The incidence of Bordetella pertussis infections estimated in the population from a combination of serological surveys

Melker, Hester E. de; Versteegh, F. G. A.; Schellekens, J. F. P.; Teunis, Peter; Kretzschmar, Mirjam

doi:10.1016/j.jinf.2005.10.020

Cited by 158 publications

(149 citation statements)

References 43 publications

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“…The incidence of pertussis infection was estimated using the method described by de Melker et al 25 It was shown that after pertussis infection, PT IgG will be declined to 100 IU/ml after the average time of 58.6 d. With the cut-off of 100 IU/ml, the incidence of infection can be calculated using the formula: 365.2/58.6£proportion of subjects with PT IgG 100 IU/ml. To exclude potential interference of vaccination on the antibody level, only subjects 5 years old were included in the analysis on incidence of pertussis infection.…”

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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“…This strategy has already been put in place in some other European countries, e.g. the Netherlands and the Czech Republic, where a high rate of infection in older people has been observed (de Melker et al, 2006;Guiso et al, 2011aGuiso et al, , 2011b.…”

Section: Discussionmentioning

confidence: 99%

Retrospective space-time cluster analysis of whooping cough re-emergence in Barcelona, Spain, 2000-2011

et al. 2014

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Abstract.A retrospective, space-time study of whooping cough cases reported to the Public Health Agency of Barcelona, Spain between the years 2000 and 2011 is presented. It is based on 633 individual whooping cough cases and the 2006 population census from the Spanish National Statistics Institute, stratified by age and sex at the census tract level. Cluster identification was attempted using space-time scan statistic assuming a Poisson distribution and restricting temporal extent to 7 days and spatial distance to 500 m. Statistical calculations were performed with Stata 11 and SatScan and mapping was performed with ArcGis 10.0. Only clusters showing statistical significance (P <0.05) were mapped. The most likely cluster identified included five census tracts located in three neighbourhoods in central Barcelona during the week from 17 to 23 August 2011. This cluster included five cases compared with the expected level of 0.0021 (relative risk = 2436, P <0.001). In addition, 11 secondary significant space-time clusters were detected with secondary clusters occurring at different times and localizations. Spatial statistics is felt to be useful by complementing epidemiological surveillance systems through visualizing excess in the number of cases in space and time and thus increase the possibility of identifying outbreaks not reported by the surveillance system.

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“…However, the paired serum sample assay is impractical for routine diagnosis. For this reason, single-sample serology has been developed and IgG cutoff values have been determined for a number of laboratories (3,8,9), and this method is now used for routine diagnosis. In the present study, we compared single and paired serology and two different cutoffs.…”

Section: Discussionmentioning

confidence: 99%

“…Using culture alone to diagnose pertussis is likely to lead to underreporting of pertussis cases (8). Serological assays, using one or two serum samples, have been developed to improve the sensitivity of the pertussis diagnosis, but they have a lower specificity than culture (3,9,20,25). PCR techniques were developed to overcome these limitations, but despite a consensus meeting in 2005 (24), these techniques still require further standardization and optimization.…”

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confidence: 99%

Comparison of Serological and Real-Time PCR Assays To Diagnose Bordetella pertussis Infection in 2007

et al. 2008

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Bacterial culture for diagnosing pertussis infection has high specificity but poor sensitivity and is slow. Highly sensitive real-time PCR assays and single-serum pertussis serology have been developed to overcome these limitations, but there are few data available on the relative sensitivities and specificities of such assays for pertussis diagnosis. Using data on 195 participants (>7 years old) from an epidemiological study, we assessed the sensitivity, specificity, and performance (Youden index) for pertussis diagnosis of the pertussis toxin enzyme-linked immunosorbent assay (using single and paired serology) and of real-time PCR assays (using the IS481 and ptxA-Pr targets). All available diagnostic information (clinical and laboratory) was pooled to serve as the gold standard. Single serology was the most efficient diagnostic test (Youden index, 0.57 to 0.58), with relatively high sensitivity (>64%) and high specificity (>90%), independent of the cutoff level. IS481 PCR performance was superior to that of ptxA-Pr PCR, and it was the second-most-efficient tool (Youden index, 0.30). Performing both ptxA-Pr and IS481 PCRs did not improve diagnostic performance. The greatest test efficiency (Youden index, 0.69 to 0.74) was achieved when single-serum serology was used in combination with IS481 or ptxA-Pr PCR or paired serology. Combining single serology with one PCR or paired serology increased the sensitivity with an associated limited decrease in specificity. The most specific tests for diagnosis of pertussis were single serology and ptxA-Pr PCR, and the most sensitive diagnostic tool was the combination of IS481 PCR with single serology.Currently there is no satisfactory gold standard technique for laboratory confirmation of a pertussis infection. Although culture is highly specific, sensitivity is low and declines with the duration of illness, and the method may take up to 7 days to provide a result. Using culture alone to diagnose pertussis is likely to lead to underreporting of pertussis cases (8). Serological assays, using one or two serum samples, have been developed to improve the sensitivity of the pertussis diagnosis, but they have a lower specificity than culture (3,9,20,25). PCR techniques were developed to overcome these limitations, but despite a consensus meeting in 2005 (24), these techniques still require further standardization and optimization. To date there are few reports (8) in which the sensitivities and specificities of these different techniques are compared using a population exposed to pertussis.The objective of this study was to compare the sensitivities and specificities of the current most widely used techniques to diagnose pertussis in exposed populations, namely, two PCR methods (IS481 and ptxA-Pr targets) and single and paired serology for detection of antipertussis toxin (PT) antibodies in the serum of the patients using enzyme-linked immunosorbent assay (ELISA) with two different cutoffs (two-or fourfold change for paired serology and Ն100 or Ն125 ELISA units [EU]/ml for single...

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The incidence of Bordetella pertussis infections estimated in the population from a combination of serological surveys

Cited by 158 publications

References 43 publications

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

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

Retrospective space-time cluster analysis of whooping cough re-emergence in Barcelona, Spain, 2000-2011

Comparison of Serological and Real-Time PCR Assays To Diagnose Bordetella pertussis Infection in 2007

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