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Epidemiology of pertussis in Casablanca (Morocco): contribution of conventional and molecular diagnosis tools
Khalid Katfy1,2,3, Nicole Guiso4, Idrissa Diawara5,6
1Laboratoire de Microbiologie, Faculté de Médecine et de Pharmacie, Hassan II University of Casablanca, B, P 5696, Casablanca, Morocco. khalidkatfy@hotmail.com.
Insights
Pertussis remains a global threat, especially for newborns. This study in Casablanca found high rates of Bordetella pertussis and Bordetella holmesii, including co-infections, in infants and their mothers, suggesting young parents as a source.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Pertussis (whooping cough) is a vaccine-preventable illness causing significant global morbidity and mortality, particularly in newborns.
- Surveillance and prevalence analysis of pertussis in Casablanca, Morocco, were lacking, especially concerning its transmission within households.
Purpose of the Study:
- To establish pertussis surveillance at a major pediatric hospital in Casablanca.
- To determine the prevalence of pertussis among children under 14 and their close contacts in Casablanca.
Main Methods:
- A prospective study was conducted from January 2013 to June 2015 at Abderrahim Harouchi Pediatric Hospital.
- Nasopharyngeal samples were analyzed using Bordetella spp. culture and Real-time PCR (RT-PCR) for B. pertussis, B. parapertussis, and B. holmesii.
- Household contacts of suspected pediatric pertussis cases were also tested for Bordetella spp.
Main Results:
- Bordetella DNA was detected in 61% of hospitalized children and 47% of their contacts via RT-PCR.
- Bordetella pertussis was the predominant species (91.7% of positive children, 90% of positive contacts).
- Bordetella holmesii was frequently detected (39.5% of positive children, 18.6% of positive contacts), with significant co-infection rates (36.5% in children).
Conclusions:
- Bordetella pertussis and Bordetella holmesii are circulating in Casablanca, with frequent co-infections observed in infants and mothers.
- Younger parents may be a significant source of pertussis infection for unvaccinated infants.
- RT-PCR is a sensitive and specific diagnostic tool for pertussis, suitable for clinical laboratories.
Background:
Pertussis, a vaccine preventable disease, is still responsible of significant morbidity and mortality around the world, mostly in newborns. The aim of the present study was (1) to introduce pertussis surveillance in the major pediatric hospital of Casablanca (2) to analyze the prevalence of pertussis among children under 14 years of age and their entourage in Casablanca, Morocco.
Methods:
This is a prospective and non-case controlled study, including children suspected of Pertussis admitted at the Abderrahim Harouchi Pediatric Hospital in Casablanca, from January 2013 to June 2015. Nasopharyngeal samples were obtained for Bordetella spp. culture and Real time PCR detection (RT-PCR) with specific primers of Bordetella spp., B. pertussis, B. parapertussis and B. holmesii. The detection of Bordetella spp. was also performed in some household contacts of the children suspected of pertussis.
Results:
During the 2.5-years period, a total of 282 samples were collected from hospitalized children (156) and in some of their contacts (126). Among 156 samples from the children (from whom 57% were under 2 month of age), Bordetella DNA was detected in 61% (96/156) by RT-PCR. Among these positive samples, 91.7% (88/96) corresponded to B. pertussis DNA. Furthermore, in 39.5% (38/96) of the Bordetella positive samples, B. holmesii DNA was also detected. B. parapertussis DNA was detected in only one sample (1/156). Out of the 156 samples collected from the hospitalized children, only 48 were tested by culture, and 4 B. pertussis were isolated (8.3%). Among the 126 samples from the contacts of the children, mostly mothers (115 cases), Bordetella DNA was detected in 47% (59/126), 90% (53/59) being B. pertussis DNA. Moreover, B. holmesii DNA was also detected in 18.6% (11/59) of the Bordetella positive samples, and coexistence of B. pertussis and B. holmesii DNA in 36.5% (35/96). Two B. pertussis were isolated by culture performed on 43 samples of the contacts of the children (4.6%).
Conclusions:
This study highlights the circulation of B. pertussis but also of B. holmesii in Casablanca-Morocco with a high proportion of co-infections B. holmesii/B. pertussis in infants and their mothers, indicate that infection of non-vaccinated infants could be more associated with young parents. Moreover, the RT- PCR provides a sensitive and specific diagnosis of B. pertussis infections and distinguishes it from other Bordetella species, and is therefore suitable for implementation in the diagnostic laboratory.
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