Acute pertussis infection among adults can cause its transmission to the larger population, especially to infants and young children, who can develop severe disease. In order to determine an age-dependent pertussis immune response, anti-pertussis toxin (PT) antibody was detected by the indirect enzyme-linked immunosorbent assay (ELISA) method in serum samples from 2,085 healthy subjects ranging in age from 6 months to > or = 60 years. Also included in the evaluation were responses to a questionnaire including sociodemographic characteristics, vaccination, and infection history. Titers of 50-99 ELISA units (EU)/mL and of > or = 100 EU/mL were accepted as indicative for recent exposure or infection. In addition, 30 EU/mL was estimated to be a sufficient titer in women of childbearing age to protect their newborns until administration of their first dose of pertussis vaccine. After the age of 4-5 years, presence of high-titered antibodies that increase with age might be a reflection of circulating infection and indicate the magnitude of the threat to infants. According to the questionnaires, in the groups younger than 15 years old, three to four doses of diphtheria toxoid-whole cell pertussis-tetanus toxoid (DwPT) were administered in 47.2 to 77.4%, 91.2 to 100.0%, and 83.5 to 100.0% of participants in Diyarbakir, Samsun, and Antalya, respectively. In addition, up to half of the expectant mothers we studied lacked a sufficient level of estimated antibody titers. To protect infants from life-threatening pertussis infection, improving vaccination coverage to ensure herd immunity and uniformly establishing coverage throughout the country are essential. Furthermore, revaccination with acellular vaccine for schoolchildren as well as for the households of pregnant women is recommended.

No abstract

Objective: Immun response against pertussis can be induced by infection and/or vaccination and vaccine induced immunity is known to wane within the following decade. Our aim was to assess the pertussis immun response among adolescent girls in Edirne province in Turkey and to determine its relationship with some parameters.Material and Method: The serum sample collection, representing 12 to 17 years old adolescent girls was consisted of 359 subjects and was selected from school lists by systematic and random sampling which weighted by age, urban-rural residence strata proportional to the corresponding distributions in Edirne population. Pertussis immunity was determined by in-house ELISA method and anti-PT and anti-FHA antibody titers were measured quantitatively.Results: The overall ratio of having protective levels of antibody (Ͼ10 EU/ml) were 95,3% and 97,2% for anti-pertussis toxin and anti-filamentous hemagglutinin, respectively. The ratio of antibody in protective levels for anti-pertussis toxin and anti-filamentous hemagglutinin in 12 and 14 years age group were found as 94,1%; 97,0%; in 15 and 17 years age group 97,5% and 97,5%; in rural area 96,7%; 97,5%, in urban area 94,5%, 97,5%, respectively (pϾ0.05).Conclusion: The high ratio of having protective levels of antibodies might be an indicator of the previous infections that is a threat for infants who have not completed primary immunization. In this respect, adult immunization should be discussed. BRAIN DAMAGE OF EXTREMELY LOW BIRTH WEIGHT INFANTS WITH HISTOPATHOLOGIC CHORIOAMNIONITIS DEPARTMENT OF ONCOLOGICAL AND SURGICAL SCIENCES-SECTION OF PATHOLOGY (ITALY)Background/aims: Neonatal cerebral white matter injury is the major precursor for neurological impairment and cerebral palsy. Chorioamnionitis has been associated with periventricular leukomalacia (PVL) in very low birth weight (VLBW) infants. We evaluated the association between occurrence and pathological severity of histological chorioamnionitis (HCA) and brain damage in VLBW infants.Methods: A prospective histological study on 287 placentas was performed in preterm infants (Ͻ 32ϩ6 weeks gestation), consecutively admitted to III level NICU of Padua University from January 1999 to December 2004. Development of intraventricular hemorrhage (IVH) or PVL was related to the evidence of HCA and to chorioamnion inflammatory scores, according to Naeye et al.Results: Among the 287 NICU admitted preterm infants, 68 (23.6%) showed HCA, and 39/287 (13.5%) had brain damage, IVH or PVL. Brain damage was present in 15/68 (22%) of infants in the setting of HCA and in 24/219 (10.9%) of infants in the absence of HCA (pϽ0.05). HCA is also associated with a significantly increased frequency of PVL (5.8% vs 0.4%; pϽ 0.01), but failed to reveal any association with IVH (16.1% vs 10.5%; pϭ0.2). However, severe fetal HCA, stage II-III vs I and grade II-III vs I, were unrelated to brain damage. HCA infants were comparable to non-HCA infants in all selected demographics and clinical variables, except for increased vagina...

It has recently been reported that the worldwide increase in the number of pertussis cases is a result of the waning of whole-cell vaccine-induced immunity. Thus, in this study, we aimed to investigate the pertussis immunity status of primary and secondary school students in a district of Ankara, Turkey. A total of 997 healthy students, aged 9-17 years, who had been immunized with four doses of whole-cell pertussis vaccine were included in the study. The subjects were divided into two age groups: 9-14 and 15-17 years. To determine the immune status, serum levels of IgG anti-pertussis toxin (aPT) antibody were tested by in-house ELISA and arbitrarily evaluated as non-immune [< 10 ELISA units (EU)/ml], immune (10-100 EU/ml), and recent infection (> 100 EU/ml). Serum samples of 997 students (559 females, 438 males) aged between 9 and 17 years (mean 13.02 +/- 2.25, median 13 years) were tested. Non-immune, immune and recent infection levels of aPT were found in 27.3%, 59.3% and 13.4% of individuals, respectively. The immune group did not have statistically significant differences between males and females (P = 0.68). In the 9-14 and 15-17 years age groups, serum aPT antibody levels 10 EU/ml were 73.1% and 72.2%, respectively, which did not represent any statistical difference (P = 0.81). Students aged 15-17 years had a higher immunity rate than the 9-14 years group, and the percentage of students with recent infection in the 9-14 years group was higher than the 15-17 years group (P < 0.001). The peak age of non-immunized subjects was 9 years (47.0%), and decreased to a minimum at age 12-13 years, and began to increase again from age 13-14 years. In contrast, the ratio of recent infection was least at age 9-10 years, began to increase, and reached a peak at 12 years, and then decreased. On the other hand, it was observed that household size and monthly income were not associated with the immunity status (P = 0.65, P = 0.37, respectively). The results of the present study show that levels of antibody against pertussis decreased in the younger age groups and, as a result, there is an increase in the number of pertussis cases. Thus, in order to decrease the incidence of pertussis and protect infants, we recommend the application of booster doses at regular intervals.

The immune status against tetanus in relation to vaccination was investigated among healthy populations in 3 selected provinces in Turkey (n=2094). In-house ELISA supplemented with the particle agglutination test was performed for this purpose. An exact correlation was found between vaccination status and immunity against tetanus. The immunity was high among children and sharply decreased with age among adults. The primary vaccination for children increased the immunity, reaching a geometric mean titer (GMT) of 6.2 IU/ml at the fourth dose. There was a reduction of immunity during the next y, followed by an increase with a booster injection at primary school age. Among adolescents and adults, the GMTs after the last vaccination fell off exponentially with a slope of -0.068 log10 IU/ml per y. Extrapolation of the regression line predicted that the minimum protective level (> or =0.01 IU/ml) would be maintained for approximately 30 y on average after the last vaccination. Diyarbakir, 1 of the selected provinces, had lower immunity than the other 2 provinces with poor immunization. Adult females tended to show slightly higher GMTs than males, probably due to the neonatal tetanus elimination program. Reinforcement of immunization against tetanus for adults is recommended.

No abstract

No abstract