Old Disease and New Challenges: Major Obstacles of Current Strategies in the Prevention of Pertussis

Abstract

ContextUniversal immunization against Bordetella pertussis has partially controlled the burden of the disease and its transmission. However, according to recent data, the epidemiology of this vaccine-preventable disease has changed. Now, younger infants, adolescents, and adults are at greater risk of infection. This article has studied the interaction between the various factors involved in the changing epidemiology of pertussis and the major obstacles faced by the current strategies in its prevention.Evidence AcquisitionIn this narrative review, the most recently published sources of information on pertussis control measures, consisting of textbooks and articles, have been reviewed. We focused on the more recent data about the changing epidemiology or pertussis in Scopus through the use of the MeSH-term words [pertussis] or [whooping cough] and [epidemiology] or [outbreak] or [resurgence], but our search was not restricted to this particular strategy; we also tried to find all of the most recent available data in the general field through other means.ResultsPrimary and booster doses of the pertussis vaccine seem to partially control transmission of the disease, but despite the different preventive strategies available, pertussis continues to cause mortality and morbidity among high-risk groups.ConclusionsAdding booster doses of acellular pertussis vaccine to the current national immunization practices with whole-cell vaccines for young adults and pregnant women seems to be a good option for controlling mortality and morbidity among high-risk groups such as very young infants.

Transversal sero-epidemiological study of Bordetella pertussis in Tehran, Iran

“…The delivery of 3 primary doses of wPV in children less than 12 months of age has been continuously increasing in Iran since EPI implementation in 1984 [21,25]. The Iranian national monitoring system estimate coverage to be 95% since 1995 for dose 1 and 3, and coverage with the 1 st booster dose to be 98-99% since 2014 [25,26]. To our knowledge, no data report coverage of the 2 nd booster dose yet.…”

Seroprevalence of Bordetella pertussis among a nationally representative sample of Iranian pediatric population

“…Pertussis or whooping cough is a communicable respiratory illness caused by Bordetella pertussis (BP), which is a Gram-negative microorganism. [ 1 ] This infection is endemic in the world; the World Health Organization reported 139,535 cases of pertussis with 89,000 deaths in 2016. [ 2 ] Despite affecting all age groups, children are at more considerable risk.…”

“…Pertussis vaccine does not offer lifelong protection, and despite vaccination, the disease is one of the most bacterial illnesses among vaccine-preventable diseases. [ 1 ] The first pertussis vaccine, whole-cell pertussis vaccines (wP), had a serious side effect, which caused a decrease in vaccination coverage. [ 6 7 ] The second generation of vaccines, the acellular vaccines (acellular pertussis [aP]), was used in Japan in 1981.…”

“…Despite acceptable coverage of pertussis vaccination in Iran, the illness continues to happen in highly-immunized adolescents. [ 1 ] This phenomenon is even seen in industrialized countries. [ 11 12 ] immunoglobulin G (IgG) antibody against pertussis in Iranian children have been evaluated in several studies, and different results were reported.…”

Spatio-temporal analysis of Pertussis using geographic information system among Iranian population during 2012-2018

“…However, the immunization against pertussis cannot produce long immunity (15); hence an increasing trend of new cases of pertussis is possible (16). In Iran, the reported cases of pertussis had an increasing trend in recent years (17). Also, it seems the distribution of pertussis has a spatial pattern.…”