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BMC Neurology Mar 2022Multiple sclerosis (MS) is one of the most common neurological disorders which main cause is not identified yet. Some studies mentioned the possible role of infectious...
BACKGROUND
Multiple sclerosis (MS) is one of the most common neurological disorders which main cause is not identified yet. Some studies mentioned the possible role of infectious agents such as chlamydia pneumonia, mycoplasma and also, B. pertussis via asymptomatic nasopharyngeal colonization. The current study aimed to investigate and compared the serum level of B. pertussis antibody and the rate of nasopharyngeal colonization by this pathogen in subjects with and without MS.
METHODS
In this case-control study, 109 patients with MS and 114 subjects without MS referred to Sina Hospital in Hamadan in 2019 are studied and compared in terms of serum titer of B. pertussis antibody and nasopharyngeal colonization by this bacterium. Colonization was evaluated using culture and real-time PCR techniques. Data were analyzed using SPSS version 16 with a 95% confidence interval.
RESULTS
The serum titer of B. pertussis antibody in case and control groups was 37.8 and 35.1%, respectively (P = 0.74). Culture and real-time PCR techniques revealed no case of nasopharyngeal colonization by B. pertussis.
CONCLUSION
There was no difference between B. pertussis antibody titer and the rate of nasopharyngeal colonization between both MS patients and the healthy control group. Therefore, it seems that probably B. pertussis has not a role in MS development.
Topics: Bordetella pertussis; Case-Control Studies; Humans; Multiple Sclerosis; Nasopharynx; Whooping Cough
PubMed: 35232387
DOI: 10.1186/s12883-022-02606-4 -
Clinical Microbiology and Infection :... Dec 2016Pertussis is a highly contagious infectious disease caused by Bordetella pertussis that can be extremely serious, particularly in young infants. For many years the...
Pertussis is a highly contagious infectious disease caused by Bordetella pertussis that can be extremely serious, particularly in young infants. For many years the efforts of health authorities throughout the world to prevent pertussis had the main goals of reducing the morbidity of infants and children under 5 years of age, maintaining protection for several years during the school-age period and developing a significant herd immunity to directly and indirectly reduce the risk of the spread of the disease among young infants and the risk of transmission of the infection from preschool children to infants. However, the increased risk of B. pertussis infection among adolescents and adults due to the waning immunity to this bacterium induced by vaccines and natural infection seems to be the main reason for the resurgence of pertussis. We discuss the reasons for the administration of pertussis vaccines to individuals for whom they were previously not recommended, the expected results of the administration of additional pertussis vaccine doses and the differences in the administration of pertussis vaccines in different countries. An analysis of the literature revealed several reports indicating the need for the modification of immunization schedules against pertussis, with booster doses among adolescents and the need for the vaccination of pregnant women. However, to monitor the true epidemiology of pertussis, effective programmes to collect pertussis cases, adequate reporting systems and vaccination coverage monitoring should be urgently implemented.
Topics: Adolescent; Adult; Europe; Female; Humans; Immunization Schedule; Immunization, Secondary; Infant, Newborn; Pertussis Vaccine; Pregnancy; Whooping Cough
PubMed: 27130670
DOI: 10.1016/j.cmi.2016.01.003 -
MBio Jun 2022What causes the cough in whooping cough (pertussis) has been a longstanding question in the field but has been difficult to answer because of the perceived lack of...
What causes the cough in whooping cough (pertussis) has been a longstanding question in the field but has been difficult to answer because of the perceived lack of convenient small animal models. Y. Hiramatsu, K. Suzuki, T. Nishida, N. Onoda, et al. (mBio 13:e01397-21, 2022, https://doi.org/10.1128/mbio.03197-21) used a mouse model and cellular studies to investigate bacterial and host factors that contribute to cough production during Bordetella pertussis infection. In elegant studies, they found that the bacterial factors pertussis toxin, lipooligosaccharide, and Vag8 function cooperatively to produce cough. These factors induce production of host bradykinin, a known cough inducer that sensitizes the ion channel TRPV1 on neurons, and they investigated host signaling pathways altered by the bacterial factors that exacerbate cough responses. This is a highly significant and important finding that not only elucidates mechanisms underlying the pathophysiology of the severe cough, but also may reveal potential novel therapeutic approaches to treat individuals suffering from the debilitating effects of cough in pertussis.
Topics: Animals; Bordetella Infections; Bordetella pertussis; Cough; Mice; Whooping Cough
PubMed: 35604095
DOI: 10.1128/mbio.00917-22 -
Frontiers in Immunology 2021Current vaccination strategies against pertussis are sub-optimal. Optimal protection against , the causative agent of pertussis, likely requires mucosal immunity....
BACKGROUND
Current vaccination strategies against pertussis are sub-optimal. Optimal protection against , the causative agent of pertussis, likely requires mucosal immunity. Current pertussis vaccines consist of inactivated whole cells or purified antigens thereof, combined with diphtheria and tetanus toxoids. Although they are highly protective against severe pertussis disease, they fail to elicit mucosal immunity. Compared to natural infection, immune responses following immunization are short-lived and fail to prevent bacterial colonization of the upper respiratory tract. To overcome these shortcomings, efforts have been made for decades, and continue to be made, toward the development of mucosal vaccines against pertussis.
OBJECTIVES
In this review we systematically analyzed published literature on protection conferred by mucosal immunization against pertussis. Immune responses mounted by these vaccines are summarized.
METHOD
The PubMed Library database was searched for published studies on mucosal pertussis vaccines. Eligibility criteria included mucosal administration and the evaluation of at least one outcome related to efficacy, immunogenicity and safety.
RESULTS
While over 349 publications were identified by the search, only 63 studies met the eligibility criteria. All eligible studies are included here. Initial attempts of mucosal whole-cell vaccine administration in humans provided promising results, but were not followed up. More recently, diverse vaccination strategies have been tested, including non-replicating and replicating vaccine candidates given by three different mucosal routes: orally, nasally or rectally. Several adjuvants and particulate formulations were tested to enhance the efficacy of non-replicating vaccines administered mucosally. Most novel vaccine candidates were only tested in animal models, mainly mice. Only one novel mucosal vaccine candidate was tested in baboons and in human trials.
CONCLUSION
Three vaccination strategies drew our attention, as they provided protective and durable immunity in the respiratory tract, including the upper respiratory tract: acellular vaccines adjuvanted with lipopeptide LP1569 and c-di-GMP, outer membrane vesicles and the live attenuated BPZE1 vaccine. Among all experimental vaccines, BPZE1 is the only one that has advanced into clinical development.
Topics: Humans; Immunity, Mucosal; Pertussis Vaccine; Whooping Cough
PubMed: 34211481
DOI: 10.3389/fimmu.2021.701285 -
PloS One 2020Pertussis, a severe respiratory infection caused by Bordetella pertussis, is distributed globally. Vaccination has been crucial to annual reductions in the number of...
Pertussis, a severe respiratory infection caused by Bordetella pertussis, is distributed globally. Vaccination has been crucial to annual reductions in the number of cases. However, disease reemergence has occurred over the last decade in several countries, including Brazil. Here we describe the clinical and epidemiological aspects of suspected pertussis cases in Salvador, Brazil, and evaluate factors associated with case confirmation. This descriptive and retrospective study was conducted in the five hospitals in Salvador that reported the highest number of pertussis cases between 2011-2016. Demographic and clinical data were recorded for each patient. Bivariate analysis was performed to evaluate differences between groups (confirmed vs. unconfirmed cases) using Pearson's Chi-square test or Fisher's exact test. Results: Of 529 suspected pertussis cases, 29.7% (157/529) were confirmed by clinical, clinical-epidemiological or laboratory criteria, with clinical criteria most frequently applied (63.7%; 100/157). Unvaccinated individuals (43.3%; 68/157) were the most affected, followed by age groups 2-3 months (37.6%; 59/157) and <2 months (31.2%; 49/157). Overall, ≤50% of the confirmed cases presented a complete vaccination schedule. All investigated cases presented cough in association with one or more symptoms, especially paroxysmal cough (66.9%; 105/529) (p = 0.001) or cyanosis (66.2%; 104/529) (p<0.001). Our results indicate that pertussis occurred mainly in infants and unvaccinated individuals in Salvador, Brazil. The predominance of clinical criteria used to confirm suspected cases highlights the need for improvement in the laboratory tools used to perform rapid diagnosis. Fluctuations in infection prevalence demonstrate the importance of vaccination strategies in improving the control and prevention of pertussis.
Topics: Bordetella pertussis; Brazil; Child, Preschool; Female; Humans; Infant; Male; Pertussis Vaccine; Respiratory Tract Infections; Retrospective Studies; Time Factors; Vaccination; Whooping Cough
PubMed: 32915869
DOI: 10.1371/journal.pone.0238932 -
Anales de Pediatria Oct 2022Pertussis is a respiratory infection caused by bacteria of the genus Bordetella, mainly pertussis and parapertussis species. Despite the high vaccination coverage in...
INTRODUCTION
Pertussis is a respiratory infection caused by bacteria of the genus Bordetella, mainly pertussis and parapertussis species. Despite the high vaccination coverage in developed countries, it is considered a re-emerging disease that is also underreported and underdiagnosed, especially in patients who do not require hospital referral.
MATERIAL AND METHODS
Descriptive, prospective and multicentre study of pertussis diagnosis and contact investigation in 17 primary care paediatric clinics through collection of samples for polymerase chain reaction (PCR) testing over a period of 4 years and after the implementation of routine vaccination against pertussis during pregnancy.
RESULTS
Pertussis was diagnosed in a total of 50 patients; the estimated incidence in these years was higher compared to previous rates in the paediatric age group. Fourteen percent of the cases occurred in children aged less than 1 year. The mean age was 6.7 years. Cough was present in 100% of cases, followed in frequency by vomiting and rhinorrhoea. Only 1 patient required hospital admission, and none died or developed complications. B. pertussis was the predominant causative agent. Only 40% knew the source of infection. In 26% of the cases, pertussis was confirmed in contacts of the patient by PCR, and in 46% it was suspected based on the clinical presentation but without microbiological confirmation.
CONCLUSIONS
Access to diagnostic tests (PCR) for pertussis in primary care allows us to optimise its diagnosis and treatment, to break the chain of transmission, to know the real incidence rates and to assess the impact of routine vaccination of pregnant women on this disease.
Topics: Bordetella pertussis; Child; Female; Humans; Polymerase Chain Reaction; Pregnancy; Primary Health Care; Prospective Studies; Whooping Cough
PubMed: 35995698
DOI: 10.1016/j.anpede.2022.02.005 -
Value in Health : the Journal of the... May 2023This study aimed to evaluate the health and economic impact of diphtheria, tetanus, whole-cell pertussis vaccine (DTwP) and diphtheria-tetanus-acellular pertussis...
OBJECTIVES
This study aimed to evaluate the health and economic impact of diphtheria, tetanus, whole-cell pertussis vaccine (DTwP) and diphtheria-tetanus-acellular pertussis vaccine (DTaP) vaccination on pertussis prevention and control in China during the 40 years from 1978 to 2017.
METHODS
We conducted cost-benefit analyses with a decision tree model populated with historical vaccination coverage levels and pertussis incidence and mortality data from before 1978 and during 1978 to 2017. We modeled 40 birth cohorts from birth until death. Costs and benefits were estimated from direct cost and societal perspectives (direct and indirect costs). Costs and benefits were adjusted to 2017 US dollars (USD), and future values were discounted at a 3% annual rate. We calculated net benefit values (net savings) and benefit-cost ratios of pertussis vaccination of children younger than 5 years. We conducted sensitivity analyses by varying key parameters within plausible ranges.
RESULTS
Without DTwP and DTaP vaccination, there would be an estimated 115.76 million pertussis cases and 426 650 pertussis deaths in the 40 cohorts. With DTwP/DTaP vaccination, pertussis cases and deaths were decreased by an estimated 92.57% and 97.43%, saving 46 987.81 million USD in direct costs and 82 013.37 million USD from societal perspective. Pertussis vaccination program costs were 2168.76 million USD and 3961.28 million USD from direct cost and societal perspectives. Benefit-cost ratios were 21.67:1 from the direct cost perspective and 20.70:1 from the societal perspective. Sensitivity analyses showed the results to be robust.
CONCLUSIONS
Over the lifetime of 40 birth cohorts, China's immunization program is preventing 93% of pertussis cases and 97% of pertussis deaths, resulting in substantial savings to the healthcare system and society.
Topics: Child; Humans; Whooping Cough; Cost-Benefit Analysis; Vaccination; Diphtheria-Tetanus-acellular Pertussis Vaccines; China
PubMed: 36328326
DOI: 10.1016/j.jval.2022.10.011 -
Epidemiology and Infection Sep 2015Two hundred and fourteen patients who had a cough illness lasting at least 2 weeks were studied to investigate Bordetella pertussis as a cause of prolonged cough in...
Two hundred and fourteen patients who had a cough illness lasting at least 2 weeks were studied to investigate Bordetella pertussis as a cause of prolonged cough in adolescents and adults. Medical history and nasopharyngeal swab specimens for culture and polymerase chain reaction (PCR) were obtained at presentation. Three (1·4%) patients were B. pertussis culture-positive; 15 (7%) were B. pertussis PCR-positive (including the culture-positive patients) and 11 (5·1%) were Bordetella spp. PCR-positive. Symptom combinations were significantly high both in patients with pertussis and patients with indeterminate results (P < 0·05). We conclude that B. pertussis should be considered among differential diagnoses of prolonged cough in adolescents and adults and PCR and culture should be used to detect these cases and facilitate public health response.
Topics: Adolescent; Adult; Bordetella pertussis; Child; Chronic Disease; Cough; DNA, Bacterial; Female; Humans; Male; Medical History Taking; Nose; Pharynx; Turkey; Vomiting; Whooping Cough; Young Adult
PubMed: 25524454
DOI: 10.1017/S0950268814003483 -
The Journal of Infection Apr 2024
Topics: Humans; Whooping Cough; China; Pertussis Vaccine; Bordetella pertussis
PubMed: 38513738
DOI: 10.1016/j.jinf.2024.106140 -
Przeglad Epidemiologiczny 2018In Poland, the high incidence of pertussis has been maintained for 10 years – in 2016 it was 17,77 per 100,000 population and it was 38% more compared to the previous...
INTRODUCTION
In Poland, the high incidence of pertussis has been maintained for 10 years – in 2016 it was 17,77 per 100,000 population and it was 38% more compared to the previous year. The high percentage of pertussis is still present in those who are older, who may be a source of infection for non-immunized or not fully immunized newborns and infants. The most effective prevention strategy remains the implementation of vaccinations in accordance with the current calendar.
OBJECTIVES
The aim of the article is to assess the epidemiological situation of pertussis in Poland in 2016 compared to the situation in previous years, with particular emphasis on the assessment of the status of inoculation of children against pertussis.
MATERIALS AND METHODS
Analysis of the epidemiological situation of pertussis in Poland was carried out on the basis of individual reports of suspected cases of pertussis sent to NIZP-PZH by regional sanitaryepidemiological stations, data from the bulletin “Infectious diseases and poisoning in Poland in 2016”(2) and the bulletin “Protective vaccinations in Poland in 2016”(3).
RESULTS
In 2016, 6 828 cases of pertussis were registered. The incidence was 17.77 per 100,000 population and was 38% higher compared to the previous year (12.89). The highest incidence of pertussis occurred in people aged 10-14 (88.1), and high in children aged 0 and 3 years - 76.7 and 77.0 per 100,000 population. Of the 6 828 patients with pertussis, 1 640 people were hospitalized (24% of total). In 2016, no deaths were reported due to pertussis.
SUMMARY AND CONCLUSIONS
The increase in pertussis observed in 2016 indicates the persistent circulation of bacteria in the environment and still persistent population sensitivity to infection. The only effective strategy to reduce the number of cases remains the use of vaccinations according to the current calendar and recommendations of experts.
Topics: Adolescent; Age Distribution; Child; Child, Preschool; Female; Humans; Incidence; Infant; Infant, Newborn; Male; Poland; Registries; Rural Population; Sex Distribution; Urban Population; Vaccination; Whooping Cough; Young Adult
PubMed: 30394037
DOI: 10.32394/pe.72.3.1