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Remesh AT, Alagarasu K, Jadhav S, Prabhakar M, Viswanathan R. Pertussis Vaccines Scarcely Provide Protection against Bordetella parapertussis Infection in Children-A Systematic Review and Meta-Analysis. Vaccines (Basel) 2024; 12:253. [PMID: 38543887 PMCID: PMC10974608 DOI: 10.3390/vaccines12030253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/12/2024] [Accepted: 01/16/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Pertussis, or whooping cough, is a global public health concern. Pertussis vaccines have demonstrated good protection against Bordetella pertussis infections, but their effectiveness against Bordetella parapertussis remains debated due to conflicting study outcomes. METHODS A systematic review and meta-analysis were conducted to assess the effectiveness of pertussis vaccines in protecting children against B. parapertussis infection. A comprehensive search of PubMed, Web of Science, and Scopus databases was conducted, and randomized controlled trials (RCTs) and observational studies that met inclusion criteria were included in the analysis. RESULTS The meta-analysis, involving 46,533 participants, revealed no significant protective effect of pertussis vaccination against B. parapertussis infection (risk ratio: 1.10, 95% confidence interval: 0.83 to 1.44). Subgroup analyses by vaccine type and study design revealed no significant protection. The dearth of recent data and a limited pool of eligible studies, particularly RCTs, underscore a critical gap that warrants future research in the domain. CONCLUSIONS These findings offer crucial insights into the lack of effectiveness of pertussis vaccines against B. parapertussis. Given the rising incidence of cases and outbreaks, coupled with the lack of cross-protection by the existing vaccines, there is an urgent need to develop vaccines that include specific antigens to protect against B. parapertussis.
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Affiliation(s)
| | - Kalichamy Alagarasu
- Dengue-Chikungunya Group, ICMR-National Institute of Virology, Pune 411001, India;
| | - Santoshkumar Jadhav
- Bioinformatics & Data Management Group, ICMR-National Institute of Virology, Pune 411001, India;
| | - Meera Prabhakar
- Bacteriology Group, ICMR-National Institute of Virology, Pune 411021, India; (A.T.R.); (M.P.)
| | - Rajlakshmi Viswanathan
- Bacteriology Group, ICMR-National Institute of Virology, Pune 411021, India; (A.T.R.); (M.P.)
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Wu X, Du Q, Li D, Yuan L, Meng Q, Fu Z, Xu H, Yao K, Zhao R. A Cross-Sectional Study Revealing the Emergence of Erythromycin-Resistant Bordetella pertussis Carrying ptxP3 Alleles in China. Front Microbiol 2022; 13:901617. [PMID: 35923401 PMCID: PMC9342848 DOI: 10.3389/fmicb.2022.901617] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background Previous limited studies have identified that Bordetella pertussis (B. pertussis) isolates circulating in China possess distinct molecular features and high rates of erythromycin-resistance (ER). Their evolution and potential impact on the prevention and control of global pertussis are worthy of attention. Methods The present cross-sectional study involved 311 non-duplicate and unrelated B. pertussis strains isolated from Chinese children from 2017 to 2019. Their antimicrobial susceptibilities were assessed using both E-test strips and Kirby-Bauer (KB) disk diffusion methods. Seven virulence-related genes (ptxA, ptxC, ptxP, prn, fim2, fim3, and tcfA2) and the A2047G mutation in the 23S rRNA gene were detected by PCR. Based on the susceptibilities and genotypes, 50 isolates were selected for multi-locus variable-number tandem-repeat analysis (MLVA) typing and whole-genome sequencing. Results A total of 311 B. pertussis strains were isolated from children with a median age of 4 months (interquartile range: 2–9 months). Strains carrying the ptxP1 allele were more frequent (84.9%, 264/311), were always ER (except for one strain), and were mainly related to ptxA1/ptxC1/prn1 alleles (99.6%, 263/264). The remaining 47 (15.1%) strains carried the ptxP3 allele, mainly harboring the ptxA1/ptxC2/prn2 alleles (93.6%, 44/47), and were sensitive to erythromycin (except for two strains). The two ER-ptxP3 isolates were first identified in China, belonged to MT27 and MT28 according to MLVA, and were classified into sub-lineage IVd by phylogenetic analysis of their genome sequences. This sub-lineage also includes many strains carrying the ptxP3 allele spreading in developed countries. For each tested antimicrobial, the susceptibilities judged by KB disks were consistent with those determined by E-test strips. Conclusion The present results reveal that B. pertussis strains with the ptxP1-ER profile still dominate in China, and a few strains carrying the ptxP3 allele have acquired the A2047G mutation in the 23S rRNA gene and the ER phenotype. The surveillance of the drug susceptibility of B. pertussis is necessary for all countries, and the KB disk method can be adopted as a screening test.
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Affiliation(s)
- Xiaoying Wu
- Department of Infectious Diseases, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Chongqing, China
| | - Qianqian Du
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Dongfang Li
- BGI Pathogenesis Pharmaceutical Technology, BGI-Shenzhen, Shenzhen, China
| | - Lin Yuan
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Qinghong Meng
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Zhou Fu
- Department of Respiratory Diseases, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Hongmei Xu
- Department of Infectious Diseases, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Chongqing, China
| | - Kaihu Yao
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
- *Correspondence: Kaihu Yao,
| | - Ruiqiu Zhao
- Department of Infectious Diseases, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Chongqing, China
- Ruiqiu Zhao,
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Cimolai N. Pharmacotherapy for Bordetella pertussis infection. I. A synthesis of laboratory sciences. Int J Antimicrob Agents 2020; 57:106258. [PMID: 33310116 DOI: 10.1016/j.ijantimicag.2020.106258] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 11/09/2020] [Accepted: 11/28/2020] [Indexed: 11/15/2022]
Abstract
There is considerable history and practice experience both with laboratory susceptibility testing for Bordetella pertussis and clinical treatment. This two-part narrative review provides a synthesis of the laboratory and clinical sciences as they apply to this bacterium and the clinical consequences of treating infection. It is generally held that antibiotic susceptibility testing for B. pertussis is not sufficiently standardised, but there has not been an urgent need to consolidate the same given the lack global experience with major resistance profiles. Experience in China, however, has provided concern for high-level macrolide resistance. The nature of and frequency of such resistance has raised the bar for reconsideration of susceptibility testing given that first-line treatment may be regionally compromised. Disk diffusion and Etest susceptibility testing can be recommended for screening resistance among individual isolates of B. pertussis and on an ad hoc manner. Disk diffusion, Etest and/or critical agar dilution testing can be recommended for large-scale studies. Standards for inoculum, growth atmosphere, timing of interpretation, preferred testing media and controls can be extrapolated from the publications to date. Such methods should be able to detect high-level resistance to several antibiotics, but especially macrolides. Concern for intermediate-susceptible categories requires consideration as well as the correlation with bacteriological and clinical outcomes. Provisional standards can be applied at this time, and modification or fine-tuning of any such standards are open to future investigation.
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Affiliation(s)
- Nevio Cimolai
- Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada; Department of Pathology and Laboratory Medicine, Children's and Women's Health Centre of British Columbia, 4480 Oak Street, Vancouver, British Columbia, V6H3V4 Canada.
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4
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Yao K, Deng J, Ma X, Dai W, Chen Q, Zhou K, Ye J, Shi W, Wang H, Li D, Wang H, Wang J, Zhang J, Wu D, Xie G, Shen K, Zheng Y, Yang Y. The epidemic of erythromycin-resistant Bordetella pertussis with limited genome variation associated with pertussis resurgence in China. Expert Rev Vaccines 2020; 19:1093-1099. [PMID: 33034224 DOI: 10.1080/14760584.2020.1831916] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The resurgence of Bordetella pertussis infections leading to whooping cough is a concern in many parts of the world. The number of pertussis cases in China has increased significantly since 2013. RESEARCH DESIGN AND METHODS In this study, whole-genome sequencing analysis was performed for 388 B. pertussis strains isolated in China from the 1970s to 2018, combining 594 published strains from around the world. RESULTS This study revealed that lineage V diverged about 50 years ago in China, while lineage IV is dominant in the other countries. It also revealed that the erythromycin-resistant sub-lineages Va, Vb, and Vc with limited genomic variation emerged 11 ~ 12 years ago. These three sub-lineages were identified after the co-purified acellular vaccines (cp-ACVs) completely replaced the previous whole cell vaccines (WCVs) after the national immunization program of 2012. It suggests that the cp-ACVs cannot induce immunity that is potent enough to restrict the spread of the lineage V, antibiotic abuse further favors the spread of this lineage in China. CONCLUSIONS These findings demand a reassessment of the immunization strategy and development of new vaccines in China to stop the resurgence and drug resistance of B. pertussis.
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Affiliation(s)
- Kaihu Yao
- Beijing Pediatric Research Institute of Beijing Children's Hospital Affiliated to Capital Medical University , Beijing, China
| | - Jikui Deng
- Department of Infectious Disease and Department of Pulmonology, Shenzhen Children's Hospital , Shenzhen, China
| | - Xiang Ma
- Pediatric Department, Jinan Children's Hospital , Jinan, China
| | - Wenkui Dai
- WeHealthGene Institute , Shenzhen, China
| | - Qiang Chen
- Department of Pulmonology, Jiangxi Provincial Children's Hospital , Nanchang, China
| | - Kai Zhou
- Department of Infectious Disease, Nanjing Children's Hospital , Nanjing, China
| | - Jinyan Ye
- Clinical Laboratory, Jiaxing University Affiliated Women and Children Hospital , Jiaxing, China
| | - Wei Shi
- Beijing Pediatric Research Institute of Beijing Children's Hospital Affiliated to Capital Medical University , Beijing, China
| | - Heping Wang
- Department of Infectious Disease and Department of Pulmonology, Shenzhen Children's Hospital , Shenzhen, China
| | | | - Hongmei Wang
- Department of Infectious Disease and Department of Pulmonology, Shenzhen Children's Hospital , Shenzhen, China
| | - Jingmin Wang
- Beijing Pediatric Research Institute of Beijing Children's Hospital Affiliated to Capital Medical University , Beijing, China.,Pediatric Department, Peking University First Hospital , Beijing, China
| | - Jiaosheng Zhang
- Department of Infectious Disease and Department of Pulmonology, Shenzhen Children's Hospital , Shenzhen, China
| | - Danxia Wu
- Department of Pulmonology, Jiangxi Provincial Children's Hospital , Nanchang, China
| | - Gan Xie
- Beijing Pediatric Research Institute of Beijing Children's Hospital Affiliated to Capital Medical University , Beijing, China.,Department of Infectious Disease and Department of Pulmonology, Shenzhen Children's Hospital , Shenzhen, China
| | - Kunling Shen
- Beijing Pediatric Research Institute of Beijing Children's Hospital Affiliated to Capital Medical University , Beijing, China
| | - Yuejie Zheng
- Department of Infectious Disease and Department of Pulmonology, Shenzhen Children's Hospital , Shenzhen, China
| | - Yonghong Yang
- Beijing Pediatric Research Institute of Beijing Children's Hospital Affiliated to Capital Medical University , Beijing, China.,Department of Infectious Disease and Department of Pulmonology, Shenzhen Children's Hospital , Shenzhen, China.,WeHealthGene Institute , Shenzhen, China
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5
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Wi CI, Wheeler PH, Kaur H, Ryu E, Kim D, Juhn Y. Spatio-temporal comparison of pertussis outbreaks in Olmsted County, Minnesota, 2004-2005 and 2012: a population-based study. BMJ Open 2019; 9:e025521. [PMID: 31110089 PMCID: PMC6530371 DOI: 10.1136/bmjopen-2018-025521] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Two pertussis outbreaks occurred in Olmsted County, Minnesota, during 2004-2005 and 2012 (5-10 times higher than other years), with significantly higher incidence than for the State. We aimed to assess whether there were similar spatio-temporal patterns between the two outbreaks. SETTING Olmsted County, Minnesota, USA PARTICIPANTS: We conducted a population-based retrospective cohort study of all Olmsted County residents during the 2004-2005 and 2012 outbreaks, including laboratory-positive pertussis cases. PRIMARY OUTCOME MEASURE For each outbreak, we estimated (1) age-specific incidence rate using laboratory-positive pertussis cases (numerator) and the Rochester Epidemiology Project Census (denominator), a medical record-linkage system for virtually all Olmsted County residents, and (2) pertussis case density using kernel density estimation to identify areas with high case density. To account for population size, we calculated relative difference of observed density and expected density based on age-specific incidence. RESULTS We identified 157 and 195 geocoded cases in 2004-2005 and 2012, respectively. Incidence was the highest among adolescents (ages 11 to <14 years) for both outbreaks (9.6 and 7.9 per 1000). The 2004-2005 pertussis outbreak had higher incidence in winter (52% of cases) versus summer in 2012 (53%). We identified a consistent area with higher incidence at the beginning (ie, first quartile) of two outbreaks, but it was inconsistent for later quartiles. The relative difference maps for the two outbreaks suggest a greater role of neighbourhood population size in 2012 compared with 2004-2005. CONCLUSIONS Comparing spatio-temporal patterns between two pertussis outbreaks identified a consistent geographical area with higher incidence of pertussis at the beginning of outbreaks in this community. This finding can be tested in future outbreaks, and, if confirmed, can be used for identifying epidemiological risk factors clustered in such areas for geographically targeted intervention.
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Affiliation(s)
- Chung-Il Wi
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Philip H Wheeler
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Harsheen Kaur
- Department of Pediatrics, Univeristy of New Mexico, Albuquerque, New Mexico, USA
| | - Euijung Ryu
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Dohyeong Kim
- Geospatial Health Research Group, School of Economic, Political and Policy Sciences, University of Texas at Dallas, Richardson, Texas, USA
| | - Young Juhn
- Department of Community Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
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6
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Assessment of clinical symptoms in household contacts of confirmed pertussis cases. J Infect 2017; 75:426-432. [DOI: 10.1016/j.jinf.2017.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 08/06/2017] [Accepted: 08/18/2017] [Indexed: 11/22/2022]
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7
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Karalius VP, Rucinski SL, Mandrekar JN, Patel R. Bordetella parapertussis outbreak in Southeastern Minnesota and the United States, 2014. Medicine (Baltimore) 2017; 96:e6730. [PMID: 28514288 PMCID: PMC5440125 DOI: 10.1097/md.0000000000006730] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Whooping cough is traditionally ascribed to Bordetella pertussis; however, Bordetella parapertussis can cause a similar clinical syndrome. This study describes an outbreak of B. parapertussis in Southeastern Minnesota and the United States (US) in 2014. This was a retrospective analysis of Mayo Clinic and Mayo Medical Laboratories patients who tested positive for B. parapertussis from 2012 to 2014. The medical records of Mayo Clinic patients who tested positive in 2014 were reviewed for demographic information, presenting symptoms, disease course, and vaccination history. In Southeast Minnesota, 81% of the 31 patients who tested positive for B. parapertussis in 2014 were found to be positive from October through December. Their mean age was 5.9 years. Five reported "exposure to pertussis." Two pairs of siblings were affected. Patients reported having had symptoms for an average of 2.6 weeks before nasopharyngeal specimen collection for B. parapertussis testing. Cough was the primary symptom reported. Forty percent reported posttussive vomiting, 40% coryza, 32% apnea/sleep disturbance, and 12% sore throat. All were current with pertussis vaccination. Based on the review of national data, an outbreak occurred nationally in the Northeast and Midwest US over the same time period. In 2014, there was an outbreak of B. parapertussis in Southeastern Minnesota and likely other parts of the US. The presenting illness was similar to that of B. pertussis. All patients were vaccinated against pertussis, suggesting that pertussis vaccination is ineffective against B. parapertussis.
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Affiliation(s)
| | - Stefanea L. Rucinski
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology
| | - Jayawant N. Mandrekar
- Division of Biomedical Statistics and Informatics, Department of Laboratory Medicine and Pathology
| | - Robin Patel
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology
- Division of Infectious Disease, Department of Medicine, Mayo Clinic, Rochester, MN
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8
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Metz B, Hoonakker M, Uittenbogaard JP, Weyts M, Mommen GPM, Meiring HD, Tilstra W, Pennings JLA, van der Pol LA, Kuipers B, Sloots A, van den IJssel J, van de Waterbeemd B, van der Ark A. Proteome Analysis Is a Valuable Tool to Monitor Antigen Expression during Upstream Processing of Whole-Cell Pertussis Vaccines. J Proteome Res 2016; 16:528-537. [PMID: 27977922 DOI: 10.1021/acs.jproteome.6b00668] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Physicochemical and immunochemical assays were applied to substantiate the relation between upstream processing and the quality of whole-cell pertussis vaccines. Bordetella pertussis bacteria were cultured on a chemically defined medium using a continuous cultivation process in stirred tank reactors to obtain uniform protein expression. Continuous culture favors the consistent production of proteins known as virulence factors. Magnesium sulfate was added during the steady state of the culture in order to diminish the expression of virulence proteins. Changes in gene expression and antigen composition were measured by microarrays, mass spectrometry and ELISA. Transcriptome and proteome data revealed high similarity between the biological triplicates demonstrating consistent cultivation of B. pertussis. The addition of magnesium sulfate resulted in an instant downregulation of the virulence genes in B. pertussis, but a gradual decrease of virulence proteins. The quantity of virulence proteins concurred highly with the potency of the corresponding whole-cell pertussis vaccines, which were determined by the Kendrick test. In conclusion, proteome analysis provided detailed information on the composition and proportion of virulence proteins present in the whole-cell preparations of B. pertussis. Moreover, proteome analysis is a valuable method to monitor the production process of whole-cell biomass and predict the product quality of whole-cell pertussis vaccines.
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Affiliation(s)
- Bernard Metz
- Institute for Translational Vaccinology (Intravacc) , P.O. Box 450, 3720 AL Bilthoven, The Netherlands
| | - Marieke Hoonakker
- Institute for Translational Vaccinology (Intravacc) , P.O. Box 450, 3720 AL Bilthoven, The Netherlands
| | - Joost P Uittenbogaard
- Institute for Translational Vaccinology (Intravacc) , P.O. Box 450, 3720 AL Bilthoven, The Netherlands
| | - Michel Weyts
- Institute for Translational Vaccinology (Intravacc) , P.O. Box 450, 3720 AL Bilthoven, The Netherlands
| | - Geert P M Mommen
- Institute for Translational Vaccinology (Intravacc) , P.O. Box 450, 3720 AL Bilthoven, The Netherlands
| | - Hugo D Meiring
- Institute for Translational Vaccinology (Intravacc) , P.O. Box 450, 3720 AL Bilthoven, The Netherlands
| | - Wichard Tilstra
- Institute for Translational Vaccinology (Intravacc) , P.O. Box 450, 3720 AL Bilthoven, The Netherlands
| | - Jeroen L A Pennings
- National Institute for Public Health and the Environment , P.O. Box 1, 3720 BA Bilthoven, The Netherlands
| | - Leo A van der Pol
- Institute for Translational Vaccinology (Intravacc) , P.O. Box 450, 3720 AL Bilthoven, The Netherlands
| | - Betsy Kuipers
- National Institute for Public Health and the Environment , P.O. Box 1, 3720 BA Bilthoven, The Netherlands
| | - Arjen Sloots
- Institute for Translational Vaccinology (Intravacc) , P.O. Box 450, 3720 AL Bilthoven, The Netherlands
| | - Jan van den IJssel
- Institute for Translational Vaccinology (Intravacc) , P.O. Box 450, 3720 AL Bilthoven, The Netherlands
| | - Bas van de Waterbeemd
- Institute for Translational Vaccinology (Intravacc) , P.O. Box 450, 3720 AL Bilthoven, The Netherlands
| | - Arno van der Ark
- Institute for Translational Vaccinology (Intravacc) , P.O. Box 450, 3720 AL Bilthoven, The Netherlands
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9
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Hammer R, Capili C, Wi CI, Ryu E, Rand-Weaver J, Juhn YJ. A new socioeconomic status measure for vaccine research in children using individual housing data: a population-based case-control study. BMC Public Health 2016; 16:1000. [PMID: 27655468 PMCID: PMC5031352 DOI: 10.1186/s12889-016-3673-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 09/16/2016] [Indexed: 11/10/2022] Open
Abstract
Background We recently developed HOUSES, an individual housing-based socioeconomic status (SES) measurement for health disparities research. We assessed whether HOUSES was associated with risk of pertussis and pertussis vaccine up-to-date status in children. Methods The study utilized a previous population-based case-control study cohort assembled during the 2004–2005 pertussis outbreak. We collected data on pertussis vaccine status (up-to-date status) at the time of the index date. Using a z-score for housing value, actual square footage, and numbers of bedrooms and bathrooms, HOUSES was formulated in continuous variable and categorized into quartiles. Vaccine up-to-date status was compared among subjects with different SES as measured by HOUSES using a chi-square test and logistic regression models. Results Of the 391 eligible pediatric subjects (median age of 13.1 years with male sex of 55 %), 363 (93 %) were successfully geocoded to formulate HOUSES index. HOUSES was not associated with the risk of pertussis (p = 0.82). Pertussis vaccine up-to-date statuses were 79, 86, 83, and 94 % for children in the first (the lowest SES), second, third, and fourth quartiles of HOUSES, respectively (p = 0.03). HOUSES as a continuous variable was associated with pertussis vaccine up-to-date status (adjusted OR: 1.15 per increment of one unit of HOUSES, 95 % CI: 1.04–1.27, p = 0.008). Conclusion While HOUSES is not associated with the risk of pertussis, it predicts vaccine up-to-date status among children with different SES. HOUSES may be a useful tool for vaccine delivery research among children.
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Affiliation(s)
- Rachel Hammer
- Tulane University School of Medicine, 1440 Canal Street, Suite 1000, New Orleans, LA, 70112, USA
| | - Conrad Capili
- Children's Medical Center, 1935 Medical District Drive, Dallas, TX, 75235, USA
| | - Chung-Il Wi
- Division of Community Pediatric and Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Euijung Ryu
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Jennifer Rand-Weaver
- Division of Community Pediatric and Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.,Rochester-Olmsted Planning Department, 2122 Campus Drive SE, Rochester, MN, 55904, USA
| | - Young J Juhn
- Division of Community Pediatric and Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
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10
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Kilgore PE, Salim AM, Zervos MJ, Schmitt HJ. Pertussis: Microbiology, Disease, Treatment, and Prevention. Clin Microbiol Rev 2016; 29:449-86. [PMID: 27029594 PMCID: PMC4861987 DOI: 10.1128/cmr.00083-15] [Citation(s) in RCA: 219] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Pertussis is a severe respiratory infection caused by Bordetella pertussis, and in 2008, pertussis was associated with an estimated 16 million cases and 195,000 deaths globally. Sizeable outbreaks of pertussis have been reported over the past 5 years, and disease reemergence has been the focus of international attention to develop a deeper understanding of pathogen virulence and genetic evolution of B. pertussis strains. During the past 20 years, the scientific community has recognized pertussis among adults as well as infants and children. Increased recognition that older children and adolescents are at risk for disease and may transmit B. pertussis to younger siblings has underscored the need to better understand the role of innate, humoral, and cell-mediated immunity, including the role of waning immunity. Although recognition of adult pertussis has increased in tandem with a better understanding of B. pertussis pathogenesis, pertussis in neonates and adults can manifest with atypical clinical presentations. Such disease patterns make pertussis recognition difficult and lead to delays in treatment. Ongoing research using newer tools for molecular analysis holds promise for improved understanding of pertussis epidemiology, bacterial pathogenesis, bioinformatics, and immunology. Together, these advances provide a foundation for the development of new-generation diagnostics, therapeutics, and vaccines.
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Affiliation(s)
- Paul E Kilgore
- Department of Pharmacy Practice, Eugene Applebaum Collage of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Abdulbaset M Salim
- Department of Pharmacy Practice, Eugene Applebaum Collage of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Marcus J Zervos
- Division of Infectious Diseases, Department of Internal Medicine, Henry Ford Health System and Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Heinz-Josef Schmitt
- Medical and Scientific Affairs, Pfizer Vaccines, Paris, France Department of Pediatrics, Johannes Gutenberg-University, Mainz, Germany
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11
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Sedighi I, Karimi A, Amanati A. Old Disease and New Challenges: Major Obstacles of Current Strategies in the Prevention of Pertussis. IRANIAN JOURNAL OF PEDIATRICS 2016; 26:e5514. [PMID: 27729960 PMCID: PMC5047029 DOI: 10.5812/ijp.5514] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 04/26/2016] [Accepted: 05/23/2016] [Indexed: 11/20/2022]
Abstract
Context Universal immunization against Bordetella pertussis has partially controlled the burden of the disease and its transmission. However, according to recent data, the epidemiology of this vaccine-preventable disease has changed. Now, younger infants, adolescents, and adults are at greater risk of infection. This article has studied the interaction between the various factors involved in the changing epidemiology of pertussis and the major obstacles faced by the current strategies in its prevention. Evidence Acquisition In this narrative review, the most recently published sources of information on pertussis control measures, consisting of textbooks and articles, have been reviewed. We focused on the more recent data about the changing epidemiology or pertussis in Scopus through the use of the MeSH-term words [pertussis] or [whooping cough] and [epidemiology] or [outbreak] or [resurgence], but our search was not restricted to this particular strategy; we also tried to find all of the most recent available data in the general field through other means. Results Primary and booster doses of the pertussis vaccine seem to partially control transmission of the disease, but despite the different preventive strategies available, pertussis continues to cause mortality and morbidity among high-risk groups. Conclusions Adding booster doses of acellular pertussis vaccine to the current national immunization practices with whole-cell vaccines for young adults and pregnant women seems to be a good option for controlling mortality and morbidity among high-risk groups such as very young infants.
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Affiliation(s)
- Iraj Sedighi
- Department of Pediatrics, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Abdollah Karimi
- Pediatric Infections Research Center, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Ali Amanati
- Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
- Corresponding author: Ali Amanati, Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran. E-mail:
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Phadke VK, Bednarczyk RA, Salmon DA, Omer SB. Association Between Vaccine Refusal and Vaccine-Preventable Diseases in the United States: A Review of Measles and Pertussis. JAMA 2016; 315:1149-58. [PMID: 26978210 PMCID: PMC5007135 DOI: 10.1001/jama.2016.1353] [Citation(s) in RCA: 443] [Impact Index Per Article: 55.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
IMPORTANCE Parents hesitant to vaccinate their children may delay routine immunizations or seek exemptions from state vaccine mandates. Recent outbreaks of vaccine-preventable diseases in the United States have drawn attention to this phenomenon. Improved understanding of the association between vaccine refusal and the epidemiology of these diseases is needed. OBJECTIVE To review the published literature to evaluate the association between vaccine delay, refusal, or exemption and the epidemiology of measles and pertussis, 2 vaccine-preventable diseases with recent US outbreaks. EVIDENCE REVIEW Search of PubMed through November 30, 2015, for reports of US measles outbreaks that have occurred since measles was declared eliminated in the United States (after January 1, 2000), endemic and epidemic pertussis since the lowest point in US pertussis incidence (after January 1, 1977), and for studies that assessed disease risk in the context of vaccine delay or exemption. FINDINGS We identified 18 published measles studies (9 annual summaries and 9 outbreak reports), which described 1416 measles cases (individual age range, 2 weeks-84 years; 178 cases younger than 12 months) and more than half (56.8%) had no history of measles vaccination. Of the 970 measles cases with detailed vaccination data, 574 cases were unvaccinated despite being vaccine eligible and 405 (70.6%) of these had nonmedical exemptions (eg, exemptions for religious or philosophical reasons, as opposed to medical contraindications; 41.8% of total). Among 32 reports of pertussis outbreaks, which included 10,609 individuals for whom vaccination status was reported (age range, 10 days-87 years), the 5 largest statewide epidemics had substantial proportions (range, 24%-45%) of unvaccinated or undervaccinated individuals. However, several pertussis outbreaks also occurred in highly vaccinated populations, indicating waning immunity. Nine reports (describing 12 outbreaks) provided detailed vaccination data on unimmunized cases; among 8 of these outbreaks from 59% through 93% of unvaccinated individuals were intentionally unvaccinated. CONCLUSIONS AND RELEVANCE A substantial proportion of the US measles cases in the era after elimination were intentionally unvaccinated. The phenomenon of vaccine refusal was associated with an increased risk for measles among people who refuse vaccines and among fully vaccinated individuals. Although pertussis resurgence has been attributed to waning immunity and other factors, vaccine refusal was still associated with an increased risk for pertussis in some populations.
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Affiliation(s)
- Varun K Phadke
- Division of Infectious Diseases, Emory University, Atlanta, Georgia
| | - Robert A Bednarczyk
- Department of Epidemiology, Emory University, Atlanta, Georgia3Emory Vaccine Center, Emory University, Atlanta, Georgia
| | - Daniel A Salmon
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Saad B Omer
- Department of Epidemiology, Emory University, Atlanta, Georgia3Emory Vaccine Center, Emory University, Atlanta, Georgia5Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia6Hubert Department of Global Health, Rollins School of
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Dalvi S, Kulkarni PS, Phadke MA, More SS, Lalwani SK, Jain D, Manglani M, Garg BS, Doibale MK, Deshmukh CT. A comparative clinical study to assess safety and reactogenicity of a DTwP-HepB+Hib vaccine. Hum Vaccin Immunother 2016; 11:901-7. [PMID: 25933183 DOI: 10.1080/21645515.2015.1010953] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Hepatitis B and Haemophilus influenzae type b (Hib) infections are major public health problems in developing countries, including India. Hence, combination vaccines containing DTwP, recombinant hepatitis B and Hib conjugate vaccines have been developed. Here, we report a Phase IV study which assessed safety and reactogenicity of a new DTwP-HepB+Hib vaccine. Three doses of DTwP-HepB+Hib vaccine (Pentavac, Serum Institute of India Ltd) or Tritanrix-HB+Hib (GlaxoSmithKline Beecham) were administered to infants at 6, 10 and 14 weeks of age in 2:1 ratio. The subjects were followed till one month after the third dose for safety assessment. Adverse events were captured in structured diaries and physical examinations were performed on each visit. The study was conducted in 1510 infants. Both vaccines caused injection site local and systemic reactions and the incidence was similar in both the groups. The incidence of local solicited reactions was: tenderness 35.9 %-33.6 %; redness 18.1 %-17.2 %; swelling 23.7 %-22.4 %; induration 12.8 % -13.7 %. The percentage of systemic solicited reactions were: diarrhea 2.2 %-2.2 %; drowsiness 3.3 %-3.4 %; fever 14.0 %-11.2 %; irritability 28.1 %-25.4 %; loss of appetite 6.6 %-5.6 %; persistent crying 17.7 %-15.7 %; vomiting 3.5 %-3.0 %. No serious adverse event was caused by the vaccines. The new DTwP-HepB+Hib combination vaccine showed similar safety profile to that of an imported vaccine in Indian infants.
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Affiliation(s)
- Shashank Dalvi
- a Government Medical College ; Aurangabad , Maharashtra , India
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Shah GL, Shune L, Purtill D, Devlin S, Lauer E, Lubin M, Bhatt V, McElrath C, Kernan NA, Scaradavou A, Giralt S, Perales MA, Ponce DM, Young JW, Shah M, Papanicolaou G, Barker JN. Robust Vaccine Responses in Adult and Pediatric Cord Blood Transplantation Recipients Treated for Hematologic Malignancies. Biol Blood Marrow Transplant 2015; 21:2160-2166. [PMID: 26271191 PMCID: PMC4672874 DOI: 10.1016/j.bbmt.2015.08.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 08/05/2015] [Indexed: 01/04/2023]
Abstract
Because cord blood (CB) lacks memory T and B cells and recent decreases in herd immunity to vaccine-preventable diseases in many developed countries have been documented, vaccine responses in CB transplantation (CBT) survivors are of great interest. We analyzed vaccine responses in double-unit CBT recipients transplanted for hematologic malignancies. In 103 vaccine-eligible patients, graft-versus-host disease (GVHD) most commonly precluded vaccination. Sixty-five patients (63%; engrafting units median HLA-allele match 5/8; range, 2 to 7/8) received protein conjugated vaccines, and 63 patients (median age, 34 years; range, .9 to 64) were evaluated for responses. Median vaccination time was 17 months (range, 7 to 45) post-CBT. GVHD (n = 42) and prior rituximab (n = 13) delayed vaccination. Responses to Prevnar 7 and/or 13 vaccines (serotypes 14, 19F, 23F) were seen in children and adults (60% versus 49%, P = .555). Responses to tetanus, diphtheria, pertussis, Haemophilus influenzae, and polio were observed in children (86% to 100%) and adults (53% to 89%) even if patients had prior GVHD or rituximab. CD4(+)CD45RA(+) and CD19(+) cell recovery significantly influenced tetanus and polio responses. In a smaller cohort responses were seen to measles (65%), mumps (50%), and rubella (100%) vaccines. No vaccine side effects were identified, and all vaccinated patients survived (median follow-up, 57 months). Although GVHD and rituximab can delay vaccination, CBT recipients (including adults and those with prior GVHD) have similar vaccine response rates to adult donor allograft recipients supporting vaccination in CBT recipients.
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Affiliation(s)
- Gunjan L Shah
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Leyla Shune
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Duncan Purtill
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sean Devlin
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Emily Lauer
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marissa Lubin
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Valkal Bhatt
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Courtney McElrath
- Department of Nursing, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nancy A Kernan
- Bone Marrow Transplantation Service, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Andromachi Scaradavou
- Bone Marrow Transplantation Service, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sergio Giralt
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Miguel A Perales
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Doris M Ponce
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - James W Young
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Monica Shah
- Department of Medicine, Weill Cornell Medical College, New York, New York; Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Genovefa Papanicolaou
- Department of Medicine, Weill Cornell Medical College, New York, New York; Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Juliet N Barker
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York.
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van den Biggelaar AHJ, Poolman JT. Predicting future trends in the burden of pertussis in the 21st century: implications for infant pertussis and the success of maternal immunization. Expert Rev Vaccines 2015; 15:69-80. [PMID: 26559122 DOI: 10.1586/14760584.2016.1105136] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Support is growing for maternal immunization using acellular pertussis (aP) vaccines to prevent severe pertussis disease and deaths among very young, unvaccinated infants. Vaccine effectiveness of maternal immunization is 91% in preventing laboratory-confirmed pertussis in infants aged <3 months. To date, most mothers were primed in childhood with whole-cell pertussis vaccines. Soon, the generation of aP-primed individuals will become the new mothers-to-be. The shorter duration of protection afforded by aP vaccines, which is more pronounced with repeated aP boosters, may lead to increased pertussis circulation among aP-primed parents. Maternal Tdap immunization in aP-primed mothers-to-be may become less effective. Additional measures to protect young infants may eventually be needed, along with new vaccines that induce higher quality and more durable responses.
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Affiliation(s)
- Anita H J van den Biggelaar
- a Wesfarmers Centre of Vaccines and Infectious Diseases , Telethon Kids Institute , Subiaco , WA 6008 , Australia
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Bouchez V, Guiso N. Bordetella pertussis,B. parapertussis, vaccines and cycles of whooping cough. Pathog Dis 2015; 73:ftv055. [DOI: 10.1093/femspd/ftv055] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2015] [Indexed: 11/12/2022] Open
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Koepke R, Bartholomew ML, Eickhoff JC, Ayele RA, Rodd D, Kuennen J, Rosekrans J, Warshauer DM, Conway JH, Davis JP. Widespread Bordetella parapertussis Infections-Wisconsin, 2011-2012: Clinical and Epidemiologic Features and Antibiotic Use for Treatment and Prevention. Clin Infect Dis 2015; 61:1421-31. [PMID: 26113655 DOI: 10.1093/cid/civ514] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 06/13/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND During October 2011-December 2012, concurrent with a statewide pertussis outbreak, 443 Bordetella parapertussis infections were reported among Wisconsin residents. We examined clinical features of patients with parapertussis and the effect of antibiotic use for treatment and prevention. METHODS Patients with polymerase chain reaction results positive for B. parapertussis reported during October 2011-May 2012 were interviewed regarding presence and durations of pertussis-like symptoms and receipt of azithromycin treatment. Data regarding acute cough illnesses and receipt of azithromycin prophylaxis among parapertussis patient household members (HHMs) were also collected. Using multivariate repeated measures log-binomial regression analysis, we examined associations of treatment receipt by the HHM with the earliest illness onset and prophylaxis receipt among other HHMs with the presence of any secondary cough illnesses in the household. RESULTS Among 218 patients with parapertussis, pertussis-like symptoms were frequently reported. Illness durations were significantly shorter among patients with treatment initiated 0-6 days after cough onset, compared with nonrecipients (median durations: 10 vs 19 days, P = .002). Among 361 HHMs from 120 households, compared with nonrecipients, prompt prophylaxis of HHMs was associated with no secondary cough illnesses (relative risk: 0.16; 95% confidence interval, .04-.69). CONCLUSIONS Bordetella parapertussis infection causes pertussis-like illness that might be misclassified as pertussis if B. parapertussis testing is not performed. Prompt treatment might shorten illness duration, and prompt HHM prophylaxis might prevent secondary illnesses. Further study is needed to evaluate antibiotic effectiveness for preventing parapertussis and to determine risks and benefits of antibiotic use.
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Affiliation(s)
- Ruth Koepke
- Division of Public Health, Wisconsin Department of Health Services Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison
| | - Michael L Bartholomew
- Division of Public Health, Wisconsin Department of Health Services Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jens C Eickhoff
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison
| | - Roman A Ayele
- Division of Public Health, Wisconsin Department of Health Services Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison
| | - Diane Rodd
- Wood County Health Department, Wisconsin Rapids
| | | | | | | | - James H Conway
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison
| | - Jeffrey P Davis
- Division of Public Health, Wisconsin Department of Health Services
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Fournier PE, Dubourg G, Raoult D. Clinical detection and characterization of bacterial pathogens in the genomics era. Genome Med 2014; 6:114. [PMID: 25593594 PMCID: PMC4295418 DOI: 10.1186/s13073-014-0114-2] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
The availability of genome sequences obtained using next-generation sequencing (NGS) has revolutionized the field of infectious diseases. Indeed, more than 38,000 bacterial and 5,000 viral genomes have been sequenced to date, including representatives of all significant human pathogens. These tremendous amounts of data have not only enabled advances in fundamental biology, helping to understand the pathogenesis of microorganisms and their genomic evolution, but have also had implications for clinical microbiology. Here, we first review the current achievements of genomics in the development of improved diagnostic tools, including those that are now available in the clinic, such as the design of PCR assays for the detection of microbial pathogens, virulence factors or antibiotic-resistance determinants, or the design of optimized culture media for 'unculturable' pathogens. We then review the applications of genomics to the investigation of outbreaks, either through the design of genotyping assays or the direct sequencing of the causative strains. Finally, we discuss how genomics might change clinical microbiology in the future.
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Affiliation(s)
- Pierre-Edouard Fournier
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM63, CNRS7278, IRD198, InsermU1095, Institut hospitalo-universitaire Méditerranée-Infection, Aix-Marseille University, Faculté de Medecine, 27 Blvd Jean Moulin, Marseille, 13385, cedex 5 France
| | - Gregory Dubourg
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM63, CNRS7278, IRD198, InsermU1095, Institut hospitalo-universitaire Méditerranée-Infection, Aix-Marseille University, Faculté de Medecine, 27 Blvd Jean Moulin, Marseille, 13385, cedex 5 France
| | - Didier Raoult
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM63, CNRS7278, IRD198, InsermU1095, Institut hospitalo-universitaire Méditerranée-Infection, Aix-Marseille University, Faculté de Medecine, 27 Blvd Jean Moulin, Marseille, 13385, cedex 5 France
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