Pertactin-Deficient Bordetella pertussis with Unusual Mechanism of Pertactin Disruption, Spain, 1986–2018

Abstract

B ordetella pertussis is the main causative agent of pertussis, an acute upper respiratory tract infection of humans. The most effective strategy for preventing and controlling this disease is vaccination. In Spain during 1998-2005, pertussis vaccination with whole-cell vaccine (WCV) was progressively replaced by vaccination with acellular pertussis vaccine (ACV), which contains a combination of several antigens. Although vaccines and vaccination programs might differ among countries, the 3-component ACV containing pertussis toxin (PT), filamentous hemagglutinin (FHA), and pertactin is largely used for pertussis vaccination in many countries, including Spain. Specifically, the pertactin component has been included in most vaccines used throughout the history of pertussis vaccination in Spain (Table 1).Despite extensive vaccination campaigns and high vaccination rates, pertussis has resurged in the past 20 years, and outbreaks have occurred worldwide. One of the main causes postulated for the change in pertussis epidemiology is evolution of circulating bacteria to vaccine/immunity-evasive phenotypes (1-4). In 2007, after the introduction of ACV,

Evaluation of Whole-Cell and Acellular Pertussis Vaccines in the Context of Long-Term Herd Immunity

“…Moreover, studies conducted in countries where wP vaccines are used in in the primary vaccination series show a low prevalence of pertactin-deficient strains [ 98 ]. It was speculated that this deficiency has less advantage to emerge in a wP-immunized population [ 99 ].…”

Genomic characterization of Bordetella pertussis in South Africa, 2015–2019

“…In Spain, between 1986 and 2018 a total of 342 B. pertussis isolates were collected for molecular characterization [39]. Of the 342 isolates, 27 % (93/342) were pertactin-deficient and all of these pertactin-deficient isolates were collected after the introduction of the acellular vaccine.…”

“…Additionally, isolates collected between 2012 and 2017 showed spread of pertactin-deficient strains as well as an isolate that was negative for filamentous haemagglutinin. In Spain, between 1986 and 2018 a total of 342 B. pertussis isolates were collected for molecular characterization [ 39 ]. Of the 342 isolates, 27 % (93/342) were pertactin-deficient and all of these pertactin-deficient isolates were collected after the introduction of the acellular vaccine.…”

Biological differences between FIM2 and FIM3 fimbriae of Bordetella pertussis: not just the serotype

“…This suggests a similar vaccine-driven selective pressure for PRN loss on all B. pertussis isolates, regardless of FIM serotype. Indeed, although PRN deficiency was first observed in FIM3 isolates, more recently this was also identified within FIM2 isolates, in Spain [50] and Slovenia [51].…”