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1.
J Paediatr Child Health ; 58(8): 1488, 2022 08.
Article in English | MEDLINE | ID: covidwho-1927611
2.
Vaccine ; 40(27): 3746-3751, 2022 06 15.
Article in English | MEDLINE | ID: covidwho-1926964

ABSTRACT

BACKGROUND: Immunization against Bordetella pertussis during pregnancy reduces morbidity from severe pertussis in young infants via trans-placental transfer of anti-B. pertussis Immunoglobulin G (IgG). Studies have reported a near disappearance of respiratory pathogens including B. pertussis following implementation of mitigation strategies to control Coronavirus disease 2019 (COVID-19). We explored how immunity against B. pertussis changed in women of childbearing-age through the COVID-19 pandemic. METHODS: Paired blood samples from females of childbearing-age collected at the beginning (May-June 2020) and nearly one year into the COVID-19 pandemic (February-May 2021) in British Columbia (BC), Canada were tested for anti-B. pertussis IgG levels. To ascertain whether early-pandemic IgG levels in 2020 reflected levels in pregnant women early in gestation, 1st trimester sera collected from age-matched healthy pregnant women in 2018 and 2019 were tested for anti-B. pertussis IgG. Levels were compared by t tests. P-value of 0.05 was assigned and statistical significance was set as p < 0.016 using Bonferroni correction. RESULTS: Annual provincial B. pertussis incidences per 100,000 in BC in 2020 (3/100,000) and 2021 (<1/100,000) approximated the lowest levels since 1990. In 2021 vs. 2020, anti-pertussis toxin (PT), filamentous hemagglutinin (FHA) and pertactin (PRN) IgG levels declined in women of childbearing-age: 6.8 IU/ml (95 %CI, 4.2-10.9) vs. 8.4 IU/ml (5.1-13.9; p = 0.004); 18.8 IU/ml (10.9-32.2) vs. 23.6 IU/ml (13.2-42.1; p < 0.001); and 37.1 IU/ml (18.1-75.9) vs. 47.2 IU/ml (24.8-89.9; p = 0.092), respectively. Although all values were slightly higher, anti-PT, FHA and PRN IgG levels in women of childbearing age did not significantly differ in 2020 compared with early-gestation pregnant women in 2018-2019, 8.4 IU/ml (95% CI, 5.1-13.9) vs. 5.4 IU/ml (95% CI, 3.8-7.7; p = 0.166), 23.6 IU/ml (95% CI, 13.2-42.1) vs. 20.1 IU/ml (95% CI, 13.4-30.2; p = 0.656), and 47.2 IU/ml (24.8-89.9) vs. 17.3 IU/ml (95% CI, 10.5-28.7; p = 0.021), respectively. DISCUSSION: B. pertussis infections should be closely monitored during the relaxing of mitigation measures for COVID-19.


Subject(s)
COVID-19 , Whooping Cough , Antibodies, Bacterial , Bordetella pertussis , British Columbia , COVID-19/epidemiology , COVID-19/prevention & control , Child , Female , Humans , Immunoglobulin G , Infant , Pandemics , Pertussis Toxin , Placenta , Pregnancy , Whooping Cough/epidemiology , Whooping Cough/prevention & control
3.
Euro Surveill ; 27(25)2022 Jun.
Article in English | MEDLINE | ID: covidwho-1910958

ABSTRACT

BackgroundInterventions to mitigate the COVID-19 pandemic may impact other respiratory diseases.AimsWe aimed to study the course of pertussis in France over an 8-year period including the beginning of the COVID-19 pandemic and its association with COVID-19 mitigation strategies, using multiple nationwide data sources and regression models.MethodsWe analysed the number of French pertussis cases between 2013 and 2020, using PCR test results from nationwide outpatient laboratories (Source 1) and a network of the paediatric wards from 41 hospitals (Source 2). We also used reports of a national primary care paediatric network (Source 3). We conducted a quasi-experimental interrupted time series analysis, relying on negative binomial regression models. The models accounted for seasonality, long-term cycles and secular trend, and included a binary variable for the first national lockdown (start 16 March 2020).ResultsWe identified 19,039 pertussis cases from these data sources. Pertussis cases decreased significantly following the implementation of mitigation measures, with adjusted incidence rate ratios of 0.10 (95% CI: 0.04-0.26) and 0.22 (95% CI: 0.07-0.66) for Source 1 and Source 2, respectively. The association was confirmed in Source 3 with a median of, respectively, one (IQR: 0-2) and 0 cases (IQR: 0-0) per month before and after lockdown (p = 0.0048).ConclusionsThe strong reduction in outpatient and hospitalised pertussis cases suggests an impact of COVID-19 mitigation measures on pertussis epidemiology. Pertussis vaccination recommendations should be followed carefully, and disease monitoring should be continued to detect any resurgence after relaxation of mitigation measures.


Subject(s)
COVID-19 , Whooping Cough , COVID-19/epidemiology , Child , Communicable Disease Control , France/epidemiology , Humans , Information Storage and Retrieval , Pandemics , Whooping Cough/epidemiology , Whooping Cough/prevention & control
4.
Przegl Epidemiol ; 75(4): 604-612, 2021.
Article in English | MEDLINE | ID: covidwho-1904173

ABSTRACT

INTRODUCTION: Pertussis is an endemic, highly contagious disease that can be prevented through vaccination. In Poland, since the second half of the nineties, changes in the epidemiology of pertussis have been observed - an increase in the number of cases, despite the high level of vaccination of the population. The highest percentage of registered cases of pertussis concerned people aged 15 and over. The causes of the increased incidence of pertussis are a complex problem. Immunity after pertussis vaccination is unstable, disappears within 4-12 years, and the risk of the disease increases with time after the last dose of the vaccine. Due to the loss of protection against pertussis in adults, it is important to repeat immunization with dTpa every 10 years. OBJECTIVE: The aim of the study was to assess the epidemiological situation of pertussis in Poland in 2018-2019 compared to the situation in previous years, with particular emphasis on the assessment of the vaccination status of children against pertussis. MATERIAL AND METHODS: The assessment of the epidemiological situation of pertussis in Poland was performed on the basis of the results of the analysis of unit reports of pertussis registered in the NIPH-NIH through the SRWE system and data from the bulletins "Infectious diseases and poisonings in Poland" for 2018 and 2019 and the bulletins "Vaccinations in Poland" for 2018 and 2019. RESULTS: In 2018, 1 548 were registered, and in 2019 - 1 629 cases of pertussis. The incidence was respectively: 4.0 and 4.2 per 100 000 population and was lower compared to the incidence in 2017 (8.0). The highest incidence of pertussis was in the age group 0-4 years (20.6 and 23.6 respectively), and high in children and adolescents aged 5-9 (10.9 and 11.5 respectively) and 10-14 years (respectively: 12.2 and 11.2 - per 100 000 population). About half of the cases concerned people over 15 years of age. In general, a higher incidence among women was observed than in men, as well as a higher incidence in cities than in rural areas. In 2018, among people with pertussis, 434 people (i.e. 28%) and in 2019 - 482 people (i.e. 29.6%) were hospitalized. In 2019, one fatal case of the disease was reported to the epidemiological surveillance system. SUMMARY AND CONCLUSIONS: In Poland, in the years 2018-2019, there was a decrease in the number of cases of pertussis, the most common were children under the age of four (the highest incidence). A worrying trend is the decreasing number of vaccinations in children aged 2 years against pertussis covered by compulsory primary vaccinations in individual provinces. In the current epidemiological situation, the best way to prevent new cases of pertussis is to use vaccination according to the current regimen and to recommend to adults a single dose of dTpa vaccination, which should be repeated every 10 years.


Subject(s)
Communicable Diseases , Whooping Cough , Adolescent , Adult , Age Distribution , Child , Communicable Diseases/epidemiology , Disease Outbreaks/prevention & control , Female , Humans , Incidence , Infant , Male , Pentetic Acid , Pertussis Vaccine/therapeutic use , Poland/epidemiology , Registries , Rural Population , Urban Population , Whooping Cough/epidemiology , Whooping Cough/prevention & control
5.
Rev Esp Quimioter ; 35 Suppl 1: 104-110, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1836624

ABSTRACT

Adults with lung diseases, comorbidities, smokers, and elderly are at risk of lung infections and their consequences. Community-acquired pneumonia happen in more than 1% of people each year. Possible pathogens of community-acquired pneumonia include viruses, pneumococcus and atypicals. The CDC recommend vaccination throughout life to provide immunity, but vaccination rates in adults are poor. Tetravalent and trivalent influenza vaccine is designed annually during the previous summer for the next season. The available vaccines include inactivated, adjuvant, double dose, and attenuated vaccines. Their efficacy depends on the variant of viruses effectively responsible for the outbreak each year, and other reasons. Regarding the pneumococcal vaccine, there coexist the old polysaccharide 23-valent vaccine with the new conjugate 10-valent and 13-valent conjugate vaccines. Conjugate vaccines demonstrate their usefulness to reduce the incidence of pneumococcal pneumonia due to the serotypes present in the vaccine. Whooping cough is still present, with high morbidity and mortality rates in young infants. Adult's pertussis vaccine is available, it could contribute to the control of whooping cough in the most susceptible, but it is not present yet in the calendar of adults around the world. About 10 vaccines against SARS-CoV-2 have been developed in a short time, requiring emergency use authorization. A high rate of vaccination was observed in most of the countries. Booster doses became frequent after the loss of effectiveness against new variants. The future of this vaccine is yet to be written.


Subject(s)
COVID-19 , Community-Acquired Infections , Pneumonia, Pneumococcal , Whooping Cough , Adult , Aged , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Community-Acquired Infections/epidemiology , Community-Acquired Infections/prevention & control , Humans , Infant , Pneumonia, Pneumococcal/epidemiology , Pneumonia, Pneumococcal/prevention & control , Prognosis , SARS-CoV-2 , Vaccination , Vaccines, Conjugate
6.
Euro Surveill ; 27(17)2022 04.
Article in English | MEDLINE | ID: covidwho-1834262

ABSTRACT

IntroductionIn France, three complementary surveillance networks involving hospitals and paediatrician practices currently allow pertussis surveillance among infants (<1 year old) and children (1-12 years old). Data on incidences among adolescents (13-17 years old) and adults (≥ 18 years) are scarce. In 2017, a sentinel surveillance system called Sentinelles network, was implemented among general practitioners (GPs).AimThe purpose of Sentinelles network is to assess pertussis incidence, monitor the cases' age distribution and evaluate the impact of the country's vaccination policy. We present the results from the first 4 years of this surveillance.MethodsGPs of the French Sentinelles network reported weekly numbers of epidemiologically or laboratory-confirmed cases and their characteristics.ResultsA total of 132 cases were reported over 2017-2020. Estimated national incidence rates per 100,000 inhabitants were 17 (95% confidence interval (CI): 12-22) in 2017, 10 (95% CI: 6-14) in 2018, 15 (95% CI: 10-20) in 2019 and three (95% CI: 1-5) in 2020. The incidence rate was significantly lower in 2020 than in 2017-2019. Women were significantly more affected than men (83/132; 63% of women, p = 0.004); 66% (87/132) of cases were aged 15 years or over (median age: 31.5 years; range: 2 months-87 years). Among 37 vaccinated cases with data, 33 had received the recommended number of doses for their age.ConclusionsThese results concur with incidences reported in other European countries, and with studies showing that the incidences of several respiratory diseases decreased in 2020 during the COVID-19 pandemic. The results also suggest a shift of morbidity towards older age groups, and a rapid waning of immunity after vaccination, justifying to continue this surveillance.


Subject(s)
COVID-19 , General Practitioners , Whooping Cough , Adolescent , Adult , Aged , COVID-19/epidemiology , Child , Child, Preschool , Female , France/epidemiology , Humans , Infant , Male , Pandemics , Whooping Cough/diagnosis , Whooping Cough/epidemiology , Whooping Cough/prevention & control
7.
Vaccine ; 40(25): 3455-3460, 2022 05 31.
Article in English | MEDLINE | ID: covidwho-1821520

ABSTRACT

OBJECTIVE: To determine pertussis and influenza vaccination coverage during pregnancy among women delivering in all the maternities of Geneva (Switzerland), during the COVID-19 pandemic. METHODS: All women delivering in all the maternity centres of the canton of Geneva from 1st November 2020 to 30th November 2020 (beginning of the flu vaccination season) and from 8th March 2021 to 7th April 2021 (end of the flu vaccination season) had their records checked upon admission to the labour ward regarding pertussis and influenza vaccination during pregnancy. Reasons for non-vaccination were recorded. Univariate and multivariate analyses were done to identify predictors of vaccine uptake. RESULTS: 951 women delivered in Geneva during the two study periods, of which 950 were included in the study. 86.2% were vaccinated against pertussis, with no significant difference between the study periods (87.5% vs 85% at the beginning and end of the flu vaccination season respectively). 49.8% were vaccinated against influenza, with no significant difference between the study periods (48.8% vs 50.7% beginning and end of the flu vaccination season respectively). The influenza vaccine was 5 times more likely not to be proposed (8.9% vs. 1.7%) and 3 times more likely to be refused (26.6% vs. 8%) than the pertussis vaccine. Main reason for refusal was a lack of maternal desire for both vaccines, but not vaccine fear. Maternal parity ≥ 1 was significantly associated with pertussis vaccine uptake at univariate analysis. Women were significantly more likely to accept the influenza vaccine if they had a university degree or if they did not deliver in a midwife-only run delivery unit in both univariate and multivariate analysis. CONCLUSIONS: In Geneva, most gynaecologists offer pertussis immunization during antenatal care and uptake is high, but more efforts must be done to increase influenza vaccination coverage. Education level impacts maternal flu vaccination uptake, but other social disparities did not.


Subject(s)
COVID-19 , Influenza Vaccines , Influenza, Human , Pregnancy Complications, Infectious , Whooping Cough , COVID-19/epidemiology , COVID-19/prevention & control , Female , Humans , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Pandemics/prevention & control , Pertussis Vaccine , Pregnancy , Pregnancy Complications, Infectious/prevention & control , Prospective Studies , Vaccination , Whooping Cough/epidemiology , Whooping Cough/prevention & control
8.
Travel Med Infect Dis ; 48: 102348, 2022.
Article in English | MEDLINE | ID: covidwho-1819613

ABSTRACT

The coronavirus disease 2019 (COVID-19) has promoted stringent public health measures such as hand hygiene, face mask wearing, and physical distancing to contain the spread of the viral infection. In this retrospective study, the secondary outcomes of those public health measures on containing other respiratory infections among the Thai population were investigated. Hospitalization data spanning from 2016 to 2021 of six respiratory infectious diseases, namely influenza, measles, pertussis, pneumonia, scarlet fever, and tuberculosis (TB), were examined. First, the expected respiratory infectious cases where no public health measures are in place are estimated using the seasonal autoregressive integrated moving average (SARIMA) model. Then the expected number of cases and the observed cases were compared. The results showed a significant drop in the incidence of respiratory infectious diseases by an average of 61%. The reduction in hospitalization is significant for influenza, measles, pertussis, pneumonia, and scarlet fever (p < 0.05), while insignificant for TB (p = 0.54). The notable decrease in the incidence of cases is ascribed to the implementation of public health measures that minimized the opportunity for spread of disease. This decline in cases following relaxation of pandemic countermeasure is contingent on its scope and nature, and it is proof that selective physical distancing, hand hygiene, and use of face masks in public places is a viable route for mitigating respiratory morbidities.


Subject(s)
COVID-19 , Communicable Diseases , Influenza, Human , Measles , Scarlet Fever , Whooping Cough , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Diseases/epidemiology , Humans , Influenza, Human/epidemiology , Measles/epidemiology , Measles/prevention & control , Pandemics/prevention & control , Public Health , Retrospective Studies , SARS-CoV-2 , Scarlet Fever/epidemiology , Thailand/epidemiology , Whooping Cough/epidemiology
9.
Int J Environ Res Public Health ; 19(7)2022 03 29.
Article in English | MEDLINE | ID: covidwho-1785635

ABSTRACT

BACKGROUND: While the effectiveness of tetanus-diphtheria-pertussis childhood immunization programs is unquestionable, the actual need for a periodic boosting vaccination in adults is controversial. In Italy, the Ministry of Health recommends a Tdap booster vaccination every 10 years. The aim of this study is to assess the real-world adherence of Italian regional healthcare services to national recommendations and to evaluate two alternative strategies. METHODS: Annual Tdap vaccine requirements by the 21 Italian regions were retrieved from related tender announcements, and regional and national vaccination coverage rates (VCRs) were estimated for three scenarios, namely the currently recommended 10-year booster vaccination, a single booster shot at age 50 and at age 65. RESULTS: In Scenario 1, no region reached a VCR > 30%, and the national VCR was 10.6%; in Scenario 2, five regions achieved the optimal vaccination coverage of ≥95%, but the vast majority continued to have inadequate VCRs, with a national VCR of 54.4%; in Scenario 3, five regions reached VCRs exceeding 100%, with VCRs from other regions significantly improving and a national VCR of 74.8%. CONCLUSIONS: A substantial lack of adherence by Italian regional healthcare services to current national recommendations on tetanus-diphtheria-pertussis adult vaccination was shown. Scenario 3 is the most feasible, i.e., a single booster shot at age 65, possibly administrable along with other already-recommended, age-specific vaccines.


Subject(s)
Diphtheria-Tetanus-acellular Pertussis Vaccines , Diphtheria , Tetanus , Whooping Cough , Aged , Child , Diphtheria/prevention & control , Diphtheria-Tetanus Vaccine , Diphtheria-Tetanus-acellular Pertussis Vaccines/therapeutic use , Humans , Immunization, Secondary , Italy , Middle Aged , Tetanus/prevention & control , Vaccination , Whooping Cough/prevention & control
10.
Expert Rev Vaccines ; 21(6): 853-859, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1772530

ABSTRACT

OBJECTIVES: Our aim was to estimate vaccination and susceptibility rates against vaccine-preventable diseases among healthcare personnel (HCP) in eight hospitals. METHODS: Cross-sectional survey. RESULTS: A total of 1284 HCP participated (physicians: 31.3%, nursing personnel: 36.6%, paramedical personnel: 11.1%, administrative personnel: 13.2%, supportive personnel: 7.3%). Vaccination rates were 32.9% against measles and mumps, 38.1% against rubella, 5.7% against varicella, 9.2% against hepatitis A, 65.8% against hepatitis B, 31.8% against tetanus-diphtheria, 7.1% against pertussis, 60.2% against influenza, and 80.1% against COVID-19. Susceptibility rates were as follows: 27.8% for measles, 39.6% for mumps, 33.4% for rubella, 22.2% for varicella, 86.3% for hepatitis A, 34.2% for hepatitis B, 68.2% for tetanus-diphtheria, and 92.9% for pertussis. Older HCP had higher susceptibility rates against mumps, rubella, varicella, hepatitis A, hepatitis B, tetanus-diphtheria, and pertussis (p-values <0.001 for all). Mandatory vaccinations were supported by 81.85% of HCP. CONCLUSIONS: Although most HCPs supported mandatory vaccinations, significant vaccination gaps, and susceptibility rates were recorded. The proportion of susceptible HCP to measles, mumps, rubella, and varicella has increased in the past decade, mostly because of reduction in acquired cases of natural illness. Vaccination programs for HCP should be developed. A national registry to follow HCP's vaccination rates is urgently needed.


Subject(s)
COVID-19 , Chickenpox , Diphtheria , Hepatitis A , Hepatitis B , Measles , Mumps , Rubella , Tetanus , Whooping Cough , Attitude , Cross-Sectional Studies , Delivery of Health Care , Greece/epidemiology , Humans , Measles/epidemiology , Measles/prevention & control , Mumps/epidemiology , Mumps/prevention & control , Tertiary Care Centers , Vaccination , Vaccination Coverage
11.
BMC Public Health ; 22(1): 405, 2022 02 28.
Article in English | MEDLINE | ID: covidwho-1700444

ABSTRACT

BACKGROUND: In March 2020, England went into its first lockdown in response to the COVID-19 pandemic. Restrictions eased temporarily, followed by second and third waves in October 2020 and January 2021. Recent data showed that the COVID-19 pandemic resulted in reduced transmission of some invasive diseases. We assess the impact of the COVID-19 pandemic on pertussis incidence and on the immunisation programme in England. METHODS: We assessed trends in pertussis cases from 2012 to 2020 by age group and month. Incidence from the time that England eased its initial lockdown measures in July 2020 through to summer 2021 was calculated and the incidence rate ratios of pertussis cases from five years prior to the pandemic (July 2014 - June 2019) compared to the same time period during the pandemic (July 2020 - June 2021). Vaccine coverage estimates for pertussis containing vaccines were reviewed for the maternal and childhood programmes. RESULTS: A substantial decline in pertussis cases was observed from April 2020 onwards, marking the lowest number of cases in the last decade. Pertussis incidence dropped in all age groups, particularly among infants less than one year old (0.50 / 100,000 during July 2020 to June 2021 compared to 24.49/ 100,000 from July 2014 to June 2019). The incidence rate ratio was 0.02 (95% CI 0.01 to 0.02) for July 2014 to June 2019 (pre-pandemic) compared to the pandemic period of July 2020 to June 2021. None of the cases had a co-infection with SARS-CoV-2. Vaccine coverage for infants born between January to March 2020 with three doses of pertussis vaccine by 12 months of age decreased by 1.1% points compared to infants born between January to March 2019 (91.6% and 92.7%, respectively). Prenatal pertussis coverage for the 2020 to 2021 financial year was 2.7% points lower than the year prior to the pandemic (70.5% and 76.8%, respectively). CONCLUSIONS: Lockdown measures due to the COVID-19 pandemic have had a significant impact on pertussis transmission. With the easing of restrictions it is important to continue monitoring pertussis cases in England alongside coverage of the maternal and childhood immunisation programmes.


Subject(s)
COVID-19 , Whooping Cough , Bordetella pertussis , COVID-19/epidemiology , COVID-19/prevention & control , Child , Communicable Disease Control , England/epidemiology , Female , Humans , Infant , Pandemics/prevention & control , Pertussis Vaccine , Pregnancy , SARS-CoV-2 , Whooping Cough/epidemiology , Whooping Cough/prevention & control
13.
BJOG ; 129(8): 1342-1351, 2022 07.
Article in English | MEDLINE | ID: covidwho-1662224

ABSTRACT

OBJECTIVE: To assess the frequency and associated characteristics of COVID-19 vaccine hesitancy among pregnant and postpartum individuals. DESIGN: Cross-sectional study. SETTING: Prenatal care at a single academic tertiary care centre. POPULATION: Pregnant and postpartum individuals enrolled in prenatal care at a single academic tertiary care centre from 22 March 2021 to 2 April 2021, concurrent with state guidelines recommending COVID-19 vaccination in pregnancy. METHODS: We used logistic regression to identify characteristics associated with COVID-19 vaccine hesitancy, and adjusted for: age, parity, race, trimester of pregnancy, and chronic comorbidities. MAIN OUTCOME MEASURES: COVID-19 vaccine hesitancy, defined as uncertainty or refusal of the vaccine, despite the availability of vaccine services, in accordance with the World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE) on vaccine hesitancy. RESULTS: Of the 485 individuals screened and approached, 456 (94%) enrolled and completed the survey (435/456, 95% pregnant). The frequency of COVID-19 vaccine hesitancy was 46% (95% CI 41%-51%). Sociodemographic characteristics, including non-Hispanic Black race, younger age, lower education, public health insurance receipt, parity >1, and reported substance use, were associated with a higher odds of COVID-19 vaccine hesitancy, but not clinical risk conditions. Individuals who had a family or friend vaccinated for COVID-19, prior or planned vaccination for tetanus, diphtheria and acellular pertussis (Tdap) and/or influenza, and who perceived that vaccination benefited the baby were less likely to express COVID-19 vaccine hesitancy. CONCLUSIONS: COVID-19 vaccine hesitancy was frequent among pregnant and postpartum individuals. Those who may face barriers to accessing healthcare services were more likely to report vaccine hesitancy. These results can inform interventions to increase COVID-19 vaccine uptake in pregnancy. TWEETABLE ABSTRACT: COVID-19 vaccination hesitancy is frequent among pregnant and postpartum individuals, and those who face barriers to accessing healthcare services are more likely to report COVID-19 vaccine hesitancy.


Subject(s)
COVID-19 , Diphtheria-Tetanus-acellular Pertussis Vaccines , Whooping Cough , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Cross-Sectional Studies , Female , Humans , Postpartum Period , Pregnancy , Vaccination , Whooping Cough/prevention & control
14.
Vaccine ; 40(8): 1170-1179, 2022 02 16.
Article in English | MEDLINE | ID: covidwho-1633691

ABSTRACT

The Global Pertussis Initiative (GPI) Roundtable Meeting held in 2019, which preceded the COVID-19 pandemic, focused on the incidence, surveillance, and immunization practices for pertussis in the Asian region. Participants from China, India, Indonesia, Malaysia, Pakistan, Philippines, South Korea, Taiwan, and Thailand presented country-specific information on pertussis prevalence, diagnosis, surveillance, vaccine administration and schedules, maternal and neonatal disease rates, and policies and practice of vaccination during pregnancy. In recent years, many Asian countries have seen an increase in pertussis cases, although underreporting of the disease is a concern. Currently, most Asian countries have only passive surveillance for pertussis in place. There is a need for improved surveillance to determine the disease burden and justify vaccination policies and recommendations, such as essential vaccination, boosters, and vaccination during pregnancy. Better awareness of the disease in adolescents and adults is necessary, and infant and childhood vaccination schedules need to be improved in many countries. Differences between private versus public sector vaccination schedules and between whole-cell and acellular pertussis vaccines should continue to be examined. It can be anticipated that unmet needs in the prevention and management of pertussis will continue as the COVID-19 pandemic evolves and that key recommendations highlighted in this meeting report will be of ongoing importance.


Subject(s)
COVID-19 , Whooping Cough , Adolescent , Female , Humans , Infant , Pandemics , Pertussis Vaccine , Pregnancy , SARS-CoV-2 , Thailand , Vaccination , Whooping Cough/epidemiology , Whooping Cough/prevention & control
15.
Arch Dis Child ; 107(3): e19, 2022 03.
Article in English | MEDLINE | ID: covidwho-1550915

ABSTRACT

Measures to reduce the spread of COVID-19 have been associated with reduction in other respiratory infections. Results of a national Swedish cohort study of infant pertussis during April 2020-September 2021 were compared with those during January 2014-March 2020. The number of pertussis cases decreased significantly during the COVID-19 pandemic, from an average of 21 infant cases per quarter of a year before the pandemic to an average of 1 case per quarter during the pandemic. Swedish strategies to mitigate the spread of COVID-19 seem to have had an impact on pertussis incidence in infants.


Subject(s)
COVID-19/epidemiology , Pandemics , Whooping Cough/epidemiology , Humans , Incidence , Infant , Physical Distancing , Retrospective Studies , SARS-CoV-2 , Social Isolation , Sweden/epidemiology
16.
PLoS One ; 16(10): e0259318, 2021.
Article in English | MEDLINE | ID: covidwho-1496537

ABSTRACT

PURPOSE: The purpose of this study was to characterize the nasopharyngeal microbiota of infants with possible and confirmed pertussis compared to healthy controls. METHODS: This prospective study included all infants <1 year with microbiologically confirmed diagnosis of pertussis attended at a University Hospital over a 12-month period. For each confirmed case, up to 2 consecutive patients within the same age range and meeting the clinical case definition of pertussis but testing PCR-negative were included as possible cases. A third group of asymptomatic infants (healthy controls) were also included. Nasopharyngeal microbiota was characterized by sequencing the V3-V4 region of the 16S rRNA gene. Common respiratory DNA/RNA viral co-infection was tested by multiplex PCR. RESULTS: Twelve confirmed cases, 21 possible cases and 9 healthy controls were included. Confirmed whooping cough was primarily driven by detection of Bordetella with no other major changes on nasopharyngeal microbiota. Possible cases had limited abundance or absence of Bordetella and a distinctive microbiota with lower bacterial richness and diversity and higher rates of viral co-infection than both confirmed cases and healthy controls. Bordetella reads determined by 16S rRNA gene sequencing were found in all 12 confirmed cases (100%), 3 out of the 21 possible cases (14.3%) but in any healthy control. CONCLUSION: This study supports the usefulness of 16S rRNA gene sequencing for improved sensitivity on pertussis diagnosis compared to real-time PCR and to understand other microbial changes occurring in the nasopharynx in children <1 year old with suspected whooping cough compared to healthy controls.


Subject(s)
Microbiota , Whooping Cough/microbiology , Bordetella/genetics , Bordetella/isolation & purification , Bordetella/pathogenicity , Case-Control Studies , Female , Humans , Infant , Male , Nasal Cavity/microbiology , Pharynx/microbiology , RNA, Ribosomal, 16S/genetics , Whooping Cough/diagnosis
17.
Med (N Y) ; 2(9): 1050-1071.e7, 2021 09 10.
Article in English | MEDLINE | ID: covidwho-1482809

ABSTRACT

BACKGROUND: T cells control viral infection, promote vaccine durability, and in coronavirus disease 2019 (COVID-19) associate with mild disease. We investigated whether prior measles-mumps-rubella (MMR) or tetanus-diphtheria-pertussis (Tdap) vaccination elicits cross-reactive T cells that mitigate COVID-19. METHODS: Antigen-presenting cells (APC) loaded ex vivo with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), MMR, or Tdap antigens and autologous T cells from COVID-19-convalescent participants, uninfected individuals, and COVID-19 mRNA-vaccinated donors were co-cultured. T cell activation and phenotype were detected by interferon-γ (IFN-γ) enzyme-linked immunospot (ELISpot) assays and flow cytometry. ELISAs (enzyme-linked immunosorbant assays) and validation studies identified the APC-derived cytokine(s) driving T cell activation. TCR clonotyping and single-cell RNA sequencing (scRNA-seq) identified cross-reactive T cells and their transcriptional profile. A propensity-weighted analysis of COVID-19 patients estimated the effects of MMR and Tdap vaccination on COVID-19 outcomes. FINDINGS: High correlation was observed between T cell responses to SARS-CoV-2 (spike-S1 and nucleocapsid) and MMR and Tdap proteins in COVID-19-convalescent and -vaccinated individuals. The overlapping T cell population contained an effector memory T cell subset (effector memory re-expressing CD45RA on T cells [TEMRA]) implicated in protective, anti-viral immunity, and their detection required APC-derived IL-15, known to sensitize T cells to activation. Cross-reactive TCR repertoires detected in antigen-experienced T cells recognizing SARS-CoV-2, MMR, and Tdap epitopes had TEMRA features. Indices of disease severity were reduced in MMR- or Tdap-vaccinated individuals by 32%-38% and 20%-23%, respectively, among COVID-19 patients. CONCLUSIONS: Tdap and MMR memory T cells reactivated by SARS-CoV-2 may provide protection against severe COVID-19. FUNDING: This study was supported by a National Institutes of Health (R01HL065095, R01AI152522, R01NS097719) donation from Barbara and Amos Hostetter and the Chleck Foundation.


Subject(s)
COVID-19 , Measles , Whooping Cough , COVID-19/prevention & control , Humans , Mumps Vaccine , Receptors, Antigen, T-Cell , Rubella Vaccine , SARS-CoV-2 , Spike Glycoprotein, Coronavirus , T-Lymphocytes
18.
Vaccine ; 40(11): 1572-1582, 2022 03 08.
Article in English | MEDLINE | ID: covidwho-1454561

ABSTRACT

BACKGROUND: Several countries have introduced maternal immunisation with pertussis vaccine to provide protection against pertussis in early infancy. There is increasing interest in non-specific effects of vaccines including that non-live vaccines may enhance susceptibility to non-targeted infections in females. Some studies have shown increased risk of chorioamnionitis among women receiving pertussis vaccine during pregnancy. We aimed to conduct a systematic review and meta-analysis of the effect of maternal pertussis immunisation on the risk of chorioamnionitis, as well as the secondary outcomes of non-pertussis infections in women, non-pertussis infections in infants, spontaneous abortion or stillbirth, maternal death and infant death. METHODS: We searched PubMed and Embase for articles published until January 14, 2021. We screened articles for eligibility and extracted data using Covidence. Quality was assessed using Cochrane RoB tool and Newcastle-Ottawa Scale. Data were imported into RevMan for pooling and conduction of a meta-analysis stratified by study type. Outcomes are presented as risk ratios. RESULTS: We identified 13 observational studies and six randomized controlled trials eligible for inclusion. We pooled data on chorioamnionitis from six observational studies and found maternal pertussis vaccine (mostly compared with other maternal immunizations with non-live vaccines) to be associated with an increased risk among the pertussis vaccinated women, RR = 1.27 [CI 95%: 1.14-1.42]. We found no difference in the analysis of our secondary outcomes of non-pertussis infections, spontaneous abortion or stillbirth and death. CONCLUSION: We found an increased risk of chorioamnionitis among women who received pertussis vaccine in pregnancy. The large number of women receiving pertussis vaccine during pregnancy, as well as the growing evidence of non-live vaccines causing increased susceptibility to infections, indicates a need for further randomised trials to assess potential adverse effects of maternal immunisation with pertussis-containing vaccines.


Subject(s)
Chorioamnionitis , Communicable Diseases , Whooping Cough , Chorioamnionitis/epidemiology , Communicable Diseases/complications , Female , Humans , Infant , Pertussis Vaccine/adverse effects , Pregnancy , Pregnancy Outcome , Whooping Cough/complications , Whooping Cough/epidemiology , Whooping Cough/prevention & control
19.
BMJ Case Rep ; 14(9)2021 Sep 07.
Article in English | MEDLINE | ID: covidwho-1398608

ABSTRACT

We report a case of a previously fit woman who presented at 26 weeks into her fourth pregnancy with a dry cough. Following a nasopharyngeal swab, she was diagnosed with a pertussis infection, and treated with antibiotics. A chest X-ray showed right atrial dilatation and an echocardiogram was scheduled outpatient. However, after re-presenting with worsening cough and dyspnoea, an inpatient echocardiogram was performed which suggested elevated pulmonary pressures with significant tricuspid regurgitation, as confirmed by subsequent cardiac catheterisation. She had an elective caesarean section at 34 weeks and underwent repeat right heart catheterisation which revealed persistent, and likely pre-existing, pulmonary arterial hypertension. This case highlights the importance of thorough assessment of non-obstetric symptoms in pregnancy in formulating alternative differentials, even after a diagnosis has been made, to prevent potentially life-threatening conditions from being missed. It also shows that although often associated, respiratory and cardiac causes may coexist separately.


Subject(s)
Hypertension, Pulmonary , Tricuspid Valve Insufficiency , Whooping Cough , Cesarean Section , Echocardiography , Female , Humans , Hypertension, Pulmonary/drug therapy , Hypertension, Pulmonary/etiology , Pregnancy , Whooping Cough/complications , Whooping Cough/diagnosis , Whooping Cough/drug therapy
20.
BMC Bioinformatics ; 21(Suppl 8): 344, 2020 Sep 16.
Article in English | MEDLINE | ID: covidwho-1388724

ABSTRACT

BACKGROUND: Emerging and re-emerging infectious diseases such as Zika, SARS, ncovid19 and Pertussis, pose a compelling challenge for epidemiologists due to their significant impact on global public health. In this context, computational models and computer simulations are one of the available research tools that epidemiologists can exploit to better understand the spreading characteristics of these diseases and to decide on vaccination policies, human interaction controls, and other social measures to counter, mitigate or simply delay the spread of the infectious diseases. Nevertheless, the construction of mathematical models for these diseases and their solutions remain a challenging tasks due to the fact that little effort has been devoted to the definition of a general framework easily accessible even by researchers without advanced modelling and mathematical skills. RESULTS: In this paper we describe a new general modeling framework to study epidemiological systems, whose novelties and strengths are: (1) the use of a graphical formalism to simplify the model creation phase; (2) the implementation of an R package providing a friendly interface to access the analysis techniques implemented in the framework; (3) a high level of portability and reproducibility granted by the containerization of all analysis techniques implemented in the framework; (4) a well-defined schema and related infrastructure to allow users to easily integrate their own analysis workflow in the framework. Then, the effectiveness of this framework is showed through a case of study in which we investigate the pertussis epidemiology in Italy. CONCLUSIONS: We propose a new general modeling framework for the analysis of epidemiological systems, which exploits Petri Net graphical formalism, R environment, and Docker containerization to derive a tool easily accessible by any researcher even without advanced mathematical and computational skills. Moreover, the framework was implemented following the guidelines defined by Reproducible Bioinformatics Project so it guarantees reproducible analysis and makes simple the developed of new user-defined workflows.


Subject(s)
Computational Biology/methods , Computer Simulation/standards , Vaccination/methods , Whooping Cough/epidemiology , Adolescent , Child , Humans , Reproducibility of Results
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