Severe Bordetella pertussis infection and vaccine issue in Chongqing, from 2012 to 2018

Area of Science:

• Pediatric infectious diseases
• Bacteriology
• Vaccinology

Background:

• Pertussis, caused by Bordetella pertussis, is a highly contagious respiratory illness with increasing incidence.
• Diagnosis of pertussis in children is challenging, with limited data on B. pertussis infection in Chongqing.
• Concerns exist regarding vaccine quality in China, potentially contributing to fluctuating infection rates.

Purpose of the Study:

• To investigate the epidemiological characteristics of B. pertussis infection in children in Chongqing.
• To evaluate the diagnostic performance of simultaneous amplification and testing compared to real-time PCR for B. pertussis detection.
• To assess potential issues related to pertussis vaccination in the region.

Main Methods:

• Retrospective analysis of 25,441 children with suspected pertussis (December 2012 - November 2018).
• Prospective evaluation of 800 randomly selected children using simultaneous amplification and testing.
• Comparison of diagnostic accuracy metrics (AUC, Kappa value) between simultaneous amplification and testing (RNA) and real-time PCR (DNA).

Main Results:

• Infants under 12 months bore the highest burden of pertussis.
• Pertussis incidence in Chongqing exhibited a periodic pattern.
• Simultaneous amplification and testing demonstrated superior diagnostic performance (AUC: 0.900, Kappa: 0.831) compared to real-time PCR (AUC: 0.869, Kappa: 0.690).

Conclusions:

• The study characterized B. pertussis infection patterns and vaccine-related issues in Chongqing.
• Simultaneous amplification and testing is a promising novel assay for diagnosing B. pertussis infections.
• Findings highlight the need for continued surveillance and potential improvements in pertussis vaccination strategies.