the first two weeks of cough; serology was optimally sensitive after the second week of cough. Conclusions Timing of specimen collection in relation to onset of illness should be considered when ordering diagnostic tests for pertussis. Consideration should be given to including IgG-PT serology as a confirmatory test in the Council of State and Territorial Epidemiologists (CSTE) case definition for pertussis.
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Affiliation(s)
- Adria D. Lee
- IHRC Inc., contracting agency to the Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail:
| | - Pamela K. Cassiday
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Lucia C. Pawloski
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Kathleen M. Tatti
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Monte D. Martin
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Elizabeth C. Briere
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - M. Lucia Tondella
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Stacey W. Martin
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Mandal S, Tatti KM, Woods-Stout D, Cassiday PK, Faulkner AE, Griffith MM, Jackson ML, Pawloski LC, Wagner B, Barnes M, Cohn AC, Gershman KA, Messonnier NE, Clark TA, Tondella MLC, Martin SW. Pertussis Pseudo-outbreak linked to specimens contaminated by Bordetella pertussis DNA From clinic surfaces. Pediatrics 2012; 129:e424-30. [PMID: 22250029 DOI: 10.1542/peds.2011-1710] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES We investigated a pertussis outbreak characterized by atypical cases, confirmed by polymerase chain reaction (PCR) alone at a single laboratory, which persisted despite high vaccine coverage and routine control measures. We aimed to determine whether Bordetella pertussis was the causative agent and advise on control interventions. METHODS We conducted case ascertainment, confirmatory testing for pertussis and other pathogens, and an assessment for possible sources of specimen contamination, including a survey of clinic practices, sampling clinics for B pertussis DNA, and review of laboratory quality indicators. RESULTS Between November 28, 2008, and September 4, 2009, 125 cases were reported, of which 92 (74%) were PCR positive. Cases occurring after April 2009 (n = 79; 63%) had fewer classic pertussis symptoms (63% vs 98%; P < .01), smaller amounts of B pertussis DNA (mean PCR cycle threshold value: 40.9 vs 33.1; P < .01), and a greater proportion of PCR-positive results (34% vs 6%; P < .01). Cultures and serology for B pertussis were negative. Other common respiratory pathogens were detected. We identified factors that likely resulted in specimen contamination at the point of collection: environmentally present B pertussis DNA in clinics from vaccine, clinic standard specimen collection practices, use of liquid transport medium, and lack of clinically relevant PCR cutoffs. CONCLUSIONS A summer pertussis pseudo-outbreak, multifactorial in cause, likely occurred. Recommendations beyond standard practice were made to providers on specimen collection and environmental cleaning, and to laboratories on standardizing PCR protocols and reporting results, to minimize false-positive results from contaminated clinical specimens.
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Affiliation(s)
- Sema Mandal
- Epidemic Intelligence Service, Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
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10
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Hall AJ, Cassiday PK, Bernard KA, Bolt F, Steigerwalt AG, Bixler D, Pawloski LC, Whitney AM, Iwaki M, Baldwin A, Dowson CG, Komiya T, Takahashi M, Hinrikson HP, Tondella ML. Novel Corynebacterium diphtheriae in domestic cats. Emerg Infect Dis 2010; 16:688-91. [PMID: 20350389 PMCID: PMC3321947 DOI: 10.3201/eid1604.091107] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Novel nontoxigenic Corynebacterium diphtheriae was isolated from a domestic cat with severe otitis. Contact investigation and carrier study of human and animal contacts yielded 3 additional, identical isolates from cats, although no evidence of zoonotic transmission was identified. Molecular methods distinguished the feline isolates from known C. diphtheriae.
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Affiliation(s)
- Aron J Hall
- Division of Viral Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop A47, Atlanta, GA 30333, USA.
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11
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Tiwari TSP, Golaz A, Yu DT, Ehresmann KR, Jones TF, Hill HE, Cassiday PK, Pawloski LC, Moran JS, Popovic T, Wharton M. Investigations of 2 cases of diphtheria-like illness due to toxigenic Corynebacterium ulcerans. Clin Infect Dis 2008; 46:395-401. [PMID: 18181738 DOI: 10.1086/525262] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND We present 2 case reports in the United States and investigations of diphtheria-like illness caused by toxigenic Corynebacterium ulcerans. A fatal case occurred in a 75-year-old male Washington resident who was treated with clindamycin but did not receive equine diphtheria antitoxin. A second, nonfatal case occurred in a 66-year-old female Tennessee resident who received erythromycin and diphtheria antitoxin. METHODS Both case patients and close human and animal contacts were investigated by their respective state health departments. RESULTS C. ulcerans isolated from the patient who died was resistant to erythromycin and clindamycin. For both isolates, conventional polymerase chain reaction results were positive for A and B subunits of diphtheria toxin gene tox, and modified Elek tests confirmed toxin production. The source of infection remained undetermined for both cases. Neither patient was up-to-date with diphtheria toxoid vaccination. CONCLUSION These case reports highlight the importance of early treatment with diphtheria antitoxin, the selection of effective antimicrobial agents, and prevention through up-to-date vaccination.
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Affiliation(s)
- Tejpratap S P Tiwari
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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Abstract
Arabidopsis contains eight actin genes. Of these ACT7 is the most strongly expressed in young plant tissues and shows the greatest response to physiological cues. Adult plants homozygous for the act7 mutant alleles show no obvious above-ground phenotypes, which suggests a high degree of functional redundancy among plant actins. However, act7-1 mutant plants are at a strong selective disadvantage when grown in competition with wild-type plants and therefore must have undetected physical defects. The act7-1 and act7-4 alleles contain T-DNA insertions just after the stop codon and within the first intron, respectively. Homozygous mutant seedlings of both alleles showed less than 7% of normal ACT7 protein levels. Mutants displayed delayed and less efficient germination, increased root twisting and waving, and retarded root growth. The act7-4 mutant showed the most dramatic reduction in root growth. The act7-4 root apical cells were not in straight files and contained oblique junctions between cells suggesting a possible role for ACT7 in determining cell polarity. Wild-type root growth was fully restored to the act7-1 mutant by the addition of an exogenous copy of the ACT7 gene. T-DNA insertions just downstream of the major polyadenylation sites (act7-2, act7-3) appeared fully wild type. The act7 mutant phenotypes demonstrate a significant requirement for functional ACT7 protein during root development and explain the strong negative selection component seen for the act7-1 mutant.
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Affiliation(s)
- Laura U Gilliland
- Department of Biochemistry, 215 Biochemistry Building, Michigan State University, East Lansing, MI 48824, USA
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Gilliland LU, Kandasamy MK, Pawloski LC, Meagher RB. Both vegetative and reproductive actin isovariants complement the stunted root hair phenotype of the Arabidopsis act2-1 mutation. Plant Physiol 2002; 130:2199-209. [PMID: 12481103 PMCID: PMC166731 DOI: 10.1104/pp.014068] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2001] [Revised: 09/18/2002] [Accepted: 09/18/2002] [Indexed: 05/17/2023]
Abstract
The ACT2 gene, encoding one of eight actin isovariants in Arabidopsis, is the most strongly expressed actin gene in vegetative tissues. A search was conducted for physical defects in act2-1 mutant plants to account for their reduced fitness compared with wild type in population studies. The act2-1 insertion fully disrupted expression of ACT2 RNA and significantly lowered the level of total actin protein in vegetative organs. The root hairs of the act2-1 mutants were 10% to 70% the length of wild-type root hairs, and they bulged severely at the base. The length of the mutant root hairs and degree of bulging at the base were affected by adjusting the osmolarity and gelling agent of the growth medium. The act2-1 mutant phenotypes were fully rescued by an ACT2 genomic transgene. When the act2-1 mutation was combined with another vegetative actin mutation, act7-1, the resulting double mutant exhibited extensive synergistic phenotypes ranging from developmental lethality to severe dwarfism. Transgenic overexpression of the ACT7 vegetative isovariant and ectopic expression of the ACT1 reproductive actin isovariant also rescued the root hair elongation defects of the act2-1 mutant. These results suggest normal ACT2 gene regulation is essential to proper root hair elongation and that even minor differences may cause root defects. However, differences in the actin protein isovariant are not significant to root hair elongation, in sharp contrast to recent reports on the functional nonequivalency of plant actin isovariants. Impairment of root hair functions such as nutrient mining, water uptake, and physical anchoring are the likely cause of the reduced fitness seen for act2-1 mutants in multigenerational studies.
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Affiliation(s)
- Laura U Gilliland
- Department of Genetics, University of Georgia, Athens, Georgia 30602-7223, USA
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