The problem of pertussis in some regions of the world

Abstract

Pertussis infection remains a high-priority issue both for Russian health care and abroad. A rise of pertussis incidence in various human age groups instigates a search for new ways to fight this infection and improve methods for its laboratory diagnostics. By taking into consideration a short-term effect induced by acellular and whole-cell vaccines, a feasibility of introducing the second or even the third pertussis revaccination is vigorously debated. Objective of the study was to analyze the experience and effectiveness of acellular pertussis vaccines in countries, which use the second and third pertussis revaccination in the National Immunization Schedule in order to have an insight into adjusting strategy and tactics of pertussis immunization In Russia. Analyzing pertussis prevalence demonstrated that despite a wide immunization coverage pertussis incidence in the last years (2008–2015) was increased in a large number of countries in the European region, as well as inAustralia,CanadaandUSA. However, the reasons for elevated pertussis incidence have not been clarified yet. On one hand, it may be accounted for by low vaccination coverage in adolescents and adults; weakened immune protection after vaccination; genetic changes in Bordetella pertussis; shortened durability of protective immunity in children vaccinated with acellular vs. whole-cell vaccine; improved monitoring and morbidity reporting, as well as improved laboratory diagnostics due to shifting from serological and bacteriological to molecular genetic assays. In an attempt to solve this issue, researchers from several countries collaborate to discuss and develop a strategy to reduce pertussis incidence. ForRussia, the most important is to empower and/or improve existing infant immunization strategy in order to provide wide coverage with the four dose pertussis vaccine for decreasing the risk of pertussis morbidity and mortality. It is worth noting the “cocoon” strategy given the high risk of pertussis infection in children of the first months of life. We believe that forRussiait is worth investigating an opportunity of using children 2–3 months of life an acellular vaccine as the first vaccination, which is expected to increase the coverage of this cohort and allow to increase proportion of children who might complete vaccination by 5 months of age. At the same time, more reasonable might be to preserve a number of age groups for pertussis vaccination in the current National Immunization Schedule, as expanding age limits for vaccination might put a risk at increasing pertussis morbidity in older individuals, which could be hard to diagnose.

Systematic review of immunogenicity and duration of immunity of currently licensed pertussis wP vaccines in children

“…Articles identified for the systematic review A total of 2,648 non-duplicate references were identified, and, after screening based on titles and abstracts (first phase), 517 were retained for further assessment. Although the searches were done without language restriction, seven articles had to be excluded because they were written in languages not read by the authors (two Chinese 21,22 , two German 23,24 , onw Russian 25 and two in Uzbek 26,27 . After full texts were assessed (second phase), a total of 12 studies [28][29][30][31][32][33][34][35][36][37][38][39] met the inclusion criteria.…”

Pertussis in the Voronezh Region: Epidemiology and Vaccination

“…Это происходит несмотря на высокий охват вакцинацией детского населения и введения в ряде стран ревакцинации подростков и взрослых. Вплоть до 2003 г. единственной группой риска по коклюшу были дети до года, с 2007 года второе место по рейтингу заняли дети школьного возраста -7-10 лет [4,5].…”