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Kardos P, Correia de Sousa J, Heininger U, Konstantopoulos A, MacIntyre CR, Middleton D, Nolan T, Papi A, Rendon A, Rizzo A, Sampson K, Sette A, Sobczyk E, Tan T, Weil-Olivier C, Weinberger B, Wilkinson T, Wirsing von König CH. Understanding the impact of adult pertussis and current approaches to vaccination: A narrative review and expert panel recommendations. Hum Vaccin Immunother 2024; 20:2324547. [PMID: 38564339 PMCID: PMC10989709 DOI: 10.1080/21645515.2024.2324547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 02/25/2024] [Indexed: 04/04/2024] Open
Abstract
Pertussis has several notable consequences, causing economic burden, increased strain on healthcare facilities, and reductions in quality of life. Recent years have seen a trend toward an increase in pertussis cases affecting older children and adults. To boost immunity, and protect vulnerable populations, an enduring approach to vaccination has been proposed, but gaps remain in the evidence surrounding adult vaccination that are needed to inform such a policy. Gaps include: the true incidence of pertussis and its complications in adults; regional variations in disease recognition and reporting; and incidence of severe disease, hospitalizations, and deaths in older adults. Better data on the efficacy/effectiveness of pertussis vaccination in adults, duration of protection, and factors leading to poor vaccine uptake are needed. Addressing the critical evidence gaps will help highlight important areas of unmet need and justify the importance of adult pertussis vaccination to healthcare professionals, policymakers, and payers.
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Affiliation(s)
- Peter Kardos
- Group Practice & Center, Allergy, Respiratory and Sleep Medicine, Maingau Hospital of the Red Cross, Frankfurt am Main, Germany
| | - Jaime Correia de Sousa
- Life and Health Sciences Research Institute, School of Medicine, University of Minho School of Medicine, Braga, Portugal
| | - Ulrich Heininger
- Pediatric Infectious Diseases and Vaccinology, University of Basel Children’s Hospital, BaselSwitzerland
| | | | - C. Raina MacIntyre
- Kirby Institute, UNSW Medicine, University of New South Wales, Sydney, Australia
| | - Donald Middleton
- Department of Pediatrics, University of Pittsburgh Medical Center, Pittsburgh, USA
| | - Terry Nolan
- Department of Infectious Diseases, University of Melbourne, Melbourne, Australia
| | - Alberto Papi
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Adrian Rendon
- Pulmonary/Critical Care Division, Autonomous University of Nuevo León, San Nicolás de los Garza, Mexico
| | | | - Kim Sampson
- Immunisation Coalition, Melbourne, Australia
| | - Alessandro Sette
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, San Diego, USA
| | - Elizabeth Sobczyk
- AMDA – The Society for Post-Acute and Long-Term Care Medicine, Denver, USA
| | - Tina Tan
- Feinberg School of Medicine, Northwestern University, Chicago, USA
| | | | - Birgit Weinberger
- Institute for Biomedical Aging Research, Universität Innsbruck, Innsbruck, Austria
| | - Tom Wilkinson
- Faculty of Medicine, University of Southampton, Southampton, UK
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Shi W, Wang B, Meng Q, Zhang X, Li Z, He F, Ying F, Cong L, Yao K. Seroprevalence of tetanus and pertussis antibodies among health care workers in Wuhu, China. Hum Vaccin Immunother 2024; 20:2318892. [PMID: 38465707 PMCID: PMC10936590 DOI: 10.1080/21645515.2024.2318892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/12/2024] [Indexed: 03/12/2024] Open
Abstract
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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Affiliation(s)
- Wei Shi
- MOE Key Laboratory of Major Diseases in Children,National Key Discipline of Pediatrics, National Clinical Research Center for Respiratory Diseases, Beijing Pediatric Research Institute, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
| | - Bingsong Wang
- MOE Key Laboratory of Major Diseases in Children,National Key Discipline of Pediatrics, National Clinical Research Center for Respiratory Diseases, Beijing Pediatric Research Institute, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
| | - Qinghong Meng
- MOE Key Laboratory of Major Diseases in Children,National Key Discipline of Pediatrics, National Clinical Research Center for Respiratory Diseases, Beijing Pediatric Research Institute, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
| | - Xianlai Zhang
- Pediatric Respiratory Department, The First People’s Hospital of Wuhu, Wuhu, China
| | - Zhen Li
- Department of Laboratory Medicine, The First People’s Hospital of Wuhu, Wuhu, China
| | - Fang He
- Medical Centre, The First People’s Hospital of Wuhu, Wuhu, China
| | - Fei Ying
- Department of Laboratory Medicine, The First People’s Hospital of Wuhu, Wuhu, China
| | - Linyan Cong
- Pediatric Respiratory Department, The First People’s Hospital of Wuhu, Wuhu, China
| | - Kaihu Yao
- MOE Key Laboratory of Major Diseases in Children,National Key Discipline of Pediatrics, National Clinical Research Center for Respiratory Diseases, Beijing Pediatric Research Institute, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
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3
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Ristić M, Medić S, Vuković V, Rajčević S, Koprivica M, Banjac J, Ljubičić S, Petrović V. Pertussis Epidemiology in the Autonomous Province of Vojvodina, Serbia, 1948-2023. Vaccines (Basel) 2024; 12:525. [PMID: 38793776 PMCID: PMC11126017 DOI: 10.3390/vaccines12050525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/02/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
Pertussis continues to be a significant public health concern. We aimed to examine the epidemiological characteristics of pertussis in Vojvodina, which accounts for almost a third of Serbia's population. Our aim was to determine the overall and age-specific incidence and mortality rates of pertussis in Vojvodina from 1948 to 2023, as well as the coverage of immunization against pertussis from 1960 to 2023. In the period 1948-2023, 42,259 cases of pertussis were reported. Following the introduction of the DTwP vaccine (1960) in Serbia, the reported incidence of pertussis began to decline. In 2001, for the first time since introduction of pertussis surveillance in Vojvodina, no pertussis cases were reported. Since 2012, the reported incidence of pertussis has once again increased, and peaked (41.1/100,000) in 2023, approaching the incidence rates recorded shortly after the introduction of DTwP vaccine. A shift in the age profile of pertussis from children aged 0-6 years to school-aged children (7-14 years) occurred between 2012 and 2023, when 48.3% of pertussis cases occurred in this age group. Although the incidence rates of pertussis among individuals aged 20 years and older were significantly lower than among younger age groups, there is evidence of an increasing trend in pertussis cases, particularly among those aged 40-49 years, since 2012. Based on the findings of this study, it is imperative to introduce additional booster doses of the aP vaccine for individuals aged 14 years, along with implementing maternal immunization strategies targeting women of childbearing age.
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Affiliation(s)
- Mioljub Ristić
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia (V.P.)
- Institute of Public Health of Vojvodina, 21000 Novi Sad, Serbia
| | - Snežana Medić
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia (V.P.)
- Institute of Public Health of Vojvodina, 21000 Novi Sad, Serbia
| | - Vladimir Vuković
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia (V.P.)
- Institute of Public Health of Vojvodina, 21000 Novi Sad, Serbia
| | - Smiljana Rajčević
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia (V.P.)
- Institute of Public Health of Vojvodina, 21000 Novi Sad, Serbia
| | - Marko Koprivica
- Institute of Public Health of Vojvodina, 21000 Novi Sad, Serbia
| | - Jelena Banjac
- Public Health Institute Subotica, 24000 Subotica, Serbia
| | - Stefan Ljubičić
- Institute of Public Health of Vojvodina, 21000 Novi Sad, Serbia
| | - Vladimir Petrović
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia (V.P.)
- Institute of Public Health of Vojvodina, 21000 Novi Sad, Serbia
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Gillard J, Suffiotti M, Brazda P, Venkatasubramanian PB, Versteegen P, de Jonge MI, Kelly D, Bibi S, Pinto MV, Simonetti E, Babiceanu M, Kettring A, Teodosio C, de Groot R, Berbers G, Stunnenberg HG, Schanen B, Fenwick C, Huynen MA, Diavatopoulos DA. Antiviral responses induced by Tdap-IPV vaccination are associated with persistent humoral immunity to Bordetella pertussis. Nat Commun 2024; 15:2133. [PMID: 38459022 PMCID: PMC10923912 DOI: 10.1038/s41467-024-46560-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/01/2024] [Indexed: 03/10/2024] Open
Abstract
Many countries continue to experience pertussis epidemics despite widespread vaccination. Waning protection after booster vaccination has highlighted the need for a better understanding of the immunological factors that promote durable protection. Here we apply systems vaccinology to investigate antibody responses in adolescents in the Netherlands (N = 14; NL) and the United Kingdom (N = 12; UK) receiving a tetanus-diphtheria-acellular pertussis-inactivated poliovirus (Tdap-IPV) vaccine. We report that early antiviral and interferon gene expression signatures in blood correlate to persistence of pertussis-specific antibody responses. Single-cell analyses of the innate response identified monocytes and myeloid dendritic cells (MoDC) as principal responders that upregulate antiviral gene expression and type-I interferon cytokine production. With public data, we show that Tdap vaccination stimulates significantly lower antiviral/type-I interferon responses than Tdap-IPV, suggesting that IPV may promote antiviral gene expression. Subsequent in vitro stimulation experiments demonstrate TLR-dependent, IPV-specific activation of the pro-inflammatory p38 MAP kinase pathway in MoDCs. Together, our data provide insights into the molecular host response to pertussis booster vaccination and demonstrate that IPV enhances innate immune activity associated with persistent, pertussis-specific antibody responses.
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Affiliation(s)
- Joshua Gillard
- Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Madeleine Suffiotti
- Service of Immunology and Allergy, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Peter Brazda
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | - Pauline Versteegen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Marien I de Jonge
- Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dominic Kelly
- Department of Paediatrics, Oxford Vaccine Group, University of Oxford, Oxford, UK
- Oxford NIHR Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Sagida Bibi
- Department of Paediatrics, Oxford Vaccine Group, University of Oxford, Oxford, UK
- Oxford NIHR Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Marta Valente Pinto
- Department of Paediatrics, Oxford Vaccine Group, University of Oxford, Oxford, UK
- Oxford NIHR Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, Almada, Portugal
| | - Elles Simonetti
- Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | | | - Cristina Teodosio
- Leiden University Medical Center, Immunohematology & Blood Transfusion, Leiden, The Netherlands
| | - Ronald de Groot
- Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Guy Berbers
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | | | - Craig Fenwick
- Service of Immunology and Allergy, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Martijn A Huynen
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dimitri A Diavatopoulos
- Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.
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5
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Macina D, Mathur S, Dvaretskaya M, Ekhtiari S, Hayat P, Montmerle M, Daluwatte C. Estimating the pertussis burden in adolescents and adults in the United States between 2007 and 2019. Hum Vaccin Immunother 2023; 19:2208514. [PMID: 37171153 PMCID: PMC10184607 DOI: 10.1080/21645515.2023.2208514] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
We developed a machine learning algorithm to identify undiagnosed pertussis episodes in adolescent and adult patients with reported acute respiratory disease (ARD) using clinician notes in an electronic healthcare record (EHR) database. Here, we utilized the algorithm to better estimate the overall pertussis incidence within the Optum Humedica clinical repository from 1 January 2007 through 31 December 2019. The incidence of diagnosed pertussis episodes was 1-5 per 100,000 annually, consistent with data registered by the US Centers for Disease Control and Prevention (CDC) over the same time period. Among 18,573,496 ARD episodes assessed, 1,053,946 were identified (i.e. algorithm-identified) as likely undiagnosed pertussis episodes. Accounting for these undiagnosed pertussis episodes increased the estimated pertussis incidence by 110-fold on average (34-474 per 100,000 annually). Risk factors for pertussis episodes (diagnosed and algorithm-identified) included asthma (Odds ratio [OR] 2.14; 2.12-2.16), immunodeficiency (OR 1.85; 1.78-1.91), chronic obstructive pulmonary disease (OR 1.63; 1.61-1.65), obesity (OR 1.44; 1.43-1.45), Crohn's disease (OR 1.39; 1.33-1.45), diabetes type 1 (OR 1.21; 1.17-1.24) and type 2 (OR 1.12; 1.1-1.13). Of note, all these risk factors, except Crohn's disease, increased the likelihood of severe pertussis. In conclusion, the incidence of pertussis in the adolescent and adult population in the USA is likely substantial, but considerably under-recognized, highlighting the need for improved clinical awareness of the disease and for improved control strategies in this population. These results will help better inform public health vaccination and booster programs, particularly in those with underlying comorbidities.
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Affiliation(s)
- Denis Macina
- Global Medical, PPH Franchise, Sanofi, Lyon, France
| | - Sachin Mathur
- Digital R&D, Sanofi US Services, Inc, Cambridge, MA, USA
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Roohparvar Basmenj E, Izadkhah H, Hosseinpour M, Saburi E, Abhaji Ezabadi M, Alipourfard I. A novel approach to design a multiepitope peptide as a vaccine candidate for Bordetella pertussis. J Biomol Struct Dyn 2023:1-13. [PMID: 37937610 DOI: 10.1080/07391102.2023.2278081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 10/26/2023] [Indexed: 11/09/2023]
Abstract
Bordetella pertussis is a very contagious pathogen in humans, causing pertussis disease. Pertussis is one of the 10 leading causes of death due to infectious diseases, especially among infants and children. Antibiotic-resistant strains have recently emerged in this bacterium, and despite the high vaccination coverage, the prevalence of this disease has been increasing recently in both developed and developing countries. The objective of this study is to introduce a novel in silico vaccine candidate aimed at countering B. pertussis effectively. Differing from other comparable studies, this research employed a computational screening methodology to assess the genome of 'Bordetella pertussis 18323.' The purpose was to identify an innovative antigen for the development of a vaccine against B. pertussis. Notably, our investigation introduces an innovative antigen distinguished by its elevated immunogenicity score. Importantly, this antigen lacks toxicity and allergenicity, making it recognizable to the immune system and thus capable of inducing a robust immune response. In the subsequent phase, our antigen was utilized to identify potential epitopes conducive to the construction of a B. pertussis vaccine. These epitopes, alongside linkers, his-tag and adjuvants, were amalgamated to form the vaccine candidate. Subsequently, a comprehensive evaluation of the vaccine was conducted, encompassing various computational tests such as secondary and tertiary structure analysis, physicochemical examination, and structural analysis involving docking and molecular dynamics simulations. Importantly, our vaccine successfully passed all in silico tests.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
| | - Habib Izadkhah
- Department of Computer Science, Faculty of Mathematics, Statistics, and Computer Science, University of Tabriz, Tabriz, Iran
| | - Maryam Hosseinpour
- Department of Medical Genetics and Molecular Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Saburi
- Department of Medical Genetics and Molecular Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Marjan Abhaji Ezabadi
- Department of Chemical Engineering, Faculty of Engineering, University of Tehran, Tehran, Iran
| | - Iraj Alipourfard
- Institute of Physical Chemistry, Polish Academy of Sciences, Warsaw, Poland
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Pehlivan T, Dinleyici EC, Kara A, Kurugöl Z, Tezer H, Aksakal NB, Biri A, Azap A. The Present and Future Aspects of Life-Long Pertussis Prevention: Narrative Review with Regional Perspectives for Türkiye. Infect Dis Ther 2023; 12:2495-2512. [PMID: 37815753 PMCID: PMC10651609 DOI: 10.1007/s40121-023-00876-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/18/2023] [Indexed: 10/11/2023] Open
Abstract
Pertussis, caused by Bordetella pertussis, remains one of the most widespread, contagious, and vaccine-preventable diseases. It results in notable morbidity and mortality as well as severe medical, social, and economic burden. Despite high global vaccine coverage, pertussis continues to be a significant epidemiologic problem, with outbreak episodes every few years just as in the pre-vaccination era. In Türkiye, there is a lack of comprehensive data on the current burden of pertussis in different age and risk groups, leading to underdiagnosis and underreporting of the disease, especially in adults who are often not considered at risk. Available data from Türkiye also reveal inadequate levels of protective antibodies in preterm newborns, emphasizing the need for additional preventive measures. Authors stated that improving physician awareness of pertussis symptoms in patients with prolonged cough, increasing access to routine pertussis tests, and conducting surveillance studies would aid in accurate diagnosis and reporting in Türkiye. As the Turkish Ministry of Health Antenatal Care Management Guide suggests routine second and third pregnancy check-up visits at weeks 18-24 and 28-32 correspondingly, this period can be considered the ideal vaccination time for Türkiye. Introducing a booster dose of Tdap at around 10 years of age or during national military service would reduce transmission and protect susceptible individuals. Identifying individuals at high risk of severe pertussis and prioritizing them for a booster dose is also crucial in Türkiye. Enhancing surveillance systems, increasing healthcare professionals' awareness through training, and organizing catch-up visits for missed vaccinations during the COVID-19 pandemic are mentioned as additional strategies to improve pertussis prevention in Türkiye. This review focuses on the global and regional burden of pertussis and obstacles to effective prevention and evaluates existing strategies to achieve lifelong pertussis prevention. Literature and current strategies were also discussed from a Turkish national standpoint.
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Affiliation(s)
- Tamer Pehlivan
- Public Health, Remedium Consulting Group, Izmir, Türkiye.
| | - Ener Cagri Dinleyici
- Department of Pediatrics, Eskisehir Osmangazi University School of Medicine, Eskisehir, Türkiye
| | - Ateş Kara
- Department of Pediatric Infectious Diseases, Hacettepe University School of Medicine, Ankara, Türkiye
| | - Zafer Kurugöl
- Department of Pediatric Infectious Diseases, Ege University School of Medicine, Izmir, Türkiye
| | - Hasan Tezer
- Department of Pediatric Infectious Diseases, Gazi University School of Medicine, Ankara, Türkiye
| | - Nur Baran Aksakal
- Department of Public Health, Gazi University School of Medicine, Ankara, Türkiye
| | - Aydan Biri
- Department of Obstetrics and Gynaecology, Koru Ankara Hospital, Ankara, Türkiye
| | - Alpay Azap
- Department of Infectious Diseases and Clinical Microbiology, Ankara University School of Medicine, Ankara, Türkiye
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Sharma HJ, Parekh S, Pujari P, Shewale S, Desai S, Kawade A, Ravi M, Oswal J, James S, Mahantashetti N, Munshi R, Ghosh A, Rao V, Balsubramaniam S, Varughese P, Somshekhar A, Ginsburg AS, Rao H, Gautam M, Gairola S, Shaligram U. Safety and immunogenicity of an indigenously developed tetanus toxoid, diphtheria toxoid, and acellular pertussis vaccine (Tdap) in adults, adolescents, and children in India. Expert Rev Vaccines 2023; 22:278-287. [PMID: 36883291 DOI: 10.1080/14760584.2023.2188942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
BACKGROUND This study assessed safety and immunogenicity of Serum Institute of India Pvt Ltd (SIIPL)'s tetanus toxoid (TT), diphtheria toxoid (DT), and acellular pertussis booster vaccine (Tdap). RESEARCH DESIGN AND METHODS In this Phase II/III, multicenter, randomized, active-controlled, open-label study, 1500 healthy individuals, aged 4-65 years, were randomized to receive a single dose of SIIPL Tdap or comparator Tdap vaccine (Boostrix®; GlaxoSmithKlines, India). Adverse events (AEs) during initial 30 minutes, 7-day, 30-day post-vaccination were assessed. Blood samples were taken before and 30 days post-vaccination for immunogenicity assessment. RESULTS No significant differences in incidence of local and systemic solicited AEs were observed between the two groups; no vaccine-related serious AEs were reported. SIIPL Tdap was non-inferior to comparator Tdap in achieving booster responses to TT and DT in 75.2% and 70.8% of the participants, respectively, and to pertussis toxoid (PT), pertactin (PRN), and filamentous hemagglutinin (FHA) in 94.3%, 92.6%, and 95.0% of the participants, respectively. Anti-PT, anti-PRN, and anti-FHA antibody geometric mean titers in both the groups, were significantly higher post-vaccination compared to pre-vaccination. CONCLUSIONS Booster vaccination with SIIPL Tdap was non-inferior to comparator Tdap with respect to immunogenicity against tetanus, diphtheria, and pertussis and was well tolerated.
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Affiliation(s)
- Hitt J Sharma
- Department of Clinical Research and Pharmacovigilance, Serum Institute of India Pvt. Ltd, Pune, India
| | - Sameer Parekh
- Department of Clinical Research and Pharmacovigilance, Serum Institute of India Pvt. Ltd, Pune, India
| | - Pramod Pujari
- Department of Clinical Research and Pharmacovigilance, Serum Institute of India Pvt. Ltd, Pune, India
| | - Sunil Shewale
- Department of Clinical Research and Pharmacovigilance, Serum Institute of India Pvt. Ltd, Pune, India
| | - Shivani Desai
- Department of Clinical Research and Pharmacovigilance, Serum Institute of India Pvt. Ltd, Pune, India
| | - Anand Kawade
- Department of Pediatrics, KEM Hospital Research Centre, Vadu Rural Health Program, Pune, India
| | - Mandyam Ravi
- Department of Pediatrics, JSS Hospital, Mysore, India
| | - Jitendra Oswal
- Department of Pediatrics, Bharti Vidyapeeth Deemed University Medical College and Hospital, Pune, India
| | - Saji James
- Department of Pediatrics, Sri Ramchandra Institute of Higher Education and Research, Chennai, India
| | - N Mahantashetti
- Department of Pediatrics, KLE's Dr. Prabhakar Kore Hospital, Belgavi, India
| | - Renuka Munshi
- Department of Clinical Pharmacology, Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable Hospital, Mumbai, India
| | - Apurba Ghosh
- Department of Pediatrics, Institute of Child Health, Kolkata, India
| | - Venkateshwar Rao
- Department of Medicine, Global Gleneagles Hospitals, Hyderabad, India
| | | | - P Varughese
- Department of Pediatrics, Christian Medical College, Ludhiana, India
| | - A Somshekhar
- Department of Pediatrics, M. S. Ramaiah Medical College & Hos, Bengaluru, India
| | | | - Harish Rao
- Production Department, Serum Institute of India Pvt Ltd, Pune, India
| | - Manish Gautam
- Department of Quality Control, Serum Institute of India Pvt Ltd, Pune, India
| | - Sunil Gairola
- Department of Quality Control, Serum Institute of India Pvt Ltd, Pune, India
| | - Umesh Shaligram
- Production Department, Serum Institute of India Pvt Ltd, Pune, India
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Huoi C, Vargas-Zambrano J, Macina D, Vidor E. A combined DTaP-IPV vaccine (Tetraxim®/Tetravac®) used as school-entry booster: a review of more than 20 years of clinical and post-marketing experience. Expert Rev Vaccines 2022; 21:1215-1231. [PMID: 35983656 DOI: 10.1080/14760584.2022.2084076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Routine infant primary series and toddler booster vaccination are associated with waning of antibody levels over time, which can lead to an increased incidence of vaccine-preventable diseases. A diphtheria-tetanus-pertussis (DTP) booster vaccination at school-entry (aged 4-7 years) allows continued protection against these diseases and is included in many national immunization programs. AREAS COVERED The available immunogenicity and safety data from 6 clinical studies of a diphtheria-tetanus-acellular pertussis-inactivated poliovirus vaccine (DTaP-IPV [Tetraxim®]) used as a school-entry booster vaccination were identified using a PubMed search or on file at Sanofi. The studies spanned a 15-year period (1995-2010) and were performed in different populations using different study designs, so all data were reviewed descriptively (no meta-analyses were conducted). Additionally, post-marketing experience was reviewed. EXPERT OPINION Each vaccine antigen is highly immunogenic, and the safety profile of the vaccine is satisfactory. Post-marketing evaluations have shown the effectiveness of a school-age booster, particularly against increased pertussis disease incidence around the time of school entry and the associated risk of spreading the disease through contact with younger vulnerable infants. School-entry provides an ideal opportunity to implement DTaP-IPV vaccination to close the gap between waning immunity from the previous infant/toddler vaccination and future adolescent vaccination.
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Chen Z, Pang J, Zhang Y, Ding Y, Chen N, Zhang N, He Q. Seroprevalence of Pertussis in Adults at Childbearing Age Pre- and Post- COVID-19 in Beijing, China. Vaccines (Basel) 2022; 10:vaccines10060872. [PMID: 35746480 PMCID: PMC9227865 DOI: 10.3390/vaccines10060872] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 02/04/2023] Open
Abstract
The number of reported pertussis cases has significantly decreased during the coronavirus disease 2019 (COVID-19) pandemic under the influence of strict public health measures in many countries including China. This study evaluated the prevalence of serum anti-pertussis toxin (anti-PT) IgG antibodies in adults at childbearing age pre- and post- COVID-19 in Beijing, China. Altogether, 2021 serum samples collected from individuals aged 20 to 39 years who attended an annual health examination at the Sixth Medical Center of PLA General Hospital, Beijing, in 2018~2020 were measured by ELISA. The median concentration of anti-PT IgG antibodies among participants in 2020 (2.96 IU/mL) was significantly lower than that in 2018 (3.27 IU/mL) (p = 0.011) and in 2019 (3.24 IU/mL) (p = 0.014). The percentage of participants with anti-PT IgG antibodies higher than 40 IU/mL (indicating a pertussis infection within the past few years) was 1.79% (9/503) in 2018, 2.04% (15/735) in 2019 and 1.66% (13/783) in 2020, respectively. The corresponding numbers of the non-detectable (<5 IU/mL) rate of anti-PT IgG antibodies were 66.60%, 65.99% and 70.24%. Our results showed that there was a significant difference between true and reported incidence rates even during the COVID-19 pandemic. The proportion of adults at childbearing age without pertussis-specific antibodies is high, suggesting that booster vaccinations in adults should be considered in this country.
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Affiliation(s)
- Zhiyun Chen
- Department of Medical Microbiology, Capital Medical University, Beijing 100069, China; (Z.C.); (J.P.); (N.C.); (N.Z.)
| | - Jie Pang
- Department of Medical Microbiology, Capital Medical University, Beijing 100069, China; (Z.C.); (J.P.); (N.C.); (N.Z.)
| | - Yuxiao Zhang
- Medical Research & Laboratory Diagnostic Center, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan 250013, China;
| | - Yiwei Ding
- Department of Respiratory Medicine, The Sixth Medical Center of PLA General Hospital, Beijing 100048, China;
| | - Ning Chen
- Department of Medical Microbiology, Capital Medical University, Beijing 100069, China; (Z.C.); (J.P.); (N.C.); (N.Z.)
| | - Nan Zhang
- Department of Medical Microbiology, Capital Medical University, Beijing 100069, China; (Z.C.); (J.P.); (N.C.); (N.Z.)
| | - Qiushui He
- Department of Medical Microbiology, Capital Medical University, Beijing 100069, China; (Z.C.); (J.P.); (N.C.); (N.Z.)
- Institute of Biomedicine, Research Center for Infections and Immunity, University of Turku, 20520 Turku, Finland
- Correspondence: ; Tel.: +358-50-472-2255
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Wang Q, Xiu S, Yang L, Han Y, Cui T, Shi N, Liu M, Yi Y, Liu C, Wang X, Yang G, Ji L, Zhou W, Jin H, Zhen S, Lin L. Changes in the public attitude toward childhood vaccine and the COVID-19 vaccine during different periods: A repeated cross-section study in Wuxi city, China. JMIR Public Health Surveill 2022; 8:e33235. [PMID: 35486516 PMCID: PMC9109779 DOI: 10.2196/33235] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 03/02/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND It was reported that one in four parents were hesitant about vaccinating their children in China. Previous studies have revealed a declining trend in the vaccine willingness rate in China. There is a need to monitor the level of parental vaccine hesitancy towards routine childhood vaccination and hesitancy toward the coronavirus disease 2019 (COVID-19) vaccine during the ongoing COVID-19 pandemic. OBJECTIVE This study aimed to assess changes in trends of parental attitudes toward routine childhood vaccine and COVID-19 vaccinations across different time periods in China. METHODS Three waves of cross-sectional surveys were conducted on parents residing in Wuxi City in Jiangsu province, China from September to October 2020, February to March 2021, and May to June 2021. Participants were recruited from immunization clinics. Chi-square tests used to compare the results of the three surveys, controlling for sociodemographic factors. Binary and multivariable logistic regression analysis was used to examine factors related to parental vaccine hesitancy and COVID-19 vaccine willingness. RESULTS Overall, 2,881, 1,038, and 1,183 participants were included in the survey's three-waves. Using the Vaccine Hesitancy Scale, 7.8%, 15.1%, and 5.5% of parents showed hesitancy to children vaccination (P<.001), and 59.3%, 64.6%, and 92.0% of parents agreed to receive a COVID-19 vaccine themselves in the first, second, and third surveys, respectively (P<.001). In all three surveys, "concerns about vaccine safety and side effects" was the most common reason for refusal. CONCLUSIONS There has been an increasing acceptance of COVID-19 vaccination in Wuxi City, China. Effective interventions need be taken to mitigate public concerns about vaccine safety. CLINICALTRIAL
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Affiliation(s)
- Qiang Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, 87# Dingjiaqiao 210009 Nanjing PR China, Nanjing, CN.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, CN
| | - Shixin Xiu
- Wuxi Center for Disease Control and Prevention, Wuxi, CN
| | - Liuqing Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, 87# Dingjiaqiao 210009 Nanjing PR China, Nanjing, CN.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, CN
| | - Ying Han
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, 87# Dingjiaqiao 210009 Nanjing PR China, Nanjing, CN.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, CN
| | - Tingting Cui
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, 87# Dingjiaqiao 210009 Nanjing PR China, Nanjing, CN.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, CN
| | - Naiyang Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, 87# Dingjiaqiao 210009 Nanjing PR China, Nanjing, CN.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, CN
| | - Minqi Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, 87# Dingjiaqiao 210009 Nanjing PR China, Nanjing, CN.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, CN
| | - Youqin Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, 87# Dingjiaqiao 210009 Nanjing PR China, Nanjing, CN.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, CN
| | - Chang Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, 87# Dingjiaqiao 210009 Nanjing PR China, Nanjing, CN.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, CN
| | - Xuwen Wang
- Wuxi Center for Disease Control and Prevention, Wuxi, CN
| | - Guoping Yang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, CN
| | - Lili Ji
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, CN
| | - Weijie Zhou
- Wuxi Center for Disease Control and Prevention, Wuxi, CN
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, 87# Dingjiaqiao 210009 Nanjing PR China, Nanjing, CN.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, CN
| | - Shiqi Zhen
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, CN
| | - Leesa Lin
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, GB.,Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, HongKong, CN
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Chen Z, Pang J, Zhang N, Chen N, Ding Y, He Q. Seroprevalence Study of Pertussis in Adults at Childbearing Age and Young Infants Reveals the Necessity of Booster Immunizations in Adults in China. Vaccines (Basel) 2022; 10:vaccines10010084. [PMID: 35062745 PMCID: PMC8779665 DOI: 10.3390/vaccines10010084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/31/2021] [Accepted: 01/05/2022] [Indexed: 12/04/2022] Open
Abstract
In China, the vaccination strategy against pertussis is started from 3 months of age, with no booster dose used after the booster given at two years. Despite a high vaccination coverage, pertussis has been increasingly reported since the last decade. This study evaluates the prevalence of serum anti-pertussis toxin (PT) IgG antibodies in adults at childbearing age and infants before the age of primary immunization in Beijing, China. A total of 1175 serum samples randomly selected from individuals who attended an annual health examination at the Sixth Medical Center of the PLA General Hospital, Beijing, in 2019, was included. The geometric mean concentration (GMC) and median concentration of anti-PT IgG antibodies among adults aged 20–39 years were 3.81 IU/mL and 3.24 IU/mL, and the corresponding concentrations were 1.72 IU/mL and 1.43 IU/mL among infants under 3 months of age. The seroprevalence of PT IgG antibodies ≥ 40 IU/mL in adults and infants was 2.0% (15/735) and 1.1% (5/440). In total, 65.99% (485/735) of adults and 83.41% (367/440) of infants had non-detectable pertussis-specific antibodies (<5 IU/mL). Our results showed that the majority of adults at a reproductive age and young infants are vulnerable to pertussis, suggesting that booster vaccinations in adults should be considered in this country.
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Affiliation(s)
- Zhiyun Chen
- Department of Medical Microbiology, Capital Medical University, Beijing 100069, China; (Z.C.); (J.P.); (N.Z.); (N.C.); (Y.D.)
| | - Jie Pang
- Department of Medical Microbiology, Capital Medical University, Beijing 100069, China; (Z.C.); (J.P.); (N.Z.); (N.C.); (Y.D.)
| | - Nan Zhang
- Department of Medical Microbiology, Capital Medical University, Beijing 100069, China; (Z.C.); (J.P.); (N.Z.); (N.C.); (Y.D.)
| | - Ning Chen
- Department of Medical Microbiology, Capital Medical University, Beijing 100069, China; (Z.C.); (J.P.); (N.Z.); (N.C.); (Y.D.)
| | - Yiwei Ding
- Department of Medical Microbiology, Capital Medical University, Beijing 100069, China; (Z.C.); (J.P.); (N.Z.); (N.C.); (Y.D.)
- The Sixth Medical Center, Department of Respiratory Medicine, Chinese PLA General l Hospital, Beijing 100048, China
| | - Qiushui He
- Department of Medical Microbiology, Capital Medical University, Beijing 100069, China; (Z.C.); (J.P.); (N.Z.); (N.C.); (Y.D.)
- Research Center for Infections and Immunity, Institute of Biomedicine, University of Turku, 20520 Turku, Finland
- Correspondence: ; Tel.: +358-50-472-2255
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Lin LN, Zhou JS, Hua CZ, Bai GN, Mi YM, Zhou MM. Epidemiological and clinical characteristics of pertussis in children and their close contacts in households: A cross-sectional survey in Zhejiang Province, China. Front Pediatr 2022; 10:976796. [PMID: 36061393 PMCID: PMC9434343 DOI: 10.3389/fped.2022.976796] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/02/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Despite the expanded immunization programs, the "re-emergence of pertussis" has become a global concern in recent years. At present, the prevalence of pertussis in China is seriously underestimated, and the role of close contact on the disease spreading in children remains unclear. OBJECTIVES Our study aimed to investigate pertussis's epidemiological and clinical characteristics in children and their close contacts in households, as well as the antimicrobial resistance of Bordetella pertussis (B. pertussis) in Zhejiang Province, China. METHODS We have collected the retrospective and prospective data of children who were suspected of pertussis and their close contacts in households from January 1, 2018, to December 31, 2020, in the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China. Nasopharyngeal swabs were collected and cultured for B. pertussis. Antibiotics susceptibility test was determined by using E-test methods. Clinical information was collected from the medical records systems. RESULTS A total of 350 index patients and their 946 family members (close contacts in households) from 350 families were recruited. B. pertussis strains were isolated from 130 (37.1%) index patients and 116 (12.3%) close contacts. 37 index patients had negative culture results for B. pertussis while their close contacts were positive. A higher positive rate was found in female adults than that in male adults (16.3% vs. 5.1%, P < 0.01). The positive rate in index patients from multi-child families was significantly higher than that from one-child families (51.7% vs. 37.7%, P < 0.05). 53.3% of the pertussis patients were under 6 months of age. 98 (75.4%) isolates had MICs ≥ 256 mg/L to erythromycin, azithromycin, and clindamycin, and 127 (97.7%) had MICs < 0.016 mg/L to piperacillin. CONCLUSION Infants under 6 months of age are at high risk of pertussis, and close contacts in households are prone to cluster infection. Culture for B. pertussis both in children and their close contacts contributes to improving the diagnosis rate of pertussis in children. Isolates of B. pertussis in China are highly resistant to macrolides.
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Affiliation(s)
- Luo-Na Lin
- Department of Infectious Diseases, National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jin-Si Zhou
- Department of Infectious Diseases, National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chun-Zhen Hua
- Department of Infectious Diseases, National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Guan-Nan Bai
- Department of Infectious Diseases, National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yu-Mei Mi
- Department of Infectious Diseases, National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ming-Ming Zhou
- Department of Clinical Laboratory, National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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