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An Investigation of Japanese Neonatal and Maternal Antibody Status against Pertussis
Koji Takemoto1, Naoko Nishimura1, Mako Hasegawa1
1Department of Pediatrics, Konan Kosei Hospital.
Insights
Maternal and infant pertussis (whooping cough) immunity is low in Japan. Many mothers and infants lack protective antibodies, necessitating new vaccination strategies like vaccinating pregnant women to protect newborns.
Area of Science:
- Immunology
- Pediatrics
- Public Health
Background:
- Pertussis (whooping cough) remains a concern, particularly for infants.
- Understanding the immune status of the Japanese population is crucial for effective prevention strategies.
Purpose of the Study:
- To assess the serum pertussis toxin (PT)-specific immunoglobulin G (IgG) antibody levels in Japanese infants and mothers.
- To evaluate the seroprevalence and antibody titers to determine pertussis immunity.
Main Methods:
- Serum samples were collected from 206 infants and 170 mothers between April 2016 and March 2018.
- Pertussis toxin (PT)-specific IgG antibody levels were measured using serological assays.
- Infant antibody levels were analyzed in relation to gestational age and compared to maternal levels.
Main Results:
- Maternal seroprevalence was 52.4% with a geometric mean titer (GMT) of 10.7 EU/mL.
- Infants born before 32 weeks gestational age had significantly lower antibody GMT (3.2 EU/mL) and seroprevalence (13.6%) compared to those born later.
- Antibody titers in infants showed a notable decline over short intervals, with approximately half of mothers and infants lacking protective anti-PT antibodies.
Conclusions:
- A significant portion of the Japanese mother and infant population exhibits low pertussis immunity.
- Premature infants (<32 weeks gestational age) are particularly vulnerable due to lower antibody levels.
- New vaccination strategies, including maternal vaccination during pregnancy, are recommended to enhance infant protection against pertussis.
Abstract:
To clarify the pertussis immune status of the Japanese population, we investigated levels of serum pertussis toxin (PT)-specific immunoglobulin G (IgG) antibody in infants and mothers between April 2016 and March 2018. A total of 206 infants (n = 22, < 32 weeks of gestational age [wGA]; n = 70, 32-36 wGA; n = 114, ≥ 37 wGA) and 170 mothers were enrolled. The maternal seroprevalence and antibody geometric mean titer (GMT) were 52.4% and 10.7 EU/mL, respectively. The antibody GMT, seroprevalence, and mean ratio of infant to maternal antibody titers of infants at < 32 wGA were 3.2 EU/mL, 13.6%, and 42.5%, respectively, and were significantly lower than those of infants at 32-36 wGA (9.7 EU/mL, 54.3%, and 110.2%) and infants at ≥ 37 wGA (12.1 EU/mL, 57.9%, and 112.6%). Of the 21 infants who underwent a second examination, five were positive in the first examination. Of those five, the GMT for PT had decreased by an average of 52.6% at 4.3- week intervals. In the second examination, two infants were seropositive. Approximately half of the mothers and infants were negative for anti-PT antibody. Thus, new vaccination strategies, such as the vaccination of pregnant women, are needed to prevent pertussis infection in early infancy.
