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Moosa F, Tempia S, Kleynhans J, McMorrow M, Moyes J, du Plessis M, Carrim M, Treurnicht FK, Helferscee O, Mkhencele T, Mathunjwa A, Martinson NA, Kahn K, Lebina L, Wafawanaka F, Cohen C, von Gottberg A, Wolter N. Incidence and Transmission Dynamics of Bordetella pertussis Infection in Rural and Urban Communities, South Africa, 2016‒2018. Emerg Infect Dis 2023; 29:294-303. [PMID: 36692337 PMCID: PMC9881781 DOI: 10.3201/eid2902.221125] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
We conducted 3 prospective cohort studies (2016-2018), enrolling persons from 2 communities in South Africa. Nasopharyngeal swab specimens were collected twice a week from participants. Factors associated with Bordetella pertussis incidence, episode duration, and household transmission were determined by using Poisson regression, Weibull accelerated time-failure, and logistic regression hierarchical models, respectively. Among 1,684 participants, 118 episodes of infection were detected in 107 participants (incidence 0.21, 95% CI 0.17-0.25 infections/100 person-weeks). Children <5 years of age who had incomplete vaccination were more likely to have pertussis infection. Episode duration was longer for participants who had higher bacterial loads. Transmission was more likely to occur from male index case-patients and persons who had >7 days infection duration. In both communities, there was high incidence of B. pertussis infection and most cases were colonized.
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The effect of maternal pertussis vaccination on the epidemiology of pertussis in Spain. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:467-469. [PMCID: PMC9631338 DOI: 10.1016/j.eimce.2022.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/11/2022] [Indexed: 11/06/2022]
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The effect of maternal pertussis vaccination on the epidemiology of pertussis in Spain. Enferm Infecc Microbiol Clin 2022; 40:467-469. [DOI: 10.1016/j.eimc.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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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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Bordetella pertussis in School-Age Children, Adolescents and Adults: A Systematic Review of Epidemiology and Mortality in Europe. Infect Dis Ther 2021; 10:2071-2118. [PMID: 34435338 PMCID: PMC8387212 DOI: 10.1007/s40121-021-00520-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 07/30/2021] [Indexed: 11/16/2022] Open
Abstract
Pertussis (whooping cough) epidemics persist globally despite high vaccine coverage among infants and young children. The resurgence of pertussis in high-income countries is partly due to waning vaccine immunity, resulting in a pool of unprotected adolescents and adults. However, pertussis is generally less severe in adolescents and adults, and this difference in presentation means it can often be unrecognised by healthcare professionals, meaning that it is largely under-diagnosed in older populations. A systematic search of MEDLINE, EMBASE and BIOSIS was undertaken to identify studies published between 1 January 1990 and 17 June 2019, with information on pertussis epidemiology and mortality in school-aged children, adolescents and adults in Europe. A formal statistical comparison (e.g. using meta-analyses) was not possible because of the mix of methodologies reported. There were 69 epidemiological studies and 19 mortality studies identified for review. Over the past decade, the reported incidence of notified pertussis cases varied widely between European countries, which is likely associated with differences in surveillance systems, diagnostic techniques and reporting regulations. However, several studies show that pertussis is circulating among adolescents and adults in Europe, and although pertussis-related morbidity and mortality are highest in infants, there is evidence that adults aged > 50 years are at increased risk. For example, in a hospital-based surveillance study in Portugal, between 2000 and 2015, 94% of hospitalised pertussis cases were infants aged < 1 year, with a case fatality rate (CFR) of 0.8%; however, among hospitalised adult cases of pertussis, the CFRs were 11.5% (aged 18–64 years) and 17.4% (aged > 65 years). Very few European countries currently include pertussis boosters for adults in the national immunisation strategy. In addition to increasing pertussis vaccination coverage in adolescents and adults, mitigation strategies in European countries should include improved diagnosis and treatment in these populations.
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Godoy P, García-Cenoz M, Rius C, Muñoz-Almagro C, Carmona G, Alsedà M, Jané M, Vidal MJ, Rodríguez R, Álvarez J, Camps N, Minguell S, Carol M, Sala MR, Castilla J, Domínguez À. Effectiveness of maternal pertussis vaccination in protecting newborn: A matched case-control study. J Infect 2021; 83:554-558. [PMID: 34407422 DOI: 10.1016/j.jinf.2021.08.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 02/15/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The objective was to estimate the effectiveness of maternal pertussis vaccination in protecting infants aged < 2 months. METHODS We performed a case-control study. Laboratory-confirmed cases aged <8 weeks at disease onset were identified and 2-4 matched-controls born within ± 15 days of the case were included. Information was obtained from healthcare providers and maternal interviews. Odds ratios (OR) were calculated using multivariable conditional logistic regression. Vaccine effectiveness (VE) was estimated as (1 - OR) × 100%. RESULTS 47 cases and 124 controls were studied. The mean age (in days) (39.8 ± 12.7 vs. 40.8 ± 13.2), weeks of gestation (38.8 vs. 39.1, p = 0.43) and mean birth weight (3.309 vs. 3.253 kg, p = 0.55) were comparable between cases and controls. Mothers of cases were less frequently vaccinated in the third trimester (59.6% vs. 83.9%, p <0.001). The VE of maternal vaccination in pregnancy was 88.0% (95%CI 53.8% -96.5%), and was slightly higher in those vaccinated before the 32nd week of gestation (88.5% vs 87.8%). CONCLUSION Pertussis vaccination in pregnancy is very effective in reducing pertussis in children aged < 2 months. Vaccination before and after the 32nd week of pregnancy are equally effective in reducing the risk of pertussis.
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Affiliation(s)
- Pere Godoy
- Agència de Salut Pública de Catalunya. Barcelona, Spain; Ciber de Epidemiología y Salud Pública. CIBERESP. Madrid, Spain; Institut de Recerca Biomèdica de Lleida. IRBLleida. Lleida, Spain.
| | - Manuel García-Cenoz
- Ciber de Epidemiología y Salud Pública. CIBERESP. Madrid, Spain; Instituto de Salud Pública de Navarra - idiSNA, Pamplona, Spain
| | - Cristina Rius
- Ciber de Epidemiología y Salud Pública. CIBERESP. Madrid, Spain; Agència de Salut Pública de Barcelona. Barcelona, Spain
| | - Carmen Muñoz-Almagro
- Ciber de Epidemiología y Salud Pública. CIBERESP. Madrid, Spain; Institut de Recerca Pediàtrica, Hospital de Sant Joan de Dèu, Barcelona, Spain; Departament de Medicina, Universitat Internacional de Catalunya
| | | | - Miquel Alsedà
- Agència de Salut Pública de Catalunya. Barcelona, Spain; Institut de Recerca Biomèdica de Lleida. IRBLleida. Lleida, Spain
| | - Mireia Jané
- Agència de Salut Pública de Catalunya. Barcelona, Spain; Ciber de Epidemiología y Salud Pública. CIBERESP. Madrid, Spain
| | | | | | - Josep Álvarez
- Agència de Salut Pública de Catalunya. Barcelona, Spain
| | - Neus Camps
- Agència de Salut Pública de Catalunya. Barcelona, Spain
| | | | - Mónica Carol
- Agència de Salut Pública de Catalunya. Barcelona, Spain
| | | | - Jesús Castilla
- Ciber de Epidemiología y Salud Pública. CIBERESP. Madrid, Spain; Instituto de Salud Pública de Navarra - idiSNA, Pamplona, Spain
| | - Àngela Domínguez
- Ciber de Epidemiología y Salud Pública. CIBERESP. Madrid, Spain; Departament de Medicina, Universitat de Barcelona. Barcelona, Spain
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Merdrignac L, Aït El Belghiti F, Pandolfi E, Jané M, Murphy J, Fabiánová K, García Cenoz M, Flem E, Guillot S, Tozzi AE, Carmona G, Habington A, Zavadilová J, Navasués A, Bøås H, Lévy-Brühl D, Ferretti B, Lanaspa M, O'Sullivan N, Křížová P, Fernandino L, Bekkevold T, Hanslik T, Muñoz-Almagro C, Bacci S, Spiteri G, Valenciano M, Moren A. Incidence and severity of pertussis hospitalisations in infants aged less than 1 year in 37 hospitals of six EU/EEA countries, results of PERTINENT sentinel pilot surveillance system, December 2015 to December 2018. ACTA ACUST UNITED AC 2021; 26. [PMID: 33509338 PMCID: PMC7848786 DOI: 10.2807/1560-7917.es.2021.26.4.1900762] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Introduction PERTINENT is a pilot active surveillance system of infants hospitalised with pertussis in six European Union/European Economic Area countries (37 hospitals, seven sites). Aim This observational study aimed to estimate annual pertussis incidence per site from 2016 to 2018 and respective trends between 2017 and 2018. Pertussis cases were described, including their severity. Methods We developed a generic protocol and laboratory guidelines to harmonise practices across sites. Cases were hospitalised infants testing positive for Bordetella pertussis by PCR or culture. Sites collected demographic, clinical, laboratory data, vaccination status, and risk/protective factors. We estimated sites’ annual incidences by dividing case numbers by the catchment populations. Results From December 2015 to December 2018, we identified 469 cases (247 males; 53%). The median age, birthweight and gestational age were 2.5 months (range: 0–11.6; interquartile range (IQR): 2.5), 3,280 g (range: 700–4,925; IQR: 720) and 39 weeks (range: 25–42; IQR: 2), respectively. Thirty cases (6%) had atypical presentation either with cough or cyanosis only or with absence of pertussis-like symptoms. Of 330 cases with information, 83 (25%) were admitted to intensive care units including five deceased infants too young to be vaccinated. Incidence rate ratios between 2018 and 2017 were 1.43 in Czech Republic (p = 0.468), 0.25 in Catalonia (p = 0.002), 0.71 in France (p = 0.034), 0.14 in Ireland (p = 0.002), 0.63 in Italy (p = 0.053), 0.21 in Navarra (p = 0.148) and zero in Norway. Conclusions Incidence appeared to decrease between 2017 and 2018 in all but one site. Enhanced surveillance of hospitalised pertussis in Europe is essential to monitor pertussis epidemiology and disease burden.
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Affiliation(s)
| | | | - Elisabetta Pandolfi
- Multifactorial Disease and Complex Phenotype Research Area, Bambino Gesù Children Hospital, Rome, Italy
| | - Mireia Jané
- Epidemiological surveillance and response, Public Health Agency of Catalonia, Barcelona, Spain
| | - Jane Murphy
- Research, Temple Street Children's University Hospital, Dublin, Ireland
| | | | - Manuel García Cenoz
- Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Elmira Flem
- Infectious Disease Epidemiology and Modeling, Norwegian Institute of Public Health, Oslo, Norway
| | - Sophie Guillot
- Biodiversité et Epidémiologie des bactéries et pathogènes, Institut Pasteur, Paris, France
| | - Alberto E Tozzi
- Chief Innovation Unit and Clinical Trials, Bambino Gesù Children Hospital, Rome, Italy
| | - Gloria Carmona
- Epidemiological surveillance and response, Public Health Agency of Catalonia, Barcelona, Spain
| | - Adele Habington
- Microbiology, Our Lady's Children's hospital Crumlin, Dublin, Ireland
| | | | - Ana Navasués
- Clinical Microbiology Service, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Håkon Bøås
- Infectious Disease Epidemiology and Modeling, Norwegian Institute of Public Health, Oslo, Norway
| | - Daniel Lévy-Brühl
- Direction des maladies infectieuses, Santé Publique France, Paris, France
| | - Beatrice Ferretti
- Multifactorial Disease and Complex Phenotype Research Area, Bambino Gesù Children Hospital, Rome, Italy
| | - Miguel Lanaspa
- Instituto de Recerca Pediatrica Hospital Sant Joan de Deu, Barcelona, Spain
| | - Niam O'Sullivan
- Microbiology, Our Lady's Children's hospital Crumlin, Dublin, Ireland
| | - Pavla Křížová
- National Institute of Public Health, Prague, Czech Republic
| | - Leticia Fernandino
- Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Terese Bekkevold
- Infectious Disease Epidemiology and Modeling, Norwegian Institute of Public Health, Oslo, Norway
| | - Thomas Hanslik
- Sorbonne University, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Carmen Muñoz-Almagro
- CIBER of Epidemiology and Public Health CIBERESP, Barcelona, Spain.,Universitat Internacional de Catalunya, Barcelona, Spain.,Instituto de Recerca Pediatrica Hospital Sant Joan de Deu, Barcelona, Spain
| | - Sabrina Bacci
- European Centre for Diseases Prevention and Control, Stockholm, Sweden
| | | | | | - Alain Moren
- Epidemiology Department, Epiconcept, Paris, France
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- The members of the network are listed at the end of the article
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Cimolai N. Pharmacotherapy for Bordetella pertussis infection. II. A synthesis of clinical sciences. Int J Antimicrob Agents 2020; 57:106257. [PMID: 33310117 DOI: 10.1016/j.ijantimicag.2020.106257] [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: 11/09/2020] [Accepted: 11/28/2020] [Indexed: 02/07/2023]
Abstract
Despite the plethora of studies that have examined laboratory susceptibility testing for Bordetella pertussis, assessments of treatment have lagged far behind both in quality and quantity. Macrolides and trimethoprim/sulfamethoxazole historically served the needs of both treatment and prevention, albeit there is still controversy about the degree of protection measured both bacteriologically and clinically. As high-level macrolide resistance has emerged in some geographic regions and since macrolides have been the mainstay of therapy, alternative antibiotics need to be defined for pertussis. In vitro susceptibility testing suggests the potential for several alternatives to macrolides, including trimethoprim/sulfamethoxazole, specific β-lactam agents, chloramphenicol, some quinolones and possibly some tetracyclines. For the latter antibiotics, more clinical studies for treatment and prophylaxis are required in to order to establish bacteriological-clinical correlates for outcome. In the interim, if the clinical circumstances mandate the use of proposed interim alternatives to macrolides, outcomes should be assessed with test of cure by culture, since genetic amplification technologies do not discriminate bacterial viability. Whereas there may be debate in regard to using placebo or macrolides as the controls for alternative antibiotic therapy in geographies where most B. pertussis isolates are antibiotic-susceptible, both placebo and macrolide controls should be assessed along with alternative antibiotics in well-designed controlled studies in regions pressured by macrolide resistance. Outcomes of clinical response and epidemiological patterns of disease should continue to be monitored given the degree of macrolide resistance that is emerging.
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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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Bordetella pertussis, a reemerging pathogen in pediatric respiratory infections. A study in Quito, Ecuador. Rev Argent Microbiol 2020; 53:27-33. [PMID: 33243445 DOI: 10.1016/j.ram.2020.07.001] [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: 07/13/2019] [Revised: 05/11/2020] [Accepted: 07/22/2020] [Indexed: 11/23/2022] Open
Abstract
Bordetella pertussis is the causative agent of pertussis, which mainly affects unvaccinated children, while Bordetella parapertussis causes a disease presenting clinical characteristics that are indistinguishable from whooping cough. Despite high vaccination coverage, pertussis remains a public health concern worldwide, with approximately 140000 cases reported annually. Here we determined the prevalence of B. pertussis and B. parapertussis infection among infants under one year of age by polymerase chain reaction (PCR); our aim being to identify whether the data obtained relates to the relevant sociodemographic and clinical data. The study included 86 samples of nasopharyngeal swabs from infants aged between 0-12 months, who were reported as probable cases of whooping cough by the health centers around the Ecuadorian highlands, from August 2016 to July 2017. The nasopharyngeal swabs were cultured and microbiological and molecular analyses were performed. B. pertussis was identified by PCR in 41% of the samples (30/86), more than half of which corresponded to infants aged between 0-3 months. Moreover, a statistically significant correlation (p<0.05) between the identification of bacteria in culture and the catarrhal stage of the disease was observed. The results obtained from the study highlighted the need for an active national surveillance of pertussis, in particular for laboratory testing, to provide a highly sensitive and more specific diagnosis of Bordetella infection.
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11
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Alvarez J, Godoy P, Plans-Rubio P, Camps N, Carol M, Carmona G, Solano R, Rius C, Minguell S, Barrabeig I, Sala-Farré MR, Rodriguez R, Garcia-Cenoz M, Muñoz-Almagro C, Dominguez A. Azithromycin to Prevent Pertussis in Household Contacts, Catalonia and Navarre, Spain, 2012-2013. Emerg Infect Dis 2020; 26:2678-2684. [PMID: 33079034 PMCID: PMC7588542 DOI: 10.3201/eid2611.181418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We retrospectively assessed the effectiveness of azithromycin in preventing transmission of pertussis to a patient's household contacts. We also considered the duration between symptom onset in the primary patient and azithromycin administration. We categorized contacts into 4 groups: those treated within <7 days, 8-14 days, 15-21 days, and >21 days after illness onset in the primary patient. We studied 476 primary index patients and their 1,975 household contacts, of whom 4.5% were later identified as having pertussis. When contacts started chemoprophylaxis within <21 days after the primary patient's symptom onset, the treatment was 43.9% effective. Chemoprophylaxis started >14 days after primary patient's symptom onset was less effective. We recommend that contacts of persons with pertussis begin chemoprophylaxis within <14 days after primary patient's symptom onset.
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12
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Katfy K, Diawara I, Maaloum F, Aziz S, Guiso N, Fellah H, Slaoui B, Zerouali K, Belabbes H, Elmdaghri N. Pertussis in infants, in their mothers and other contacts in Casablanca, Morocco. BMC Infect Dis 2020; 20:43. [PMID: 31937256 PMCID: PMC6961324 DOI: 10.1186/s12879-019-4680-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 11/29/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In recent decades, there has been a marked increase in the number of reported cases of pertussis around the world, and pertussis continues to be a frequently occurring disease despite an effective childhood vaccination. This study aims to determine the role of household contacts of children diagnosed with pertussis in Casablanca Morocco. METHODS From November 2015 to October 2017, children suspected of whooping cough that consulted Ibn Rochd University hospital at Casablanca with their household contacts were enrolled in the study. Nasopharyngeal (NP) samples of the suspected children were analyzed by culture and RT-PCR. For the household contacts, NP and blood samples were collected and analyzed by RT-PCR and specific detection of pertussis toxin antibodies by ELISA, respectively. RESULTS During the study period, the survey was carried out on 128 infants hospitalized for pertussis suspicion and their families (N = 140). B. pertussis DNA was specifically detected in 73 (57%) samples, coexistence of B. pertussis and B. parapertussis DNA in 3 (2.3%) samples, coexistence of B. pertussis and B. holmesii DNA in 10 (7.81%) and only one (0.78%) sample was IS 481 RT-PCR positive without the possibility of determining the Bordetella species with the diagnostic tools used. Confirmations of Pertussis infection in household contacts by culture, RT- PCR and serology were 10, 46 and 39%, respectively. B. pertussis DNA was confirmed in the infants as well in their mothers in 38% of the cases. Co detection of B. pertussis and B. parapertussis DNA in 2% and co-detection of B. pertussis and B. holmesii DNA in 4%. B. holmesii DNA alone was detected in 5 NP samples of index cases and their mothers. CONCLUSIONS The results of this study confirm that B. pertussis is still circulating in children and adults, and were likely a source of pertussis contamination in infants still not vaccinated. The use of RT-PCR specific for B. pertussis in the diagnosis of adults is less sensitive and should be associated with serologic tests to improve diagnosis of pertussis and contributes to preventing transmission of the disease in infants.
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Affiliation(s)
- Khalid Katfy
- Department of Microbiology, Faculty of Medicine and Pharmacy, 19 rue Tarik Bnou Zyad, 20360 Casablanca, Morocco
- Bacteriology-Virology and Hospital Hygiene Laboratory, University Hospital Centre Ibn Rochd, 1, Rue des Hôpitaux, 20100 Casablanca, Morocco
| | - Idrissa Diawara
- Department of Microbiology, Faculty of Medicine and Pharmacy, 19 rue Tarik Bnou Zyad, 20360 Casablanca, Morocco
- Bacteriology-Virology and Hospital Hygiene Laboratory, University Hospital Centre Ibn Rochd, 1, Rue des Hôpitaux, 20100 Casablanca, Morocco
- Faculté des Sciences et Techniques de Santé, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Fakhredine Maaloum
- Department of Microbiology, Faculty of Medicine and Pharmacy, 19 rue Tarik Bnou Zyad, 20360 Casablanca, Morocco
- Bacteriology-Virology and Hospital Hygiene Laboratory, University Hospital Centre Ibn Rochd, 1, Rue des Hôpitaux, 20100 Casablanca, Morocco
| | - Siham Aziz
- Bacteriology-Virology and Hospital Hygiene Laboratory, University Hospital Centre Ibn Rochd, 1, Rue des Hôpitaux, 20100 Casablanca, Morocco
| | - Nicole Guiso
- Molecular Prevention and Therapy of Human Diseases, Institut Pasteur, 25 rue du Dr Roux, 75015 Paris, France
| | - Hassan Fellah
- Department of Immunology, Faculty of Medicine and Pharmacy, 19 rue Tarik Bnou Zyad, 20360 Casablanca, Morocco
| | - Bouchra Slaoui
- Abderrahim Harouchi Pediatric Hospital, rue Mohamed El Faidouzi, -ex Jenner Quartier: Hôpitaux -, Casablanca, Morocco
| | - Khalid Zerouali
- Department of Microbiology, Faculty of Medicine and Pharmacy, 19 rue Tarik Bnou Zyad, 20360 Casablanca, Morocco
- Bacteriology-Virology and Hospital Hygiene Laboratory, University Hospital Centre Ibn Rochd, 1, Rue des Hôpitaux, 20100 Casablanca, Morocco
| | - Houria Belabbes
- Department of Microbiology, Faculty of Medicine and Pharmacy, 19 rue Tarik Bnou Zyad, 20360 Casablanca, Morocco
- Bacteriology-Virology and Hospital Hygiene Laboratory, University Hospital Centre Ibn Rochd, 1, Rue des Hôpitaux, 20100 Casablanca, Morocco
| | - Naima Elmdaghri
- Department of Microbiology, Faculty of Medicine and Pharmacy, 19 rue Tarik Bnou Zyad, 20360 Casablanca, Morocco
- Bacteriology-Virology and Hospital Hygiene Laboratory, University Hospital Centre Ibn Rochd, 1, Rue des Hôpitaux, 20100 Casablanca, Morocco
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Del Valle-Mendoza J, Silva-Caso W, Aguilar-Luis MA, Del Valle-Vargas C, Cieza-Mora E, Martins-Luna J, Aquino-Ortega R, Silva-Vásquez A, Bazán-Mayra J, Weilg P. Bordetella pertussis in children hospitalized with a respiratory infection: clinical characteristics and pathogen detection in household contacts. BMC Res Notes 2018; 11:318. [PMID: 29776433 PMCID: PMC5960213 DOI: 10.1186/s13104-018-3405-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 05/07/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Describe the prevalence of Bordetella pertussis via PCR in children under 5 years old hospitalized as probable cases of pertussis and report the most common clinical features among them. RESULTS A positive PCR result for B. pertussis was observed in 20.5% of our samples (18/88), one-third of them were from infants between 2 and 3 months old. The most common symptoms were paroxysms of coughing (88.9%), difficulty breathing (72.2%), cyanosis (77.8%) and fever (50%). The mother was the most common symptomatic carrier (27.8%), followed by uncles/aunts (22.2%) among children with pertussis.
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Affiliation(s)
- Juana Del Valle-Mendoza
- Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru. .,Laboratorio de Biología Molecular, Instituto de Investigación Nutricional, Lima, Peru.
| | - Wilmer Silva-Caso
- Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Laboratorio de Biología Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | - Miguel Angel Aguilar-Luis
- Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Laboratorio de Biología Molecular, Instituto de Investigación Nutricional, Lima, Peru.,Instituto de Investigación de Enfermedades Infecciosas, Lima, Peru
| | - Cristina Del Valle-Vargas
- Instituto de Investigación de Enfermedades Infecciosas, Lima, Peru.,Facultad de Medicina, Univesidad de Barcelona, Barcelona, Spain
| | - Erico Cieza-Mora
- Servicio de Pediatría, Hospital Docente Regional de Salud de Cajamarca, Cajamarca, Peru
| | - Johanna Martins-Luna
- Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Ronald Aquino-Ortega
- Laboratorio de Biología Molecular, Instituto de Investigación Nutricional, Lima, Peru.,Instituto de Investigación de Enfermedades Infecciosas, Lima, Peru
| | | | - Jorge Bazán-Mayra
- Laboratorio de Referencia, Dirección Regional de Salud de Cajamarca (DIRESA), Cajamarca, Peru
| | - Pablo Weilg
- Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
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Abstract
BACKGROUND Despite universal immunization programs, pertussis remains a major public health concern. This study aimed to describe the pertussis epidemiology in the Puglia region in 2006-2015 and to identify recent polymorphisms in Bordetella pertussis virulence-associated genes. METHODS The pertussis cases in 2006-2015 were identified from the National Hospital Discharge Database and the Information System of Infectious Diseases. Samples of pertussis cases in 2014-2016 that were confirmed by the Regional Reference Laboratory were subjected to ptxA, ptxP and prn gene sequencing and, in 10 cases, multiple-locus variable-number tandem repeat analysis. RESULTS In Puglia in 2006-2015, the pertussis incidence rose from an average of 1.39/100,000 inhabitants in 2006-2013 to 2.56-2.54/100,000 in 2014-2015. In infants <1 year of age, the incidence rose from an average of 60.4/100,000 infants in 2006-2013 to 149.9/100,000 in 2015. Of the 661 cases recorded in 2006-2015, 80.3% required hospitalization; of these, 45.4% were <1 year of age. Of the 80 sequenced samples, the allelic profile ptxA1-ptxP3-prn2 was detected in 74. This variant was detected in both vaccinated and unvaccinated people. Six Bordetella pertussis samples were prn deficient. The multiple-locus variable-number tandem repeat analysis cases exhibited multiple-locus variable-number tandem repeat analysis-type 27. CONCLUSIONS The pertussis incidence in Puglia has risen. The hypervirulent strain was also found in vaccinated people. This suggests bacterial adaptation to the vaccine and raises questions about acellular vaccine effectiveness. Prevention of infant pertussis cases is best achieved by immunizing the pregnant mother. Enhanced surveillance and systematic laboratory confirmation of pertussis should be improved in Italy.
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15
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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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