The seroepidemiology of Bordetella pertussis infection in Western Europe

Abstract

SUMMARYHigh titres of pertussis toxin (PT) antibody have been shown to be predictive of recent infection with Bordetella pertussis. The seroprevalence of standardized anti-PT antibody was determined in six Western European countries between 1994 and 1998 and related to historical surveillance and vaccine programme data. Standardized anti-PT titres were calculated for a series of whole-cell and acellular pertussis vaccine trials. For the serological surveys, high-titre sera (>125 units/ml) were distributed throughout all age groups in both high-(>90 %) and low-coverage (<90 %) countries. High-titre sera were more likely in infants in countries using high-titre-producing vaccines in their primary programme (Italy, 11 . 5% ; Western Germany, 13 . 3 % ; France, 4 . 3% ; Eastern Germany, 4 . 0%) compared to other countries (The Netherlands, 0 . 5 %; Finland, 0 %). Recent infection was significantly more likely in adolescents (10-19 years old) and adults in high-coverage countries (Finland, The Netherlands, France, East Germany), whereas infection was more likely in children (3-9 years old) than adolescents in low-coverage (<90% ; Italy, West Germany, United Kingdom) countries. The impact and role of programmatic changes introduced after these surveys aimed at protecting infants from severe disease by accelerating the primary schedule or vaccinating older children and adolescents with booster doses can be evaluated with this approach.

Assessment of humoral and cell-mediated immunity againstBordetella pertussisin adolescent, adult, and senior subjects in Italy

“…In conclusion, this study seems to confirm that the epidemiology of pertussis in Italy is changing similarly to what has already occurred in other countries where high vaccination coverage rates have been achieved and maintained for many years [25].…”

“…Some authors have assumed that high anti-PT antibody titres are indicative of a recent or ongoing infection [10,35]. This hypothesis was supported by the group that undertook the European seroepidemiological study on vaccine-preventable diseases (ESEN) [25]. In this study 6 .…”

Pertussis

“…26 Overall, these data clearly show that the burden of pertussis in terms of incidence and hospitalization rate mainly involves infants and confirms that B. pertussis spreads in the European population involving also age groups that were not considered to be a target before. This has already been highlighted by the Network ESEN (European Sero-epidemiology Network), 27,28 and, more recently, in a study carried out in 5 European countries (Finland, Germany, Italy, The Netherlands, and UK).…”

EPIREVIEW: Pertussis in New South Wales, 1993–2005: the impact of vaccination policy on pertussis epidemiology

“…15 In Europe, recent pertussis infection was found to be significantly more likely in adults and adolescents in countries with high immunisation rates. 12 A trend towards pertussis occurring in older age groups has also been documented in NSW in the Hunter/New England Area Health Service. 16 Despite high vaccination rates in many countries, pertussis continues to circulate.…”

“…1,11,12,13 In the United States from 1994-96 to 1997-2000, incidence rates in adolescents and adults increased by 62% and 60%, respectively. 14 In Canada from 1993-98, the proportion of pertussis cases in adults steadily increased 15 and in 2000 for the first time in two decades, 10-14-year-old children represented a larger proportion of cases (34%) and had a higher incidence of pertussis than infants or preschool age children (13%).…”