A big pertussis outbreak in a primary school with high vaccination coverage in northern China: An evidence of the emerging of the disease in China

Huang, Haitao; Gao, Ping; Gao, Zhicheng; Wang, Lijuan; Hao, Bao-Yun; Liu, Yong; Yang, Aimin; Liu, Peng; Guo, Liru; Zhang, Ying

doi:10.1016/j.vaccine.2018.11.009

Cited by 15 publications

(18 citation statements)

References 12 publications

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“…It was similar with our previous investigation in cord blood samples, which revealed the prevalence of unprotected neonates was 95.9% [21]. The re-emerge of pertussis in China was reported in several researches [22,23]. According to our previous research, from November 2015 to May 2019, 5.0% (34/686) of cough neonates in neonatal ward of Beijing Children's Hospital was diagnosed with pertussis (unpublished data).…”

Section: Discussionsupporting

confidence: 89%

The maternal antibody against diphtheria, tetanus and pertussis showed distinct regional difference in China

Meng

Qian

et al. 2019

BMC Pediatr

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Background: Passive transferred antibodies to the fetus play an essential role on protecting neonates and young infants until infant vaccination is more efficacious. However, very little is known about the discrepancy of DTP vaccine associated antibodies level in neonates from different economic areas in China. Methods: In 2018, 200 neonates hospitalized in Shunyi Women and Children's Hospital in Beijing, and 238 neonates hospitalized in Qianjiang Central Hospital located in the southwestern mountainous areas were included in this study. Antibodies specific for the antigens covered by DTP vaccine were determined using ELISA Kits (Euroimmun, Lübeck, Germany). The cut off value of ≥0.1 IU/ml (anti-diphtheria, anti-Dtx), > 0.1 IU/ml (anti-tetanus, anti-Ttx) and > 40 IU/ml (anti-pertussis toxin, anti-Ptx) were used to assess the percentage of protected neonates, respectively. Results: The antibody levels in the neonates from Qianjiang (0.04 IU/ml for anti-Dtx IgG and 0.07 IU/ml for anti-Ttx IgG) were significantly lower than those from Shunyi (0.12 IU/ml for anti-Dtx IgG and 0.18 IU/ml for anti-Ttx IgG). The prevalence of protective anti-Dtx and anti-Ttx IgG were lower in the neonates from Qianjiang (7.1% for anti-Dtx IgG and 7.6% for anti-Ttx IgG) than in those from Shunyi (30.5% for anti-Dtx and 38.5% for anti-Ttx). The neonates from Qianjiang also had lower detectable rate of anti-Dtx (57.5%) and anti-Ttx IgG (55.8%) than neonates from Shunyi (97.5% for anti-Dtx and 71.0% for anti-Ttx). However, the detectable rate of anti-Ptx IgG in neonates from Qianjiang (39.9%) was higher significantly than in those from Shunyi (30.5%). Two neonates from Qianjiang have anti-PT IgG ≥100.0 IU/ml, which suggested that their mothers have a recent pertussis course. Conclusions: The regional discrepancy of the protective antibody rates might be caused by different vaccine coverage and pertussis exposure, which suggested the importance of Tdap booster immunization for pregnant women or women at childbearing age, those living undeveloped areas in particular.

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Section: Discussionsupporting

confidence: 89%

The maternal antibody against diphtheria, tetanus and pertussis showed distinct regional difference in China

Meng

Qian

et al. 2019

BMC Pediatr

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“…In an attempt to improve the control of pertussis, a number of countries have included additional booster doses beyond preschool [3]. However, despite offering booster vaccinations before school entry and in adolescence, outbreaks in primary schools have been noted in such countries, including China, Germany and the United States [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Investigation of a pertussis outbreak and comparison of two acellular booster pertussis vaccines in a junior school in South East England, 2019

et al. 2021

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In March 2019, a pertussis outbreak occurred in children in a junior school (7–11 years) in England who had been offered pertussis-containing booster vaccine at 40 months of age. In a case–control investigation, we assessed the extent of transmission and any difference in protection afforded to those who had previously received a booster 3- or 5-component acellular pertussis vaccine (aP). We took oral fluid specimens from the students to determine IgG antibodies against pertussis toxin (anti-PT). Parents of students attending the school were sent a questionnaire on pertussis symptoms and vaccination status was retrieved from general practitioner records for all students. Of 381 students, 134 (35.2%) were classified as pertussis cases, 133 by demonstration of significant anti-PT IgG titres and one clinically. There was no significant difference in the risk of pertussis between students receiving 3-component (33.7%) or 5-component (32.3%) aP boosters. However, pertussis infection differed significantly in school year 4, with 22.9%, 50.0%, 23.7% and 38.1% pertussis cases in years 3, 4, 5 and 6, respectively. The proportion of students with incomplete vaccinations recorded was higher than the proportion of those not covered according to the national reported coverage, possibly contributing to sustained transmission within the school.

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“…There were 12 studies of epidemiology in Asia covering China [18][19][20], Taiwan [21,22], Japan [23][24][25][26], South Korea [27,28], and India [29]. There were 37 studies of sero-epidemiology in Asia covering China [18][19][20][30][31][32][33][34][35][36][37][38][39], Taiwan [21,22,[40][41][42], Singapore [43,44], Japan [23][24][25][26][45][46][47][48][49], South Korea [28,[50][51][52][53], Thailand [54], and multiple countries [55,56].…”

Section: Search Resultsmentioning

confidence: 99%

“…The seroprevalence was not significantly different between the age groups, although the seroprevalence in individuals aged C 51 years was significantly higher than in individuals aged \ 51 years (46.5% versus 39.1%, p = 0.017) [52]. In South Korea in 2009-2011, among adolescents and adults (n = 76 laboratory-confirmed cases, unspecified cut-off value) divided into seven age groups (11)(12)(13)(14)(15)(16)(17)(18)(19)(20) ) comprised the largest proportion of pertussis cases compared with the other six age groups; 6.6%, 15.8%, 13.2%, 15.8%, 17.1%, and 5.3%, respectively [53].…”

Section: South Koreamentioning

confidence: 97%

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Bordetella pertussis in School-Age Children, Adolescents, and Adults: A Systematic Review of Epidemiology, Burden, and Mortality in Asia

Macina

Evans²

2021

Infect Dis Ther

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Cyclic epidemics of pertussis (whooping cough) have been observed globally over the past twenty years despite high infant vaccine coverage. The resurgence of pertussis in high-income countries is partly due to waning vaccine immunity in older children and adults, as well as better surveillance and diagnostics. Moreover, in adolescents and adults, pertussis symptoms are mild and similar to common cough syndromes, meaning that it is under-diagnosed in older populations. A systematic search of MEDLINE, EMBASE, and BIOSIS was undertaken to identify studies published between 1 January 1990 and 17 June 2019, with information on pertussis epidemiology, burden of illness, and mortality in school-aged children, adolescents, and adults in Asia. Studies identified for inclusion were reviewed narratively because a statistical comparison was not possible due to the mix of methodologies used.The results showed that in East Asia, including Japan, South Korea, China, and Taiwan, pertussis is circulating in older children and adults. Diphtheria-tetanus-pertussis (DTP4) coverage is high in East Asia, yet outbreaks observed in Japan and South Korea suggest that vaccine-acquired immunity had waned in adolescents and adults. Several school outbreaks in China show that pertussis is circulating in young children, with continued circulation in adolescents and adults. There was a lack of information from Southeast/South Asian countries, although pan-Asian serosurveys showed that recent pertussis infection was common in adolescents and in adults with persistent cough. To conclude, the circulation of pertussis in Asian countries with high DTP4 coverage supports the expansion of routine vaccination to include booster doses for children at school entry and adolescents. However, surveillance is weak or absent in many countries, meaning that the true burden of pertussis, particularly among older populations, is unknown.

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A big pertussis outbreak in a primary school with high vaccination coverage in northern China: An evidence of the emerging of the disease in China

Cited by 15 publications

References 12 publications

The maternal antibody against diphtheria, tetanus and pertussis showed distinct regional difference in China

The maternal antibody against diphtheria, tetanus and pertussis showed distinct regional difference in China

Investigation of a pertussis outbreak and comparison of two acellular booster pertussis vaccines in a junior school in South East England, 2019

Bordetella pertussis in School-Age Children, Adolescents, and Adults: A Systematic Review of Epidemiology, Burden, and Mortality in Asia

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