[Whooping cough from infants to adults]
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Published on: February 23, 2014
1Institut Pasteur-Unité Prevention et Thérapie Moléculaires des Maladies Humaines--25, rue du Dr. Roux--75724 Paris Cedex 15--URA CNRS 3012. nicole.guiso@pasteur.fr
Insights
Pertussis immunity wanes over time, increasing adult and infant risk. Booster vaccines for adolescents and adults are crucial for controlling pertussis (whooping cough) spread.
Area of Science:
- Immunology
- Vaccinology
- Public Health
Background:
- Natural and vaccine-induced immunity to pertussis (whooping cough) is not lifelong.
- Pertussis, once primarily a pediatric illness, now predominantly affects adults with diminished immunity.
- Waning immunity in adults poses a significant risk of transmission to unvaccinated newborns.
Purpose of the Study:
- To highlight the shift in pertussis epidemiology towards adult populations.
- To emphasize the importance of updated vaccination strategies, including booster doses.
- To underscore the need for enhanced surveillance and diagnostic measures for pertussis.
Main Methods:
- Review of pertussis epidemiology and vaccine strategy modifications.
- Analysis of the impact of booster vaccinations in France.
- Discussion of surveillance requirements, including diagnostic standardization and bacterial characterization.
Main Results:
- Booster vaccinations for adolescents (1998) and adults (2004) in France correlated with reduced pertussis morbidity.
- The strategy aims to protect vulnerable newborns by reducing adult-to-infant transmission.
- Effective surveillance systems are essential for monitoring and controlling pertussis.
Conclusions:
- Updated pertussis vaccine strategies, including boosters, are vital for controlling the disease.
- Increased awareness among healthcare providers and the public regarding vaccine changes is necessary.
- Robust surveillance and advanced bacterial characterization are key to managing pertussis outbreaks.
Abstract:
Neither natural nor vaccine-induced immunity to pertussis lasts for life. Before intensive vaccination of toddlers, pertussis was essentially a pediatric disease. Mortality and morbidity have fallen drastically in parts of the world where toddlers have been systematically protected with efficacious whole-cell vaccines. The infection is now more common in adults with waning specific immunity, who can go on to infect newborns too young to be vaccinated, with potentially dramatic consequences. For these reasons, the vaccine strategy was recently modified in several countries, with the introduction of vaccine boosters for children, adolescents and young adults, as well as for healthcare workers in contact with newborns. In France, vaccine boosters were introduced for adolescents in 1998 and for adults in contact with newborns in 2004, leading to a decrease in morbidity in adolescents and very young adults. It is important to inform the medical community, and the families with neonates, of these changes in vaccine strategy. Efficient surveillance and notification systems are needed in all countries. Surveillance must include the use of standardized diagnostic tests and reagents. Bacterial isolates should be thoroughly characterized at the genomic, transcriptomic and proteomic levels.
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