Assessment of humoral and cell-mediated immunity against<i>Bordetella pertussis</i>in adolescent, adult, and senior subjects in Italy

Gabutti, Giovanni; Bergamini, Mauro; Bonanni, Paolo; Guido, Marcello; Fenoglio, Daniela; Giammanco, Anna; Sindoni, L; Zotti, Carla Maria; Boddi, Valentina; Bamfi, Francesco; Severini, R.; Bechini, Angela; Boccalini, Sara; Crovari, Pietro

doi:10.1017/s0950268807000192

Cited by 18 publications

(10 citation statements)

References 44 publications

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“…Finally, the pertussis hospitalisation rates did not change significantly over the study period in children aged between 10 and 17. Despite our findings, a shift in pertussis cases from school‐age children to adolescents has been widely reported, mainly due to levels of immunity becoming weaker . The first reason for this discrepancy may be that only hospitalised cases were included, and the clinical presentation of pertussis in older children is usually mild and often does not require hospitalisation .…”

Section: Discussioncontrasting

confidence: 83%

“…Despite our findings, a shift in pertussis cases from school‐age children to adolescents has been widely reported, mainly due to levels of immunity becoming weaker . The first reason for this discrepancy may be that only hospitalised cases were included, and the clinical presentation of pertussis in older children is usually mild and often does not require hospitalisation . In addition, Tuscany has provided booster doses of the tetanus diphtheria acellular pertussis vaccine for adolescents in the last few years, in common with a few other Italian regions and European countries such as Austria, Belgium, Finland, France and Germany, which may account for the reduced incidence in this age group .…”

Section: Discussioncontrasting

confidence: 67%

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Pertussis is still common in a highly vaccinated infant population

Berti

Chiappini

Orlandini³

et al. 2014

Acta Paediatrica

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Section: Discussioncontrasting

confidence: 83%

Section: Discussioncontrasting

confidence: 67%

Pertussis is still common in a highly vaccinated infant population

Berti

Chiappini

Orlandini³

et al. 2014

Acta Paediatrica

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“…Data from the routine surveillance system do not show an increase in pertussis incidence in the ≥ 15 yearsold population in Italy, as described in other European countries [2]. This is in contrast with a recent Italian seroepidemiological study, which suggests that B. pertussis actually circulates among adolescents and adults [33]. Underrecognition and missed diagnosis may partially explain the very low incidence rates reported in this age group in Italy.…”

Section: Discussionmentioning

confidence: 55%

Epidemiology of pertussis in Italy: Disease trends over the last century

et al. 2014

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We reviewed the epidemiology of pertussis in Italy over the last 125 years to identify disease trends and factors that could have influenced these trends. We described mortality rates (1888-2012), case fatality rates (1925-2012), cumulative incidence rates (1925-2013) and age-specific incidence rates (1974-2013). We compared data from routine surveillance with data from a paediatric sentinel surveillance system to estimate under-notification. Pertussis mortality decreased from 42.5 per 100,000 population in 1890 to no reported pertussis-related death after 2002. Incidence decreased from 86.3 per 100,000 in 1927 to 1 per 100,000 after 2008. Vaccine coverage increased from 32.8% in 1993 to about 96% after 2006. As for under-notification, mean sentinel/routine surveillance incidence ratio increased with age (from 1.8 in <1 yearolds to 12.9 in 10−14 year-olds). Pertussis mortality decreased before the introduction of immunisation. Incidence has decreased only after the introduction of pertussis vaccine and in particular after the achievement of a high immunisation coverage with acellular vaccines. Routine surveillance does not show an increase in cumulative incidence nor in ≥15 year-olds as reported by other countries. Underrecognition because of atypical presentation and the infrequent use of laboratory tests may be responsible for undernotification, and therefore affect incidence reports and management of immunisation programmes.

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“…A recent multicentre study performed in different geographical areas in Italy has evaluated both the humoral and the cell-mediated immunity against pertussis. This study suggests that B. pertussis continues to circulate in age groups that have been previously considered to be not involved in the circulation of this pathogen, particularly adolescents and adults [36]. …”

Section: Epidemiology In Italymentioning

confidence: 99%

Pertussis: A Review of Disease Epidemiology Worldwide and in Italy

Gabutti¹,

Rota

2012

IJERPH

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Pertussis continues to be a relevant public-health issue. The high coverage rates achieved have decreased the spread of the pathogen, but the waning of immunity implies a relevant role of adolescents and adults in the infective dynamics as they may represent a significant source of infection for unvaccinated or incompletely immunized newborns. The passive surveillance system is affected by many limitations. The underestimation of pertussis in adolescents, young adults and adults is mainly related to the atypical clinical characteristics of cases and the lack of lab confirmation. The real epidemiological impact of pertussis is not always perceived, anyway, the unavailability of comprehensive data should not hamper the adoption of active prophylactic interventions aimed at preventing the impact of waning immunity on pertussis. To avoid an increase of the mean age of acquisition of the infection, a booster dose of low-antigen content combined vaccine should be adopted in adolescents and adults. A decreased risk of infection in newborns can be achieved with the cocoon strategy, although the debate on this aspect is still open and enhanced surveillance and further studies are needed to fine-tune the pertussis prevention strategy.

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Assessment of humoral and cell-mediated immunity againstBordetella pertussisin adolescent, adult, and senior subjects in Italy

Cited by 18 publications

References 44 publications

Pertussis is still common in a highly vaccinated infant population

Pertussis is still common in a highly vaccinated infant population

Epidemiology of pertussis in Italy: Disease trends over the last century

Pertussis: A Review of Disease Epidemiology Worldwide and in Italy

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