Pertussis may be the cause of prolonged cough in adolescents and adults in the interepidemic period

Pimentel, Analíria Moraes; Baptista, Paulo Neves; Ximenes, Ricardo Arraes de Alencar; Rodrigues, Laura C.; Magalhäes, Vera; Silva, Andrea Rosane Sousa; Souza, Nadjla Ferreira; Matos, Deize Gomes Cavalcanti de; Pessoa, Ana Kelly Lins

doi:10.1016/j.bjid.2014.09.001

Cited by 17 publications

(23 citation statements)

References 13 publications

(17 reference statements)

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“…Such limitations could be overcome by using serologic markers of pertussis infection (such as a rise in anti-pertussis toxin [PTx] antibodies) or through the use of PCR, which may remain positive for weeks after the start of effective antibiotic therapy 43 . The argument that PCR could result in an artefactual increase in incidence is intuitively appealing and could also explain the increased detection of milder/atypical presentations of pertussis 44 , 45 . Serologic markers are more difficult to interpret, since rises in titer may result from boosting after natural exposure absent disease or exposure to cross-reacting antigens.…”

Section: The Evidencementioning

confidence: 99%

The relationship between mucosal immunity, nasopharyngeal carriage, asymptomatic transmission and the resurgence of Bordetella pertussis

2017

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The incidence of whooping cough in the US has been rising slowly since the 1970s, but the pace of this has accelerated sharply since acellular pertussis vaccines replaced the earlier whole cell vaccines in the late 1990s. A similar trend occurred in many other countries, including the UK, Canada, Australia, Ireland, and Spain, following the switch to acellular vaccines. The key question is why. Two leading theories (short duration of protective immunologic persistence and evolutionary shifts in the pathogen to evade the vaccine) explain some but not all of these shifts, suggesting that other factors may also be important. In this synthesis, we argue that sterilizing mucosal immunity that blocks or abbreviates the duration of nasopharyngeal carriage of Bordetella pertussis and impedes person-to-person transmission (including between asymptomatically infected individuals) is a critical factor in this dynamic. Moreover, we argue that the ability to induce such mucosal immunity is fundamentally what distinguishes whole cell and acellular pertussis vaccines and may be pivotal to understanding much of the resurgence of this disease in many countries that adopted acellular vaccines. Additionally, we offer the hypothesis that observed herd effects generated by acellular vaccines may reflect a modification of disease presentation leading to reduced potential for transmission by those already infected, as opposed to inducing resistance to infection among those who have been exposed.

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Section: The Evidencementioning

confidence: 99%

The relationship between mucosal immunity, nasopharyngeal carriage, asymptomatic transmission and the resurgence of Bordetella pertussis

2017

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“…However, the prevalence of pertussis has been found to be increased in adolescents and adults with prolonged cough in many LMICs. 46,100,101 Asymptomatic pertussis infections are also common in school children aged 7-15 y old, as showed in a recent Chinese study. 102 Similar to the findings in developed countries, 103 although reported incidences are mostly <1/100 000, true incidences estimated by seroprevalence studies are much higher, especially in adolescents and adults populations.…”

Section: Immune Persistence After Vaccination With Wpsmentioning

confidence: 79%

Immune persistence after pertussis vaccination

Chen

2017

Human Vaccines & Immunotherapeutics

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Pertussis is one of the most prevalent vaccine-preventable diseases worldwide. The true infection rate is significantly higher than the reported incidence rate. An increased prevalence of pertussis in older populations has been found, mainly caused by waning immunity after vaccination. Vaccine-induced immunity differs due to variation in vaccine content, schedule and coverage. Protection following acellular pertussis vaccines has been suggested to wane faster than whole cell pertussis vaccines. However, long-term immune persistence of whole cell pertussis vaccines may be confounded by a progressive acquisition of natural immunity. The World Health Organization has recommended that a switch from whole cell to acellular pertussis vaccines for primary immunization in infants should only be considered if additional periodic boosters or maternal immunization can be ensured and sustained in the national immunization schedules. In this review, we present data on immune persistence after different pertussis vaccinations and compare the findings from countries with different vaccination strategies. Future aspects in serological studies are briefly discussed.

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“…We found the highest mortality rate in the North and lowest in the South, in agreement with Guimaraes et al, 20 who recorded an overall mortality rate of 2.1%, highest in the North region (2.47) and lowest in the South (1.31). The differences in hospitalization and mortality rates between the regions may be explained by the different socioeconomic conditions, including care and access to health services and laboratory facilities for cases confirmation 34 and sample examination, 33,35,36,37,38,39 potentially introducing reporting bias and data incompleteness. Furthermore, the capacity of detection, investigation, and reporting of mild cases, is different between regions.…”

Section: Maternal Immunization: Pertussis Vaccine Coveragementioning

confidence: 99%

Pertussis epidemiological pattern and disease burden in Brazil: an analysis of national public health surveillance data

Barros

Nunes

Abreu

et al. 2019

Human Vaccines & Immunotherapeutics

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Objective: We described pertussis epidemiological trends in Brazil between 2010 and 2015. We also assessed tetanus, diphtheria and acellular pertussis (Tdap) vaccine coverage among pregnant women from 2014, the year of the introduction of Tdap maternal immunization recommendation in Brazil, to 2016. Methods: Epidemiological data for incidence, prevalence, hospitalization, mortality, and maternal vaccination coverage were calculated based on the Brazilian public surveillance databases. Results: The epidemiological data analysis results showed that the pertussis average incidence rate (IR) was 2.19/100,000 inhabitants for all ages, with a peak in 2014 (4.03/100,000 inhabitants) and highest incidence in <1-year-old children (IR = 175.20/100,000). 97.6% of pertussis deaths (405/415) were in <1-year-old children.

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Pertussis may be the cause of prolonged cough in adolescents and adults in the interepidemic period

Abstract: During an interepidemic period, 1 in 20 cases of prolonged cough had pertussis, suggesting this is an important cause of prolonged cough in adolescents and adults.

Cited by 17 publications

References 13 publications

The relationship between mucosal immunity, nasopharyngeal carriage, asymptomatic transmission and the resurgence of Bordetella pertussis

The relationship between mucosal immunity, nasopharyngeal carriage, asymptomatic transmission and the resurgence of Bordetella pertussis

Immune persistence after pertussis vaccination

Pertussis epidemiological pattern and disease burden in Brazil: an analysis of national public health surveillance data

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