Bordetella parapertussis outbreak in Southeastern Minnesota and the United States, 2014

Abstract

Whooping cough is traditionally ascribed to Bordetella pertussis; however, Bordetella parapertussis can cause a similar clinical syndrome. This study describes an outbreak of B. parapertussis in Southeastern Minnesota and the United States (US) in 2014. This was a retrospective analysis of Mayo Clinic and Mayo Medical Laboratories patients who tested positive for B. parapertussis from 2012 to 2014. The medical records of Mayo Clinic patients who tested positive in 2014 were reviewed for demographic information, presenting symptoms, disease course, and vaccination history. In Southeast Minnesota, 81% of the 31 patients who tested positive for B. parapertussis in 2014 were found to be positive from October through December. Their mean age was 5.9 years. Five reported “exposure to pertussis.” Two pairs of siblings were affected. Patients reported having had symptoms for an average of 2.6 weeks before nasopharyngeal specimen collection for B. parapertussis testing. Cough was the primary symptom reported. Forty percent reported posttussive vomiting, 40% coryza, 32% apnea/sleep disturbance, and 12% sore throat. All were current with pertussis vaccination. Based on the review of national data, an outbreak occurred nationally in the Northeast and Midwest US over the same time period. In 2014, there was an outbreak of B. parapertussis in Southeastern Minnesota and likely other parts of the US. The presenting illness was similar to that of B. pertussis. All patients were vaccinated against pertussis, suggesting that pertussis vaccination is ineffective against B. parapertussis.

Spatio-temporal comparison of pertussis outbreaks in Olmsted County, Minnesota, 2004–2005 and 2012: a population-based study

“…Further studies using multilevel (individual-level and neighbourhood-level data) analysis will be needed to identify specific individual-level and neighborhood-level risk factors. These include the effect of membership in a neighbourhood with hOCD and its relationship to herd immunity, reflecting the literature regarding differences in vaccination rates in this community 8 10. Also, a multilevel analysis including vaccine up-to-date status by age subgroup and specific risk factors for pertussis such as asthma prevalence will help us better understand risk factors beyond the shift to acellular pertussis containing vaccines, especially when evaluating the increase in incidence in children aged less than 11 years from 2004 to 2005 and 2012 (table 1).…”

Bordetella Adenylate Cyclase-Hemolysin Toxins

“…The increase can be due either to the use of pertussis acellular vaccine or to the evolution of the Bordetella species [ 1 , 87 ]. The circulation of B. parapertussis has also now been detected in the USA, a country using an acellular pertussis vaccine, but also in Pakistan, a country using a whole-cell pertussis vaccine [ 3 , 88 ]. This means that it could be advantageous to use a vaccine containing both detoxified Bp OMV and Bpp OMV, although it has been shown that Bpp OMV might induce protection against B. pertussis and B. parapertussis infection [ 84 ].…”

“…B. pertussis is the agent of whooping cough, a severe respiratory disease in humans which can be dramatic for newborns and elderly subjects. B. parapertussis is the agent of respiratory disease in sheep and in humans; however, the clinical symptoms induced in humans last less than those induced by B. pertussis although clinically similar [ 2 , 3 ]. B. bronchiseptica is a respiratory pathogen for several mammal species and sometimes for immuno-suppressed patients [ 1 ].…”

Cytotoxicity of the effector protein BteA was attenuated in Bordetella pertussis by insertion of an alanine residue

“…The B . parapertussis species consists of two distinct lineages, those that infect sheep and those that cause a whooping cough illness in humans [ 5 – 7 ]. The B .…”