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Pertussis outbreak, southeastern Minnesota, 2012.

Alexander G Theofiles1, Scott A Cunningham2, Nicholas Chia3

  • 1Department of Medicine, Mayo Clinic, Rochester, MN.

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Summary
This summary is machine-generated.

The 2012 pertussis outbreak involved multiple Bordetella pertussis strains, all lacking pertactin. Findings suggest reduced effectiveness of acellular vaccines and waning immunity may have contributed to the outbreak.

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Area of Science:

  • Infectious Diseases
  • Microbiology
  • Epidemiology

Background:

  • Pertussis, or whooping cough, remains a significant public health concern globally.
  • Outbreaks can occur despite high vaccination rates, necessitating ongoing surveillance and research.
  • Understanding the characteristics of circulating Bordetella pertussis strains is crucial for effective control strategies.

Purpose of the Study:

  • To investigate the clinical and laboratory features of the 2012 pertussis outbreak in southeastern Minnesota.
  • To characterize the Bordetella pertussis strains involved in the outbreak, including genetic makeup and antibiotic susceptibility.
  • To analyze patient demographics and vaccination status in relation to pertussis infection.

Main Methods:

  • Nasopharyngeal swabs from 265 patients were tested using polymerase chain reaction (PCR) and culture.
  • Bordetella pertussis isolates underwent macrolide susceptibility testing, whole genome sequencing, and pulsed-field gel electrophoresis.
  • Pertactin gene sequences were analyzed to identify pertactin-deficient strains.
  • Demographic and vaccination data were collected from patients with positive PCR results.

Main Results:

  • 160 patients tested positive for B. pertussis and 21 for B. parapertussis.
  • PCR detected B. pertussis more frequently than culture (P=.001).
  • All 12 B. pertussis isolates tested lacked functional pertactin due to genetic alterations.
  • Multiple B. pertussis strains were identified.
  • Patients with pertussis were younger on average and less likely to have received whole-cell pertussis vaccine.
  • Among those vaccinated with acellular vaccines, infection occurred significantly later after the last dose.

Conclusions:

  • The 2012 southeastern Minnesota pertussis outbreak was caused by multiple B. pertussis strains, all lacking pertactin.
  • The findings suggest that decreased efficacy and waning immunity from acellular pertussis vaccines may have contributed to the outbreak.
  • Further research into vaccine effectiveness and strain evolution is warranted.