Is Pertussis Infection Neglected in China? Evidence from a Seroepidemiology Survey in Zhejiang, an Eastern Province of China

He, Hanqing; Yao, Pingping; Zhou, Yang; Deng, Xuan; Pan, Jinren

doi:10.1371/journal.pone.0155965

Cited by 25 publications

(25 citation statements)

References 28 publications

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“…In the Zhejiang province of China, He et al conducted a seroepidemiological survey among 186 adults ≥60 years of age, in the year 2014. Based on the measured seropositivity rates (using a cut-off of 80 Food and Drug Administration units/ml for recent infection of pertussis), an infection rate of approximately 16,670 cases per 100,000 people was projected [62]. These results suggest a case underestimation of more than 10,000-fold when compared to the reported pertussis incidence in China, of <1 case per 100,000 people.…”

Section: Asiamentioning

confidence: 96%

The burden of pertussis in older adults: what is the role of vaccination? A systematic literature review

Kandeil

Atanasov²,

Avramioti³

et al. 2019

Expert Review of Vaccines

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Introduction: Pertussis (whooping cough) is a vaccine-preventable disease; however, neither naturalnor vaccine-induced protection is lifelong. Although generally not severe in adults, pertussis can be associated with complications in patients with chronic conditions such as asthma or chronic obstructive pulmonary disease, and can be readily transmitted to more vulnerable populations, including neonates before they complete their primary vaccination. Furthermore, as the global population ages, the health and economic burden of the disease is expected to rise. Areas covered: A systematic literature review was conducted to ascertain the current epidemiological and financial burden of pertussis in older adults and to discuss the potential value of a booster vaccination in this population. Expert commentary: Our review indicates a considerable underestimation of the pertussis burden amongst older adults. Seroprevalence studies consistently demonstrate that the reported incidence may be much lower than the actual incidence. Tetanus toxoid-reduced diphtheria toxoid and acellular pertussis vaccines are immunogenic in older adults, induce high booster responses and are welltolerated. There is therefore a good rationale for the advocacy of booster pertussis vaccination throughout life to prevent pertussis infection and its transmission, especially in adults aged ≥50 years.

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Section: Asiamentioning

confidence: 96%

The burden of pertussis in older adults: what is the role of vaccination? A systematic literature review

Kandeil

Atanasov²,

Avramioti³

et al. 2019

Expert Review of Vaccines

View full text Add to dashboard Cite

show abstract

“…the morbidity of pertussis may be seriously underreported to a large extent in China [11][12][13] . Furthermore, escalating work is showing that there is a tendency to continue to increase in the incidence of pertussis in China 1,3,14 .…”

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confidence: 99%

The long-term effects of meteorological parameters on pertussis infections in Chongqing, China, 2004–2018

Wang

Ren

et al. 2020

Sci Rep

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Evidence on the long-term influence of climatic variables on pertussis is limited. This study aims to explore the long-term quantitative relationship between weather variability and pertussis. Data on the monthly number of pertussis cases and weather parameters in Chongqing in the period of 2004–2018 were collected. Then, we used a negative binomial multivariable regression model and cointegration testing to examine the association of variations in monthly meteorological parameters and pertussis. Descriptive statistics exhibited that the pertussis incidence rose from 0.251 per 100,000 people in 2004 to 3.661 per 100,000 persons in 2018, and pertussis was a seasonal illness, peaked in spring and summer. The results from the regression model that allowed for the long-term trends, seasonality, autoregression, and delayed effects after correcting for overdispersion showed that a 1 hPa increment in the delayed one-month air pressure contributed to a 3.559% (95% CI 0.746–6.293%) reduction in the monthly number of pertussis cases; a 10 mm increment in the monthly aggregate precipitation, a 1 °C increment in the monthly average temperature, and a 1 m/s increment in the monthly average wind velocity resulted in 3.641% (95% CI 0.960–6.330%), 19.496% (95% CI 2.368–39.490%), and 3.812 (95% CI 1.243–11.690)-fold increases in the monthly number of pertussis cases, respectively. The roles of the mentioned weather parameters in the transmission of pertussis were also evidenced by a sensitivity analysis. The cointegration testing suggested a significant value among variables. Climatic factors, particularly monthly temperature, precipitation, air pressure, and wind velocity, play a role in the transmission of pertussis. This finding will be of great help in understanding the epidemic trends of pertussis in the future, and weather variability should be taken into account in the prevention and control of pertussis.

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“…The major limitation of the two reference standards for pertussis that are currently used in China (38,39) is the lack of positive PCR results as the criteria for laboratory diagnosis. Multiple studies pointed out that this limitation together with a lack of other laboratory diagnostic methods, insufficient clinical experience with atypical cases and low awareness of the disease, resulted in the underestimation of the incidence of pertussis infection in China (23,(40)(41)(42). In 2017, a new version of "Diagnosis and treatment recommendations in Chinese pediatric pertussis patients" was published, in which both clinical and laboratory diagnostic criteria for agespecific pertussis were modified according to the clinical case definitions for pertussis proposed by the Global Pertussis Initiative (GPI) (43,44).…”

Section: Discussionmentioning

confidence: 99%

Identification of etiologic agents and clinical characteristics for patients suspected of having pertussis in a large Children’s Hospital in China

et al. 2019

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Background: In China, pertussis is a major health problem with an increasing incidence despite immunization efforts. Timely and accurate diagnosis is essential for the optimal management of pertussis, especially in severe cases. Methods: Nasopharyngeal swabs or sputum specimens were obtained from patients suspected of having pertussis on the day of hospitalization at Shanghai Children's Medical Center from December 01, 2016, to November 30, 2017. The specimens were tested with the FilmArray Respiratory Panel, a multiplex polymerase chain reaction (PCR) assay that detects 16 viruses, Bordetella pertussis (B. pertussis), Mycoplasma pneumoniae (M. pneumoniae), and Chlamydophila pneumoniae (C. pneumoniae).Results: Among the 140 children studied, 50.0% (70/140) were detected with a single pathogen, 45.0% (63/140) were detected with multiple pathogens, and 5.0% (7/140) had no detected pathogens. Forty-nine (35%, 49/140) patients tested positive for B. pertussis. Respiratory syncytial virus (RSV), parainfluenza virus (Para) and rhinovirus/enterovirus (Rhino/Entero) were the most prevalent pathogens in patients with pertussis-like syndrome. No significant differences between the groups with pertussis and pertussis-like syndrome were observed regarding the clinical symptoms. Severe cases were more frequently observed in unvaccinated, premature and pertussis/RSV co-infection patients.Conclusions: Our study highlights the importance of the timely and accurate diagnosis of pertussis based on both clinical symptoms and laboratory methods.

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Is Pertussis Infection Neglected in China? Evidence from a Seroepidemiology Survey in Zhejiang, an Eastern Province of China

Cited by 25 publications

References 28 publications

The burden of pertussis in older adults: what is the role of vaccination? A systematic literature review

The burden of pertussis in older adults: what is the role of vaccination? A systematic literature review

The long-term effects of meteorological parameters on pertussis infections in Chongqing, China, 2004–2018

Identification of etiologic agents and clinical characteristics for patients suspected of having pertussis in a large Children’s Hospital in China

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