Comparison of Values of Antibody to Bordetella pertussis Antigens in Young German and American Men

Abstract

Pertussis is well controlled in the United States by routine childhood immunization. In contrast, this disease is endemic and epidemic in Germany because routine immunization has not been implemented. To gain information relating to the epidemiology of Bordetella pertussis infections, we examined the prevalence and magnitude of B. pertussis agglutinins and of IgG and IgA antibodies (detected by enzyme-linked immunosorbent assay) to four B. pertussis antigens--lymphocytosis-promoting factor, filamentous hemagglutinin, pertactin, and fimbriae-2--in the sera of 119 American university students and 119 German military recruits of similar age. Geometric mean titers of agglutinins and geometric mean values for IgG antibodies to the four antigens were two- to threefold higher in sera from the American students than in sera from German recruits. In contrast, the geometric mean IgA values and the percentage of subjects with detectable IgA antibodies to the four antigens were similar in the two populations. Since IgA antibody results mainly from infection and not from immunization, our data suggest that B. pertussis infections are common among both American and German young adults despite the marked difference in rates of clinical pertussis in the two countries.

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

“…Using ELISA, the qualitative and quantitative differences between class-specific antibodies (IgA, IgE, IgG, and IgM) can be determined. In general, IgG and IgM antibodies, but not IgA antibodies, develop against vaccine antigens following primary immunization (146,332,579,757,821). Interestingly, persons who have been primed by infection respond to immunization with not just an IgG response but also an IgA response (446).…”

“…The past literature suggested that immunity after B. pertussis infection was lifelong whereas vaccine-induced immunity was relatively short lived (137,141,146,244,439,695). Extensive studies during the last 30 years document the limited duration of immunity following immunization, and additional careful review of old literature and the more recent study of pertussis in adults indicate that immunity following disease is also relatively short-lived.…”

“…This suggested that vaccine-induced immunity was actually better than disease-induced immunity. Studies of IgG antibody to PT, FHA, PRN, FIM2, and agglutinins in similarly aged young adults in the United States and Germany found that the geometric mean titers (GMTs) in the Americans were two-to four-fold higher than those noted in the Germans (146). This suggested that priming by vaccine was better that priming by infection.…”

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

“…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). Although severe disease may be the greatest public health concern, undiagnosed pertussis poses an ongoing pervasive risk to very young (pre-vaccine), unvaccinated, and immune-compromised populations.…”

“…Although severe disease may be the greatest public health concern, undiagnosed pertussis poses an ongoing pervasive risk to very young (pre-vaccine), unvaccinated, and immune-compromised populations. In fact, childhood disease predates the age at which children extensively socialize with each other and appears to commonly have as its source an adult, nonor mildly symptomatic carrier (10)(11)(12)(13)(14). The ability of B. pertussis to circulate in vaccinated and immune populations has been known clinically for years but has not been well studied experimentally.…”