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[Novel approaches to control the rise in pertussis cases]
Insights
Pertussis, a bacterial respiratory illness, is increasing despite high vaccination rates. Infants are most at risk, often infected by vaccinated individuals with mild symptoms, highlighting the need for improved pertussis vaccines.
Area of Science:
- Bacteriology
- Immunology
- Public Health
Background:
- Pertussis, caused by Bordetella pertussis, is a significant respiratory disease.
- Despite high vaccination coverage, pertussis incidence is rising globally, including in the Czech Republic.
- Infants and newborns are particularly vulnerable due to infection before primary vaccination and severe disease presentation.
Purpose of the Study:
- To analyze the current epidemiological situation of pertussis.
- To investigate the reasons behind the resurgence of pertussis.
- To explore potential strategies for controlling pertussis trends.
Main Methods:
- Review of epidemiological data on pertussis incidence.
- Analysis of Bordetella pertussis mutations affecting pathogenicity.
- Evaluation of current acellular vaccine efficacy and duration of immunity.
- Assessment of alternative vaccine strategies, including whole-cell vaccines and maternal vaccination.
Main Results:
- Pertussis is increasing globally, with infants and newborns at highest risk.
- Current acellular vaccines induce short-lived immunity, and the bacterium exhibits mutations enhancing pathogenicity.
- Adults and adolescents with mild, vaccine-induced immunity are common sources of infection for infants.
- Maternal vaccination during the third trimester of pregnancy has shown effectiveness.
Conclusions:
- The rise in pertussis necessitates improved vaccination strategies.
- Novel vaccines with new adjuvants or whole-cell pertussis vaccines are potential solutions.
- Maternal vaccination is an effective method to protect newborns against pertussis.
Unlabelled:
Pertussis is a respiratory disease caused by the Gram-negative encapsulated bacterium Bordetella pertussis. Despite the high vaccination coverage rate and addition of new booster doses to the immunisation scheme (in response to the epidemiological situation), pertussis is on the rise not only in the Czech Republic but also in many other countries. The age groups at highest risk are infants and, to a lower extent, newborns who can get infected before receiving the first dose of vaccine and develop a severe course of the disease, often requiring admission to hospital. The most common source of infection are adults or adolescents from the childs close environment who experience a mild course of the disease because of the previous vaccination. The immune response induced by the currently available acellular vaccines does not last. It can be reasonably assumed that pertussis has been underreported. Multiple studies have shown mutations in the causative bacterium that confer higher pathogenicity to it, either as a result of enhanced production of pertussis toxin or loss of some antigens. Possible strategies to control these negative trends are to develop novel more effective vaccines using new adjuvants or to use whole-cell vaccines. Maternal vaccination in pregnancy trimester 3 also turned out to be effective.
Key Words:
pertussis - vaccination - epidemiology - diagnosis - newborns.
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