[Epidemiology of pertussis and studies on culture positive pertussis cases in Japan]
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M Kimura1, H Kuno-Sakai, N Kunita
1School of Medicine, Tokai University.
Abstract:
The number of pertussis patients has decreased steadily in the late 1960s and was extremely small in early 1970s. During 1973-74 the first national survey on pertussis cases confirmed by culture was conducted, when whole cell pertussis vaccine was used. The study revealed that 33.3% of culture positive cases had 2-4 doses of DT combined with whole cell pertussis vaccine. Acellular pertussis vaccine was introduced in 1981 and for the last several years the number of pertussis patients became low for the second time. During 1988-92 exactly the same study was conducted as the previous one. Among 2501 pertussis cases diagnosed clinically 403 were culture positive. Most of the patients were below 1 year of age. Most of the patients were below 1 year of age. Clinical symptoms of those infants were more serious than those of older children. Only 7 out of 403 (1.8%) had a history of 2-4 doses of DT combined with acellular pertussis vaccine. This proved that the acellular pertussis vaccine is by far more effective than the whole cell pertussis vaccine. Serotypes of 377 Bordetella pertussis were identified and 370/377 (98.1%) were serotype 1-3 group.
Insights
Acellular pertussis vaccine significantly outperforms whole-cell pertussis vaccine in preventing pertussis (whooping cough). Studies show acellular vaccines dramatically reduced cases compared to older whole-cell vaccines.
Area of Science:
- Infectious Diseases
- Vaccinology
- Microbiology
Context:
- Pertussis (whooping cough) incidence declined in the 1970s with whole-cell pertussis vaccine use.
- Acellular pertussis vaccines were introduced in 1981, leading to a second significant decrease in pertussis cases.
Purpose:
- To compare the effectiveness of whole-cell pertussis vaccine versus acellular pertussis vaccine.
- To assess pertussis vaccine efficacy in culture-confirmed cases.
Summary:
- A 1973-74 survey found 33.3% of culture-positive pertussis cases received 2-4 doses of whole-cell pertussis vaccine.
- A 1988-92 survey revealed only 1.8% of culture-positive pertussis cases received 2-4 doses of acellular pertussis vaccine.
- Infants under one year old experienced more severe clinical symptoms.
Impact:
- Demonstrates the superior efficacy of acellular pertussis vaccine over whole-cell pertussis vaccine.
- Highlights the importance of vaccination in controlling pertussis, especially in infants.
- Identified serotype 1-3 as the predominant group in Bordetella pertussis infections.