Seroprevalence of pertussis among adults in China where whole cell vaccines have been used for 50 years

Chen, Zhiyun; Zhang, Jing; Cao, Lina; Zhang, Nan; Zhu, Junping; Ping, Guoling; Zhao, Jianhong; Li, Shu-Ming; He, Qiushui

doi:10.1016/j.jinf.2016.04.004

Cited by 26 publications

(13 citation statements)

References 33 publications

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“…Other seroprevalence studies in pregnant women living in developed countries also revealed that 1–2% of them could have recent pertussis infections 17 , 27 . It was also in line with the incidence of 1% for recent B. pertussis infection estimated in another study on seroprevalence of pertussis among adult in child-bearing ages 28 . These cases have exactly proved that the pregnant population was vulnerable to B. pertussis infection.…”

Section: Discussionsupporting

confidence: 89%

Seroprevalence of Maternal and Cord Antibodies Specific for Diphtheria, Tetanus, Pertussis, Measles, Mumps and Rubella in Shunyi, Beijing

Meng

Liu

et al. 2018

Sci Rep

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Maternal antibodies contribute to the protection of young infants from infectious diseases during the early life. However, vaccinations for women of child-bearing age are not routine in China. Therefore, we investigated the level of protective immunity against vaccine preventable diseases in pregnant women and newborns in China. A total of 194 paired maternal and cord blood samples were collected in Beijing from 2016 to 2017. Antibodies specific for the antigens covered by diphtheria-tetanus-pertussis (DTP) and measles-mumps-rubella (MMR) vaccine were determined by ELISA (Euroimmun, Lübeck, Germany). The cut off value of ≥0.1 IU/ml (anti-diphtheria), >0.1 IU/ml (anti-tetanus), >40 IU/ml (anti-pertussis toxin), ≥200 IU/l (anti-measles), ≥45 RU/ml (anti-mumps) and ≥10 IU/ml (anti-rubella) were used to assess the percentage of newborns with protective IgG concentrations, respectively. The results revealed that 61.3%, 73.2%, 97.4%, 30.4%, 65.5% and 17.0% of newborns had no protection against diphtheria, tetanus, pertussis, measles, mumps and rubella. Only 1.0% and 23.7% of newborns had protection against all three components of DTP or MMR, respectively. The finding suggested that most of newborns were susceptible to diphtheria, tetanus, pertussis and mumps, almost one-third of this population had no immune protection against measles, and about one-sixth of them were under threat of rubella infection. These data supported the immunization program for DTP and MMR vaccine in women at child-bearing age.

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Section: Discussionsupporting

confidence: 89%

Seroprevalence of Maternal and Cord Antibodies Specific for Diphtheria, Tetanus, Pertussis, Measles, Mumps and Rubella in Shunyi, Beijing

Meng

Liu

et al. 2018

Sci Rep

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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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“…Results were interpreted based on the manufacturer's protocol and previous studies [13][14][15]. Anti-Dtx level < 0.1 IU/ml was defined as no protection, the level of 0.1-1.0 IU/ml was defined as short term protection, a value > 1.0 was defined as long term protection (The values of > 1.0-1.5 IU/ml, > 1.5-2.0 IU/ml, and > 2.0 IU/ml mean booster after 5 years, 7 years and 10 years).…”

Section: Cut-off Valuesmentioning

confidence: 99%

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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Seroprevalence of pertussis among adults in China where whole cell vaccines have been used for 50 years

Cited by 26 publications

References 33 publications

Seroprevalence of Maternal and Cord Antibodies Specific for Diphtheria, Tetanus, Pertussis, Measles, Mumps and Rubella in Shunyi, Beijing

Seroprevalence of Maternal and Cord Antibodies Specific for Diphtheria, Tetanus, Pertussis, Measles, Mumps and Rubella in Shunyi, Beijing

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

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

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