Sources of pertussis infection in young infants: A review of key evidence informing targeting of the cocoon strategy

Wiley, Kerrie; Zuo, Yang; Macartney, Kristine; McIntyre, Peter

doi:10.1016/j.vaccine.2012.11.052

Cited by 171 publications

(122 citation statements)

References 20 publications

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“…Many studies have already found evidences that asymptomatic infections of pertussis were very common in adolescents and adults, which became the important source of childhood infections. [17][18][19] In some developed countries with high coverage of childhood immunization, the incidence of infection or disease showed a trend of increase in adolescents. 3 Although there were no significant differences in the incidences of infection among age groups in this study, attention should be paid to those born after 2005 because these population were vaccinated with DTaP.…”

Section: Discussionmentioning

confidence: 99%

Seroepidemiology of diphtheria and pertussis in Beijing, China: A cross-sectional study

Chen²,

Zhang³

et al. 2015

Human Vaccines & Immunotherapeutics

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The aim of this study was to assess the level of humoral immunity against diphtheria and pertussis by measuring IgG to diphtheria toxoid (DT) and pertussis toxin (PT) in general population of Beijing. A total of 2147 subjects aged 0-74 y were selected with a random sample of resident population in Beijing. The information of socio-demographic characteristics, vaccination history, disease history of diphtheria and pertussis were collected for each subject by questionnaire. Serum samples were tested for IgG antibodies to DT and PT by using commercial ELISA kits. The overall positivity rate of anti-DT IgG was 66.28% with the mean concentration of 2.169 IU/ml. Age stratified data showed that the highest positivity rate of 97.63% was observed in 1-4 y and the rates decreased with age. The positivity rates were only around 50% or below since 25 y old. The positivity rate of anti-PT IgG was 12.34% with the mean concentration of 15.163 IU/ml. The highest level of positivity rate (22.23%) and antibody level (23.101 IU/ml) was seen in <1 year old. In subjects older than 10 y old, the anti-PT IgG positivity rate was 10.19%-13.51% and concentration was 13.295 IU/ml ¡16.353 IU/ml, with no significant differences between these groups (x2 D 1.664, P D 0.948; F D 0.369, P D 0.899). The subjects with anti-PT IgG 100 IU/ml were observed in nearly all the groups older than 5 y except for 10-14 age group. The estimated incidences of pertussis infection were higher than 6000/100000 in these age groups. A sharp increase of immunity level of diphtheria was observed at 1 y and 6 y respectively, which was consistent with the current immunization schedule. But there was no significant increase of immunity to pertussis observed after booster immunization at 18-24 months, but the proportions of undetectable were lowest in <1, 1, 2 years in children <14 years. As shown in the present study, the adult population was generally lack of protective antibody against diphtheria and all the age groups showed a low immunity to pertussis indicating the potential risk of transmission and outbreaks of the 2 diseases in Beijing.

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Section: Discussionmentioning

confidence: 99%

Seroepidemiology of diphtheria and pertussis in Beijing, China: A cross-sectional study

Chen²,

Zhang³

et al. 2015

Human Vaccines & Immunotherapeutics

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“…They demonstrate that parents, family members and cohabitants frequently are the source of infection in infants, 74 and suggest that oligo-and asymptomatic patients play an important role in spreading the infection. 75,76 The role of adults in spreading the infection is reinforced by the difficulty in identifying symptoms in this age group; the diagnosis of pertussis is rarely considered in adult patients.…”

Section: Strategies For the Prevention Of Pertussismentioning

confidence: 96%

“…Immunization of contacts, and therefore of potential sources of infection of infants has been an interesting strategy for a long time, with a number of possibilities. 74 One natural approach is the post-partum vaccination of mothers. However, the problem of this approach is that vaccination should induce protection very rapidly to achieve a protective effect on infants.…”

Section: Strategies For the Prevention Of Pertussismentioning

confidence: 99%

Pertussis

Gabutti

Azzari

Bonanni

et al. 2014

Human Vaccines & Immunotherapeutics

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“…Alternative strategies include "cocooning" and maternal immunization. Based on observations that most infant infections derive from contact with family member, the cocooning approach involves Tdap vaccination of parents and persons in close contact with the susceptible infants before completing the vaccination schedule of children with diphtheria-tetanus-pertussis vaccine (either acellular or whole-cell) to reduce the risk of pertussis transmission [35,36]. However, the main obstacle to this approach is the need to vaccinate multiple individuals, and it has therefore yielded variable results, ranging from no effects to >80% decrease in infant deaths [30,37].…”

Section: Pertussismentioning

confidence: 99%

Maternal immunization: where are we now and how to move forward?

et al. 2018

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Pregnancy and the postpartum period are associated with elevated risks to both mother and infant from infectious disease. Vaccination of pregnant women, also called maternal immunization, has the potential to protect pregnant women, foetuses and infants from several vaccinepreventable diseases. Maternal immunoglobulin G antibodies are actively transferred through the placenta to provide passive immunity to new-borns during the first months of life, until the time for infant vaccinations or until the period of greatest susceptibility has passed. Currently, inactivated influenza, tetanus, and pertussis vaccines are recommended during pregnancy in many countries, but other vaccines may also be administered to pregnant women when risk factors are present. Several new vaccines with a specific indication for use during pregnancy are under development (e.g. respiratory syncytial virus and group B streptococcus vaccines). Years of experience suggest that maternal immunization against influenza, tetanus or pertussis has an acceptable safety profile, is well tolerated, effective and confers significant benefits to pregnant women and their infants. This review describes the principles of maternal immunization and provides an update of the recent evidence regarding the use and timing of maternal immunization. Finally, the barriers preventing wider vaccination coverage and the current limitations in addressing these are also described (Supplementary Material). KEY MESSAGESMaternal immunization gives pregnant women greater protection against infectious diseases; induces high levels of maternal antibodies that can be transferred to the foetus; and helps protect new-borns during their first months of life, until they are old enough to be vaccinated. Pregnant women and new-borns are more vulnerable to infectious diseases than the overall population; nevertheless, vaccination rates are often low in pregnant women. This review provides an update of the recent evidence regarding the use and timing of maternal immunization and describes the barriers preventing wider vaccination uptake and the current limitations in addressing these. ARTICLE HISTORY

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Sources of pertussis infection in young infants: A review of key evidence informing targeting of the cocoon strategy

Cited by 171 publications

References 20 publications

Seroepidemiology of diphtheria and pertussis in Beijing, China: A cross-sectional study

Seroepidemiology of diphtheria and pertussis in Beijing, China: A cross-sectional study

Pertussis

Maternal immunization: where are we now and how to move forward?

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