Antibody Responses to Bordetella pertussis Antigens and Clinical Correlations in Elderly Community Residents

Abstract

A serological study to determine the frequency of Bordetella pertussis infection in 100 adults aged >/=65 years was carried out over a 3-year period. Ten serum samples (collected every 4 months) from each subject were examined for IgA and IgG antibodies to the following B. pertussis antigens: pertussis toxin (PT), filamentous hemagglutinin (FHA), pertactin, and fimbriae-2. A >/=2-fold titer increase in ELISA units from one time period to the next was considered serological evidence of infection. The rate of serologically defined infection (i.e., in which there was an increase in titer against any antigen) was 19.7 per 100 person-years. With the use of more specific criteria that indicate definite B. pertussis infection (>/=2-fold increase in titer to PT) and probable B. pertussis infection (>/=2-fold increase in titer to PT or >/=2-fold increase to fimbriae-2), the rates were 3.3 and 8.0 per 100 person-years, respectively. Fifty percent of individuals with definite B. pertussis infections had time-associated symptomatology. Antibody patterns over time suggest that antibody to FHA and perhaps to pertactin is stimulated by infections with other organisms, as well as B. pertussis infections. Our data suggest that symptomatic pertussis occurs in elderly individuals. Consideration should be given to immunization of the elderly with acellular pertussis vaccines.

Molecular Pathogenesis, Epidemiology, and Clinical Manifestations of Respiratory Infections Due toBordetella pertussisand OtherBordetellaSubspecies

“…During the last two decades, a number of studies have indicated that B. pertussis infections in adolescents and adults are common (55,200,271,354,390,397,534,550,586,634,665,675,695,739,759,788,828,835). There has also been an increase in the number reported cases of pertussis in adolescents and adults in concert with these studies (112,135,199,232,309,702,710,838).…”

Pertussis toxin inhibits neutrophil recruitment to delay antibody-mediated clearance of Bordetella pertussis

“…In 3-µM transwell chambers, 10 5 PMNs were allowed to migrate across endothelial cells toward supernatant from alveolar macrophages (Mf) incubated with B. pertussis or B. pertussis∆PTx. Purified PTx or catalytically inactive PTx (∆PTx) were added to the supernatant as indicated.…”

“…However, recent surveys reveal that a majority of individuals in a vaccinated population are transiently infected with the causative agent, Bordetella pertussis, and that it is widespread and endemic (4)(5)(6)(7)(8). In vaccinated populations, however, the bacterium induces a mild form of the disease that often goes undiagnosed (9)(10)(11).…”

Evidence of pertussis clusters in three aged-care facilities in the former Macquarie Area Health Service, NSW

“…The efficacy of pertussis vaccination in adults during an outbreak has been suggested but has yet to be established. 2,7,8 These three clusters also underline the limitation of detection using specific IgA alone. IgA may persist for some time after the acute infection and may have delayed the identification of the initial case.…”

“…Other researchers have found an incidence rate of serologically defined infection of 19.7 per 100 person-years in a group of 100 people aged over 65. 2 Pertussis in adults produces considerable morbidity and, in addition, provides a significant reservoir of infection for children.…”