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Factors contributing to pertussis resurgence
1Pertussis Reference Laboratory, National Public Health Institute, Kiinamyllynkatu 13, 20520 Turku, Finland. qiushui.he@ktl.fi
Insights
Pertussis, a vaccine-preventable illness, is resurging globally despite widespread immunization. This resurgence is linked to waning immunity and changes in the pertussis bacteria, posing risks to infants.
Area of Science:
- Immunology
- Infectious Diseases
- Vaccinology
Background:
- Pertussis (whooping cough) remains a significant global health threat, causing substantial mortality and morbidity despite extensive vaccination efforts.
- A concerning resurgence of pertussis is evident even in populations with high immunization rates, particularly affecting adolescents and adults who can transmit the disease to vulnerable infants.
Purpose of the Study:
- To summarize recent findings on the factors contributing to the resurgence of pertussis in highly immunized populations.
- To discuss the implications of antigenic divergence between vaccine strains and circulating pertussis bacteria.
Main Methods:
- Review of existing literature and surveillance data on pertussis epidemiology.
- Analysis of studies investigating vaccine-induced immunity duration and bacterial evolution.
Main Results:
- Multiple factors contribute to pertussis resurgence, including increased disease awareness, improved diagnostics, enhanced surveillance, and waning vaccine immunity.
- Antigenic divergence between pertussis vaccine strains and contemporary clinical isolates has been identified in numerous countries with high vaccination coverage.
Conclusions:
- The resurgence of pertussis is a complex issue driven by immunological and microbiological factors.
- Understanding these factors, including antigenic drift, is crucial for developing effective strategies to control pertussis in vaccinated populations and protect infants.
Abstract:
Despite extensive immunization, the disease pertussis remains one of the world's leading causes of vaccine-preventable deaths. An estimated 50 million cases and 300,000 deaths occur every year. A resurgence of pertussis is observed in highly immunized populations. Increasing numbers of pertussis are reported in adolescents and adults who transmit bacteria to newborns and infants to whom pertussis may be a life-threatening disease. Many studies have shown that the causes for the resurgence are multiple, such as increased awareness of disease, use of better diagnostic tools, improved surveillance methods and waning vaccine-induced immunity. Recently, antigenic divergence has been found between vaccine strains and clinical isolates in many countries with high vaccination coverage. Here, we summarize these findings and discuss the factors contributing to pertussis resurgence in immunized populations.
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