The decline in immunity and circulation of pertussis among Chinese population during the COVID-19 pandemic: A cross-sectional sero-epidemiological study

He, Hanqing; Zhu, Yao; Jin, Minjuan; Zhou, Yang; Tang, Xuewen; Yan, Rui; Deng, Xuan; Chen, Kun

doi:10.1016/j.vaccine.2022.10.020

Cited by 8 publications

(6 citation statements)

References 35 publications

(43 reference statements)

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“…In this study, the overall IgG-PT serum positivity rate among participants was 25.4%, which was lower than the rates reported in studies conducted in Zhejiang, China (29.8%) 12 and among healthcare workers in Spain (31.2%). 18 This discrepancy may be attributed to various factors influencing pertussis antibody levels and duration, such as age, vaccine type, and immunization history.…”

Section: Discussioncontrasting

confidence: 83%

“…To enhance comprehension of the immunity imparted by vaccines against pertussis, this study also assessed serum anti-FHA antibodies. Anti-FHA levels in the entire study population [27.0 (25.4–28.7) IU/mL] surpassed those reported in prior studies conducted in Henan 11 and Zhejiang provinces, 12 China. Furthermore, a correlation between anti-FHA and anti-PT was observed, albeit with the titer of anti-FHA IgG seemingly higher than that of PT.…”

Section: Discussioncontrasting

confidence: 56%

“…Unlike PT-specific anti-PT IgG, which is generated following exposure to pertussis bacteria, anti-FHA IgG can be elicited not only by pertussis bacteria but also by human respiratory pathogens such as Bordetella parapertussis, influenza hemophilus, and pneumococcal pathogens . 12 …”

Section: Discussionmentioning

confidence: 99%

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The seroepidemiology of immunoglobulin G antibodies against pertussis toxin and filamentous hemagglutinin in the east of China during the COVID-19 pandemic

Sun,

Zhang,

Sun

et al. 2024

Human Vaccines & Immunotherapeutics

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This study employed sero-epidemiological methods to estimate the incidence of pertussis within a healthy population located in eastern China. The aim was to gain deeper insights into the epidemiological characteristics and burden of pertussis within the country. Blood samples were collected from healthy individuals in Jiangsu Province between June 2019 and December 2022. The levels of IgG antibodies against pertussis toxin (anti-PT) and filamentous hemagglutinin (anti-FHA) in the serum were quantitatively measured using enzyme-linked immunosorbent assay (ELISA). Additionally, pertussis case data reported in Jiangsu Province were collected from the China Information System for Disease Control and Prevention and compared with the results of this study. In 2022, the reported incidence of pertussis stood at 1.0 per 100,000 individuals, marking the highest rate observed in the past two decades. Among 1,909 patients examined, the geometric mean concentration (GMC) of anti-PT IgG antibody was 20.2 (18.5–21.9) IU/ml, while that of anti-FHA IgG antibody was 27.0 (25.4–28.7) IU/ml. The IgG-PT and IgG-FHA seropositivity rate (>20.0 IU/ml) was highest in the 1 ~ 2 y old group and decreased rapidly to the lowest in the 3 ~ 4 y old group and then increased gradually with age. The estimated rate of pertussis infection based on seroprevalence was approximately 25,625‐fold higher than the reported notification rate in the ≥15 year age group. Our findings highlight decreased immunity post-vaccination, stressing the importance of additional booster shots for adolescents and adults to maintain immunity and reduce severe illness. Additionally, they offer vital guidance for policymakers to enhance immunization strategies.

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Section: Discussioncontrasting

confidence: 83%

Section: Discussioncontrasting

confidence: 56%

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The seroepidemiology of immunoglobulin G antibodies against pertussis toxin and filamentous hemagglutinin in the east of China during the COVID-19 pandemic

Sun,

Zhang,

Sun

et al. 2024

Human Vaccines & Immunotherapeutics

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“…The variations in results across different studies are likely attributed to differences in study populations, detection methods, cutoff values, regional disparities [ 13 ]. Nevertheless, these findings collectively underscore the widespread existence of pertussis infection in diverse populations [ 13 , 26 ], emphasizing the urgent need to reevaluate the epidemiology of this vaccine-preventable disease and assess its burden.…”

Section: Discussionmentioning

confidence: 99%

Seroepidemiology of pertussis in Huzhou: A population-based, cross-sectional study

Liu,

Zhang,

Wang

et al. 2024

PLoS ONE

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Purpose The resurgence of pertussis has occurred around the world. However, the epidemiological profiles of pertussis cannot be well understood by current diseases surveillance. This study was designed to understand the seroepidemiological characteristics of pertussis infection in the general population of Huzhou City, evaluate the prevalence infection of pertussis in the population, and offer insights to inform adjustments in pertussis prevention and control strategies. Methods From September to October 2023, a cross-sectional serosurvey was conducted in Huzhou City, involving 1015 permanent residents. Serum samples were collected from the study subjects, and pertussis toxin IgG antibodies (Anti-PT-IgG) were quantitatively measured using enzyme-linked immunosorbent assay (ELISA). The analysis included the geometric mean concentration (GMC) of Anti-PT-IgG, rates of GMC≥40IU/mL, ≥100IU/mL, and <5IU/mL. Stratified comparisons were made based on age, vaccination history, and human categories. Results Among the 1015 surveyed individuals, the geometric mean concentration (GMC) of Anti-PT-IgG was 10.52 (95% CI: 9.96–11.11) IU/mL, with a recent infection rate of 1.58%, a serum positivity rate of 11.43%, and a proportion with <5IU/mL of 40.49%. Among 357 children with clear vaccination history, susceptibility decreased with an increasing number of vaccine doses (Z = -6.793, P < 0.001). The concentration of Anti-PT-IgG exhibited a significant post-vaccination decline over time (Z = -5.143, P < 0.001). In women of childbearing age, the GMC of Anti-PT-IgG was 7.71 (95% CI: 6.90–8.62) IU/mL, with no significant difference in susceptibility among different age groups (χ2 = 0.545, P = 0.909). The annual pertussis infection rate in individuals aged ≥3 years was 9321 (95%CI: 3336–16039) per 100,000, with peak infection rates in the 20–29, 40–49, and 5–9 age groups at 34363 (95%CI: 6327–66918) per 100,000, 22307.72 (95%CI: 1380–47442) per 100,000, and 18020(95%CI: 1093–37266) per 100,000, respectively. Conclusions In 2023, the actual pertussis infection rate in the population of Huzhou City was relatively high. Vaccine-induced antibodies exhibit a rapid decay, and the estimated serum infection rate increases rapidly from post-school age, peaking in the 20–29 age group. It is recommended to enhance pertussis monitoring in adolescents and adults and refine vaccine immunization strategies.

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“…However, there is no uniform criterion for pertussis seropositivity. Many studies have used different cutoffs such as 80 IU/ml, 27 40 IU/ml, 18 , 25 30 IU/ml, 28 and 20 IU/ml 29 to determine pertussis infection. Since ECDC has published their recommendations recently, our present study referenced the ECDC recommendations of 100 IU/ml and 50 IU/ml as indications of recent infection and positivity.…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence of tetanus and pertussis antibodies among health care workers in Wuhu, China

Shi,

Wang,

Meng

et al. 2024

Human Vaccines & Immunotherapeutics

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This study aimed to elucidate the seroprevalence of antibodies to tetanus and pertussis among Chinese health care workers. Blood specimens from health care workers were collected during the 2021 annual medical examination at the First People’s Hospital of Wuhu. Commercial ELISA kits were employed to quantify serum IgG antibodies against tetanus toxin (anti-TT IgG) and both IgG and IgA antibodies against pertussis toxin (anti-PT IgG, anti-PT IgA). A concentration of anti-TT IgG exceeding 0.1 IU/ml was deemed seroprotective against tetanus, while concentrations of anti-PT IgG ≥ 50 IU/ml or anti-PT IgA ≥ 15 IU/ml were indicative of a prior pertussis infection. The overall seroprotective rate for anti-TT IgG stood at 10.43% (92/882), with the highest seroprotective rate (13.91%) in the 20–29 age group, followed by the 30–39 age group (10.57%), 40–49 age group (5.80%), and 50–59 age group (5.63%). Eighteen (2.04%) of the studied subjects were positive to anti-PT IgG, and the positive rate in 20–39 age group and 40–59 age group was 1.19% (8/673) and 4.78% (10/209), respectively. Thirty (3.40%) subjects displayed anti-PT IgG levels ≥100 IU/ml and/or anti-PT IgA ≥ 15 IU/ml, suggesting a recent pertussis infection within the preceding year. Over half (503/882, 57.03%) had undetectable anti-PT IgG antibodies. The majority of health care workers in China appear susceptible to tetanus and pertussis, and a significant subset has experienced pertussis infection. The implementation of booster vaccinations against these diseases for Chinese health care workers is recommended.

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The decline in immunity and circulation of pertussis among Chinese population during the COVID-19 pandemic: A cross-sectional sero-epidemiological study

Cited by 8 publications

References 35 publications

The seroepidemiology of immunoglobulin G antibodies against pertussis toxin and filamentous hemagglutinin in the east of China during the COVID-19 pandemic

The seroepidemiology of immunoglobulin G antibodies against pertussis toxin and filamentous hemagglutinin in the east of China during the COVID-19 pandemic

Seroepidemiology of pertussis in Huzhou: A population-based, cross-sectional study

Seroprevalence of tetanus and pertussis antibodies among health care workers in Wuhu, China

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