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Protecting Newborns Against Pertussis: Treatment and Prevention Strategies
Abdulbaset M Salim1, Yan Liang2,3, Paul E Kilgore4
1Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA. asalim@med.wayne.edu.
Insights
Pertussis, a severe respiratory illness, requires ongoing research for better vaccines and treatments. Surveillance is key to track Bordetella pertussis strains and protect vulnerable populations, especially infants.
Area of Science:
- Medical Microbiology
- Immunology
- Epidemiology
Background:
- Pertussis (whooping cough) is a severe respiratory illness affecting all age groups, causing significant global mortality.
- Molecular diagnostic assays like PCR improve Bordetella pertussis detection and outbreak response.
- Vaccine hesitancy is reducing coverage, while pertussis risk in newborns necessitates maternal immunization strategies.
Purpose of the Study:
- To review the current understanding of pertussis pathogenesis, immunology, and diagnosis.
- To highlight challenges and strategies for improving pertussis vaccination coverage and control.
- To emphasize the need for enhanced surveillance and development of next-generation vaccines.
Main Methods:
- Review of current literature on pertussis research, diagnosis, and vaccination.
- Analysis of trends in pertussis incidence, vaccine coverage, and emerging B. pertussis strains.
- Examination of challenges in achieving immunization targets and recommendations for future vaccine development.
Main Results:
- Molecular assays have enhanced pertussis diagnosis and outbreak detection.
- Vaccine hesitancy poses a challenge to achieving high immunization rates, particularly in certain communities.
- Existing antimicrobial treatments focus on reducing disease severity and transmission, but new vaccine strategies are crucial.
Conclusions:
- Continued surveillance is vital for identifying opportunities to reduce infant exposure and manage outbreaks.
- Laboratory surveillance for emerging B. pertussis strains is essential to detect vaccine-evading variants.
- Developing new-generation pertussis vaccines is a long-term necessity to combat evolving disease threats.
Abstract:
Pertussis is a potentially severe respiratory disease, which affects all age groups from young infants to older adults and is responsible for an estimated 195,000 deaths occurred globally in 2008. Active research is ongoing to better understand the pathogenesis, immunology, and diagnosis of pertussis. For diagnosis, molecular assays (e.g., polymerase chain reaction) for detection of Bordetella pertussis have become more widely available and support improved outbreak detection. In children, pertussis vaccines have been incorporated into routine immunization schedules and deployed for pertussis outbreak control. Lower levels of vaccine coverage are now being observed in communities where vaccine hesitancy is rising. Additionally, recognition that newborn babies are at risk of pertussis in the USA and UK has led to recommendations to immunize pregnant women. Among adolescents and older adults in the USA, Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular pertussis (Tdap) Vaccines are recommended, but substantial individual- and system-level barriers exist that will make achieving national Healthy People 2020 targets for immunization challenging. Current antimicrobial regimens for pertussis are focused on reducing the severity of disease, reducing rates of sequelae, and minimizing transmission of infection to susceptible individuals. Continued surveillance for pertussis will be important to identify opportunities for reducing young infants' exposure and reducing the impact of outbreaks among school-aged children. Laboratory-based surveillance for newly emerging strains of B. pertussis will be important to identify strains that may evade protection elicited by currently available vaccines. Efforts to develop new-generation pertussis vaccines should be considered now in anticipation of vaccine development programs, which may require ten or more years to deliver a licensed vaccine.
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