Prevalence of Pertussis Antibodies in Maternal Blood, Cord Serum, and Infants From Mothers With and Those Without Tdap Booster Vaccination During Pregnancy in Argentina.

BACKGROUND: Morbidity and mortality rates for pertussis in infants are high because disease often occurs before the onset of routine immunization or in those who do not complete a primary immunization series. Pertussis immunization is recommended during pregnancy to achieve antibody levels sufficient to protect young infants. To our knowledge, no previous reports of maternal pertussis immunization results in Latin America exist in the literature. METHODS: This study compared pertussis antibody levels in newborns from mothers who received or did not receive a tetanus-diphtheria-acellular pertussis vaccination (TdapV) during pregnancy. Each mother's level of immunoglobulin G antibodies against pertussis toxin (IgG-PT) was measured with a validated, specific enzyme-linked immunosorbent assay (ELISA). RESULTS: Paired mother and cord serum samples were compared in 105 mothers with and 99 mothers without a TdapV. At birth, the mothers with and those without a TdapV had serum IgG-PT geometric mean concentrations (GMCs) of 35.1 and 9.8 ELISA units (EU)/mL, respectively (P < .0001); cord blood GMCs were 51.3 and 11.6 EU/mL, respectively (P < .0003); and cord blood IgG-PT levels were <5 EU/mL in 2.9% and 16.1% of the cord blood samples, respectively (P < .001). The mothers received their TdapV at a mean (± standard deviation [SD]) of 24.7 ± 4.8 weeks' gestation. Vaccination timing did not affect the IgG-PT GMC at birth. Placental antibody transference efficiencies (measured as the ratio of the cord blood GMC to the maternal GMC) were 1.46 and 1.18 for mothers with and those without a TdapV, respectively. The IgG-PT GMCs were 17.7 EU/mL in 36 infants in their first month of life and 11.6 EU/mL in 32 infants in their second month of life. CONCLUSIONS: Women who received a TdapV during pregnancy had significantly a higher serum/cord IgG-PT concentration at birth than mothers who did not receive a TdapV. Timing of the immunization was not correlated with antibody concentrations. Infants born to immunized mothers had significantly higher antibody levels during their first 2 months of life.

Estudio de seroprevalencia de coqueluche en adultos jóvenes, mujeres en puerperio inmediato y sangre del cordón umbilical / Pertussis seroprevalence in adults, post-partum women and umbilical cord blood

La coqueluche es una enfermedad inmunopreve-nible que afecta a todas las edades. Los adultos jóvenes que han perdido su inmunidad contra pertussis son una importante fuente de infección para los lactantes. Ante el aumento sostenido de casos de coqueluche, se plantean nuevas estrategias de prevención.Objetivo. Evaluar la seroprevalencia de coqueluche en donantes de sangre adultos, puérperas y cordones.Métodos. Determinación de títulos de anticuerpos totales anti-Bordetella spp (Bordetella) mediante el ensayo por inmunoabsorción ligado a enzimas. Se evaluaron sueros de 103 donantes, 101 puérperas y 100 cordones. Los títulos < 80 fueron considerados de bajo impacto contra la enfermedad. El pasaje transplacentario de anticuerpos fue evaluado como la relación en los títulos de anticuerpos en cordones/madres. Resultados. Media de edad de los donantes: 28 ± 6 años. Mediana títulos anti-Bordetella: 320; rango intercuartil: 160-320 (RIC); 10% presentaron títulos < 80. Media de edad de las puérperas: 26 ± 6 años. Mediana títulos anti-Bordetella: 160 (RIC: 80320), títulos significativamente menores que las mujeres donantes (p= 0,00002). El 30% de las puérperas presentaron títulos < 80. Mediana anti-Bordetella cordones: 160 (RIC: 80160). Los cordones presentaron títulos < 80 más frecuentemente que sus madres (44% vs. 30%, p= 0,04). El pasaje transplacentario fue 0,83. El título en los cordones fue igual a sus madres en el 54%, menor en el 37% y mayor solo en el 8%.Conclusiones. Los títulos de anticuerpos anti-Bordetella en las puérperas fueron significativamente menores que en las donantes. Las madres y los cordones presentaron títulos < 80 en el 30% y el 44%, respectivamente. Estos datos podrían explicar las altas tasas de ataque en lactantes pequeños que no han completado su esquema de vacunación.

Estudio de seroprevalencia de coqueluche en adultos jóvenes, mujeres en puerperio inmediato y sangre del cordón umbilical / Pertussis seroprevalence in adults, post-partum women and umbilical cord blood

La coqueluche es una enfermedad inmunopreve-nible que afecta a todas las edades. Los adultos jóvenes que han perdido su inmunidad contra pertussis son una importante fuente de infección para los lactantes. Ante el aumento sostenido de casos de coqueluche, se plantean nuevas estrategias de prevención.Objetivo. Evaluar la seroprevalencia de coqueluche en donantes de sangre adultos, puérperas y cordones.Métodos. Determinación de títulos de anticuerpos totales anti-Bordetella spp (Bordetella) mediante el ensayo por inmunoabsorción ligado a enzimas. Se evaluaron sueros de 103 donantes, 101 puérperas y 100 cordones. Los títulos < 80 fueron considerados de bajo impacto contra la enfermedad. El pasaje transplacentario de anticuerpos fue evaluado como la relación en los títulos de anticuerpos en cordones/madres. Resultados. Media de edad de los donantes: 28 ± 6 años. Mediana títulos anti-Bordetella: 320; rango intercuartil: 160-320 (RIC); 10% presentaron títulos < 80. Media de edad de las puérperas: 26 ± 6 años. Mediana títulos anti-Bordetella: 160 (RIC: 80320), títulos significativamente menores que las mujeres donantes (p= 0,00002). El 30% de las puérperas presentaron títulos < 80. Mediana anti-Bordetella cordones: 160 (RIC: 80160). Los cordones presentaron títulos < 80 más frecuentemente que sus madres (44% vs. 30%, p= 0,04). El pasaje transplacentario fue 0,83. El título en los cordones fue igual a sus madres en el 54%, menor en el 37% y mayor solo en el 8%.Conclusiones. Los títulos de anticuerpos anti-Bordetella en las puérperas fueron significativamente menores que en las donantes. Las madres y los cordones presentaron títulos < 80 en el 30% y el 44%, respectivamente. Estos datos podrían explicar las altas tasas de ataque en lactantes pequeños que no han completado su esquema de vacunación.(AU)

Pertussis seroprevalence in adults, post-partum women and umbilical cord blood.

Pertussis is a vaccine-preventable disease that affects people of all ages. Young adults who have lost their immunity to pertussis are the major source of infection in infants. Given the steady increase of pertussis cases, new prevention strategies are required. Objective. To assess pertussis seroprevalence in adult blood donors, post-partum women, and umbilical cords. Metod. Measurement of total titers of anti-Bordetella spp. (Bordetella) antibodies using an enzyme-linked immunosorbent assay. Serum samples from 103 donors, 101 post-partum women and 100 umbilical cords were analyzed. Titers <80 were considered of low impact against the disease. The assessment included transplacental transfer of antibodies and the umbilical cord/maternal ratio of antibody titers. Results. Donors mean age was: 28 ± 6 years old. Mediananti-Bordetella titers: 320; interquartile range (IQR):160-320; 10% had titers <80. Post-partum women mean age was: 26 ± 6 years old. Median anti-Bordetella titers:160 (IQR:80-320), with titers significantly lower than in female donors (p= 0.00002). Titers <80 were found in 30% of post-partum women. Median anti-Bordetella titers in umbilical cords: 160 (IQR: 80-160). Titers <80 were more frequently found in umbilical cords than in mothers (44% versus 30%, p= 0.04). Transplacental transfer was 0.83. Umbilical cord titers were equal to maternal titers in 54% of cases, lower in 37%, and higher only in 8%. Conclusion. Titers of anti-Bordetella antibodies in post-partum women were significantly lower than in female blood donors. Titers <80 were found in 30% of post-partum women and 44% of umbilical cords. These data may account for the high rates of pertussis in young infants who have not yet completed their vaccination schedule.

Pertussis seroprevalence in adults, post-partum women and umbilical cord blood. / Pertussis seroprevalence in adults, post-partum women and umbilical cord blood.

Pertussis is a vaccine-preventable disease that affects people of all ages. Young adults who have lost their immunity to pertussis are the major source of infection in infants. Given the steady increase of pertussis cases, new prevention strategies are required. Objective. To assess pertussis seroprevalence in adult blood donors, post-partum women, and umbilical cords. Metod. Measurement of total titers of anti-Bordetella spp. (Bordetella) antibodies using an enzyme-linked immunosorbent assay. Serum samples from 103 donors, 101 post-partum women and 100 umbilical cords were analyzed. Titers <80 were considered of low impact against the disease. The assessment included transplacental transfer of antibodies and the umbilical cord/maternal ratio of antibody titers. Results. Donors mean age was: 28 ± 6 years old. Mediananti-Bordetella titers: 320; interquartile range (IQR):160-320; 10

had titers <80. Post-partum women mean age was: 26 ± 6 years old. Median anti-Bordetella titers:160 (IQR:80-320), with titers significantly lower than in female donors (p= 0.00002). Titers <80 were found in 30

of post-partum women. Median anti-Bordetella titers in umbilical cords: 160 (IQR: 80-160). Titers <80 were more frequently found in umbilical cords than in mothers (44

versus 30

, p= 0.04). Transplacental transfer was 0.83. Umbilical cord titers were equal to maternal titers in 54

of cases, lower in 37

, and higher only in 8

. Conclusion. Titers of anti-Bordetella antibodies in post-partum women were significantly lower than in female blood donors. Titers <80 were found in 30

of post-partum women and 44

of umbilical cords. These data may account for the high rates of pertussis in young infants who have not yet completed their vaccination schedule.