Whoop! There it is: The surprising resurgence of pertussis

Abstract

Despite high global vaccine coverage, whooping cough, also known as pertussis, caused by the gram-negative obligate human pathogen Bordetella pertussis (Bp), is resurging worldwide. The inactivated whole cell vaccines (wPV), introduced in the 1940s, were extremely effective in preventing severe disease, controlling the bacterial burden in the entire respiratory tract, and preventing transmission. Because of severe reactogenicity and negative public perceptions regarding safety, wPV were discontinued and acellular subunit (1 to 5 protein components) vaccines adjuvanted with alum (aPV) were introduced in many countries. While safer and effective in disease prevention, these aPVs elicit poor and short-lived immunity and fail to prevent infection [1, 2]. Here, we discuss reasons for pertussis resurgence, bacterial evolution, and limitations of current pertussis vaccines. We also propose new directions to fill existing research gaps and accelerate the development of more effective vaccines.

Bbvac: A Live Vaccine Candidate That Provides Long-Lasting Anamnestic and Th17-Mediated Immunity against the Three Classical Bordetella spp.

“…Whooping cough-like disease is unfortunately remerging ( 4 , 5 , 51 ) despite international vaccination efforts. In the manuscript, we describe a novel live attenuated vaccine, Bbvac, which profoundly outperforms the currently available vaccines, providing a combination of humoral and cellular immunity that lasts for at least 15 months in the murine model.…”

Shortening the Lipid A Acyl Chains of Bordetella pertussis Enables Depletion of Lipopolysaccharide Endotoxic Activity

“…Therefore, it was replaced by subunit-based vaccines, which were shown to be safe and effective in inducing protective immunity [ 1 ]. However, particularly the industrialized countries, where these vaccines are in use, have witnessed a resurgence of pertussis in the past decades [ 2 ]. This could be related to the rapid waning of the immunity induced by the acellular vaccines, which evoke a T-helper (Th) 2 response in contrast to the long-lived Th1/Th17-skewed immunity elicited by whole-cell vaccines or by natural infection [ 3 ].…”

Impact of Childhood and Maternal Vaccination against Diphtheria, Tetanus, and Pertussis in Colombia

“…The resurgence of pertussis reported worldwide has been explained by different factors including the loss of vaccine immunity over time and the reduction in vaccination coverage. 28 , 29 Although the effectiveness of maternal vaccination has been widely studied, 8 , 30 , 31 there is a need to strengthen epidemiological surveillance of pertussis and develop new approaches based on hospital reporting, to avoid late consultation, complications, and death. In our study, a percentage increase in hospitalization and mortality, higher frequency of cases in the dispersed rural area, and lower laboratory confirmation of cases were observed after the epidemic period compared with the epidemic period.…”