Pertussis Disease Burden in the Household: How to Protect Young Infants

Greeff, Sabine C. de; Mooi, Frits R.; Westerhof, Anneke; Verbakel, J. M. M.; Peeters, Marcel; Heuvelman, C.J.; Notermans, Daan W.; Elvers, L.H.; Schellekens, J. F. P.; Melker, Hester E. de

doi:10.1086/652281

Cited by 209 publications

(150 citation statements)

References 39 publications

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“…Many studies have already found evidences that asymptomatic infections of pertussis were very common in adolescents and adults, which became the important source of childhood infections. [17][18][19] In some developed countries with high coverage of childhood immunization, the incidence of infection or disease showed a trend of increase in adolescents. 3 Although there were no significant differences in the incidences of infection among age groups in this study, attention should be paid to those born after 2005 because these population were vaccinated with DTaP.…”

Section: Discussionmentioning

confidence: 99%

Seroepidemiology of diphtheria and pertussis in Beijing, China: A cross-sectional study

Chen²,

Zhang³

et al. 2015

Human Vaccines & Immunotherapeutics

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The aim of this study was to assess the level of humoral immunity against diphtheria and pertussis by measuring IgG to diphtheria toxoid (DT) and pertussis toxin (PT) in general population of Beijing. A total of 2147 subjects aged 0-74 y were selected with a random sample of resident population in Beijing. The information of socio-demographic characteristics, vaccination history, disease history of diphtheria and pertussis were collected for each subject by questionnaire. Serum samples were tested for IgG antibodies to DT and PT by using commercial ELISA kits. The overall positivity rate of anti-DT IgG was 66.28% with the mean concentration of 2.169 IU/ml. Age stratified data showed that the highest positivity rate of 97.63% was observed in 1-4 y and the rates decreased with age. The positivity rates were only around 50% or below since 25 y old. The positivity rate of anti-PT IgG was 12.34% with the mean concentration of 15.163 IU/ml. The highest level of positivity rate (22.23%) and antibody level (23.101 IU/ml) was seen in <1 year old. In subjects older than 10 y old, the anti-PT IgG positivity rate was 10.19%-13.51% and concentration was 13.295 IU/ml ¡16.353 IU/ml, with no significant differences between these groups (x2 D 1.664, P D 0.948; F D 0.369, P D 0.899). The subjects with anti-PT IgG 100 IU/ml were observed in nearly all the groups older than 5 y except for 10-14 age group. The estimated incidences of pertussis infection were higher than 6000/100000 in these age groups. A sharp increase of immunity level of diphtheria was observed at 1 y and 6 y respectively, which was consistent with the current immunization schedule. But there was no significant increase of immunity to pertussis observed after booster immunization at 18-24 months, but the proportions of undetectable were lowest in <1, 1, 2 years in children <14 years. As shown in the present study, the adult population was generally lack of protective antibody against diphtheria and all the age groups showed a low immunity to pertussis indicating the potential risk of transmission and outbreaks of the 2 diseases in Beijing.

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Section: Discussionmentioning

confidence: 99%

Seroepidemiology of diphtheria and pertussis in Beijing, China: A cross-sectional study

Chen²,

Zhang³

et al. 2015

Human Vaccines & Immunotherapeutics

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“…Our model is relatively simple and leaves out many putative mechanisms that may affect pertussis transmission and control, including the spatial or social aggregation of unvaccinated individuals (28), asymptomatic infections (48), and household structure (48). Other potential factors that could drive changes in the effectiveness of a booster vaccination strategy over the course of its use, such as vaccine-driven pathogen evolution, changing attitudes to vaccination, and changing public awareness of pertussis, are also excluded from our model.…”

Section: Discussionmentioning

confidence: 99%

Combating pertussis resurgence: One booster vaccination schedule does not fit all

Riolo

Rohani

2015

Proc. Natl. Acad. Sci. U.S.A.

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Pertussis has reemerged as a major public health concern in many countries where it was once considered well controlled. Although the mechanisms responsible for continued pertussis circulation and resurgence remain elusive and contentious, many countries have nevertheless recommended booster vaccinations, the timing and number of which vary widely. Here, using a stochastic, age-stratified transmission model, we searched for cost-effective booster vaccination strategies using a genetic algorithm. We did so assuming four hypothesized mechanisms underpinning contemporary pertussis epidemiology: (I) insufficient coverage, (II) frequent primary vaccine failure, (III) waning of vaccine-derived protection, and (IV) vaccine "leakiness." For scenarios I-IV, successful booster strategies were identified and varied considerably by mechanism. Especially notable is the inability of booster schedules to alleviate resurgence when vaccines are leaky. Critically, our findings argue that the ultimate effectiveness of vaccine booster schedules will likely depend on correctly pinpointing the causes of resurgence, with misdiagnosis of the problem epidemiologically ineffective and economically costly.R econciling the historical successes of routine infant pertussis vaccination programs in reducing incidence (1-3) with the recent resurgence in a number of highly vaccinated countries (4, 5) has proved challenging, especially in the context of the global heterogeneity in contemporary pertussis epidemiology (6). A variety of explanations for pertussis resurgence have been proposed, ranging from improvements in surveillance and diagnostics (7) to reduced protection afforded by vaccination, whether due to the waning of vaccine-derived immunity (8), the evolution of the etiological agent (the bacterium Bordetella pertussis) (9), the switch from whole-cell to acellular vaccines (10), or the invasion and spread of Bordetella congeners (11). It has also been demonstrated that even in the absence of changes in the nature of transmission, vaccine, or reporting, pertussis resurgence might be expected in some countries as an inevitable consequence of insufficient historical vaccination (12).Disentangling the many pathways to pertussis resurgence is particularly difficult because pertussis immunity and, in particular, vaccine-derived immunity are not well understood (13). With no known reliable serological marker of protection (14), the properties of infection-and vaccine-derived immunity against pertussis must be inferred indirectly (15). However, the models of pertussis immunity that best reconcile individual-level clinical data (16) and population-level incidence data (17), respectively, are strikingly different. Data from serological studies (16, 18) and animal models (19) paint a picture of a vaccine that protects against disease for a limited duration and may afford little protection against transmission. In contrast, large-scale pertussis incidence data from countries such as Denmark (20), England and Wales (21), Thailand (17), and Sweden (2...

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“…Several cases of pertussis in which mothers were the source of infection are characterized by the onset of symptoms in the pregnant woman before delivery. 98 Moreover, maximal response to immunization in terms of antibody levels does not occur until 14 days after administration of a booster dose, thus leaving a potentially uncovered time window. 99 Finally, besides mothers, several other family members are also potential sources of infection.…”

Section: Strategies For the Prevention Of Pertussismentioning

confidence: 99%