Transient reemergence of Bordetella parapertussis in France in 2022.

Between March and October 2022, a peak of detection of Bordetella parapertussis by qPCR, real-time PCR was observed in France.Hypothesis/Gap Statement. Whether this peak was due to resurgence from previous circulating lineages or reintroduction into the country was unknown.Objective. The objective of this study is to understand B. parapertussis-transient increase observed in France in 2022 whereas it had virtually stopped being reported since the start of the COVID-19 pandemic in 2020.Methods. We analysed real-time PCR (qPCR) data from the two largest French outpatient laboratories performing whooping cough diagnosis and characterized all B. parapertussis isolates collected in the 2016-2022 period by the French National Reference Centre for Whooping Cough.Results. Microbiological analyses reveal that 13 of 18 bacterial isolates collected in 2022 produce the vaccine antigen pertactin, whereas none of the 22 isolates collected in the 2016-2021 period did.Conclusion. We hypothesize a re-introduction of B. parapertussis from regions of the world where whole-cell vaccines are still in use.

Detection of Bordetella spp. in children with pertussis-like illness from 2018 to 2024 in China.

OBJECTIVE: To evaluate the role of Bordetella pertussis (B. pertussis), B. parapertussis, B. holmesii, and B. bronchiseptica on pertussis resurgence in China, particularly the sharp rise since the latest winter. METHODS: Nasopharyngeal swabs collected from children with pertussis-like illness from January 2018 to March 2024 were cultured to detect B. pertussis, B. parapertussis, B. holmesii, and B. bronchiseptica, and tested for all of these except for B. bronchiseptica using a pooled real-time polymerase chain reaction (PCR) kit targeting insertion sequences ptxS1, IS481, IS1001, and hIS1001. RESULTS: Out of the collected 7732 nasopharyngeal swabs, 1531 cases tested positive for B. pertussis (19.8%, 1531/7732), and 10 cases were positive for B. parapertussis (0.1%, 10/7732). B. holmesii and B.bronchiseptica were not detected. The number of specimens and the detection rate of B. pertussis were 1709 and 26.9% (459/1709) in 2018, 1936 and 20.7% (400/1936) in 2019, which sharply declined to 308 and 11.4% (35/308) in 2020, 306 and 4.2% (13/306) in 2021, and then notably increased to 754 and 17.6% (133/754) in 2022, 1842 and 16.0% (295/1842) in 2023, 877 and 22.3% (196/877) in the first quarter of 2024. The proportion of children aged 3 to less than 6 years (preschool age) and 6 to 16 years (school age) in pertussis cases increased significantly during the study period, especially the proportion of school-aged children increased from 2.0% (9/459) in 2018 to 40.8% (80/196) in 2024. CONCLUSIONS: B. pertussis was the predominant pathogen among children with pertussis-like illness in China, with sporadic detection of B. parapertussis and no detection of B. holmesii or B.bronchiseptica. The preschool and school-age children are increasingly prevalent in B. pertussis infection cases, which may be associated with the latest rapid escalation of pertussis outbreak.

Reemergence of Bordetella parapertussis, United States, 2019-2023.

To determine changes in Bordetella pertussis and B. parapertussis detection rates, we analyzed 1.43 million respiratory multiplex PCR test results from US facilities from 2019 through mid-2023. From mid-2022 through mid-2023, Bordetella spp. detection increased 8.5-fold; 95% of detections were B. parapertussis. While B. parapertussis rates increased, B. pertussis rates decreased.

Estudio clínico-epidemiológico de la infección por Bordetella pertussis en la isla de Gran Canaria en el período 2008-2016 / Evaluation of sensitization to Der p 1 and Der p 2 in a pediatric population of the North of Portugal

OBJETIVO: Describir el patrón epidemiológico y clínico de la infección por Bordetella pertussis (tosferina) en niños menores de un año hospitalizados en un hospital pediátrico de Gran Canaria. PACIENTES Y MÉTODOS: Se revisaron retrospectivamente las historias clínicas de los pacientes con diagnóstico microbiológico de infección por B. pertussis mediante reacción en cadena de la polimerasa, de enero de 2008 a diciembre de 2016. RESULTADOS: Se identificaron 110 pacientes, de los cuales 105 (95,4%) fueron menores de 6 meses y el 59,1% eran varones. La incidencia anual de hospitalización se estimó entre 13,7 y 425,0 casos por cada 100.000 lactantes menores de 12 meses, con 2picos en 2011 y 2015. Los familiares cercanos fueron las principales fuentes de contagio potenciales. Las principales manifestaciones fueron la tos pertusoide asociada con signos catarrales, cianosis y linfocitosis. El 15,4% de los pacientes presentaron complicaciones (principalmente neumonía), pero la evolución fue favorable en todos los casos. La menor edad y la no vacunación se asociaron con un mayor riesgo de desarrollar complicaciones (p < 0,05). La coinfección viral ocurrió en el 31,6% de los pacientes diagnosticados de infección por B. pertussis. CONCLUSIONES: La incidencia de infección por B. pertussis ha aumentado en los últimos años en nuestra área, con un menor desarrollo de complicaciones y con tasas de mortalidad inferiores al período anterior. La menor edad y la no vacunación previa se consideran factores de riesgo para el desarrollo de complicaciones. La vacunación en mujeres embarazadas probablemente disminuirá la incidencia en el futuro, sobre todo en niños menores de 6 meses

OBJECTIVE: Describe the epidemiological and clinical pattern of Bordetella pertussis infection (whooping cough) among hospitalised infants less than one year-old in a paediatric hospital in Gran Canaria. PATIENTS AND METHODS: A retrospective review of the patient hospital records was performed, and recording only those with a microbiological diagnosis of pertussis infection detected using polymerase chain reaction, from January 2008 to December 2016. RESULTS: A total of 110 patients were identified, of which 105 (95.4%) were less than 6 months-old, and 59.1% were males. The annual incidence of hospital admissions was estimated between 13.7 to 425.0 cases per 100,000 infants <12 months old, with 2peaks in 2011 and 2015. Household members were the main potential sources of infection. Main clinical features were pertussis cough associated with signs of catarrh, cyanosis, and lymphocytosis. Complications occurred in 15.4% of the patients (mainly pneumonia), but the outcome was favourable in all the cases. A lower age and non-vaccination were associated with an increased risk of developing complications (P<.05). Viral co-infection occurred in 31.6% of infants diagnosed with pertussis. CONCLUSIONS: The incidence of pertussis has increased in the last years in Gran Canaria, with a lower development of complications and mortality rates compared with the previous period. Lower age and non-vaccination status are considered risk factors for developing complications. Vaccination in pregnant women will probably lead to a decline in the incidence in the future, especially in infants younger than 6 months

Vacunación frente a Bordetella pertussis en embarazadas. ¿Es adecuada nuestra estrategia de vacunación? / Immunization of pregnant women against pertussis. Are we using the best approach?

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Pertussis epidemic despite high levels of vaccination coverage with acellular pertussis vaccine

INTRODUCTION: We describe the pertussis epidemic, based only on confirmed whooping cough cases. We have analyzed data on the diagnosis, epidemiology and vaccine history in order to understand the factors that might explain the trends of the disease. METHODS: A descriptive study of the confirmed pertussis cases reported during 2011 in the Vallès region (population 1,283,000). Laboratory criteria for confirmed pertussis cases include isolation of Bordetella pertussis from a clinical specimen or detection of B. pertussis by PCR in nasopharyngeal swabs. RESULTS: A total of 421 pertussis confirmed cases were reported, which was the highest incidence reported in the last decade (33 cases/100,000 people/year in 2011). The highest incidence rate was among infants less than 1 year old (448/100,000), followed by children 5-9 years old (154/100,000). Pertussis cases aged 2 months-1 year were 90% vaccinated following the current DTaP schedule for their age group in Catalonia, and cases of 5-9 years were 87% fully vaccinated with 5 doses of DTaP vaccine. There were no deaths, although 8% of cases were hospitalized. Pertussis was more severe in infants, 30% required hospitalization despite having received the vaccine doses corresponding to their age. Children of 5-9 years were most often identified as primary cases in households or school clusters. CONCLUSIÓN: Despite high levels of vaccination coverage, pertussis circulation cannot be controlled at all. The results question the efficacy of the present immunization programmes

INTRODUCCIÓN: Se describe la epidemia de tos ferina en el año 2011 solo en casos confirmados. Se analizan datos sobre diagnóstico, epidemiología y antecedentes vacunales que podrían explicar las tendencias de la enfermedad. MÉTODOS: Estudio descriptivo de los casos confirmados de tos ferina notificados durante 2011 en la región del Vallès (población 1.283.000 habitantes). Los criterios de laboratorio para confirmación de un caso incluyen el aislamiento de Bordetella pertussis mediante cultivo en una muestra clínica o detección deB. pertussis por PCR en muestras nasofaríngeas. RESULTADOS: Fueron declarados 421 casos confirmados, siendo la incidencia más alta de los últimos 10 años (33 casos por 100.000 personas/año en 2011). La mayor tasa de incidencia fue en niños < 1 año de edad (448/100.000), seguido de los de 5-9 años (154/100.000). Los casos entre 2 meses y 1 año de edad estaban el 90% vacunados con DTaP según el calendario vacunal vigente en Cataluña para esta edad, entre 5-9 años el 87% estaban completamente vacunados con 5 dosis de DTaP. No hubo defunciones, pero el 8% de los casos fueron hospitalizados. La enfermedad fue más grave en < 1 año, y el 30% fueron hospitalizados a pesar de estar bien vacunados para su edad. Los casos de 5-9 años fueron más frecuentemente identificados como casos primarios en los hogares o grupos escolares. CONCLUSIÓN: A pesar de los altos niveles de cobertura vacunal, la circulación de la tos ferina no se puede controlar del todo. Los resultados ponen en duda la eficacia de los programas de inmunización actuales

Diferencias clínicas y epidemiológicas entre las infecciones por Bordetella pertussis y por virus respiratorio sincitial en lactantes: estudio de casos controles emparejados / Clinical and epidemiological differences between Bordetella pertussis and respiratory syncytial virus infections in infants: A matched case control study

INTRODUCCIÓN: En los últimos años se ha descrito un incremento de casos de tos ferina, fundamentalmente en lactantes de corta edad. La presentación clínica de esta enfermedad es muy similar a la producida por el virus respiratorio sincitial (VRS), lo que dificulta el diagnóstico adecuado. Objetivo Comparar las características clínico-epidemiológicas de la infección por Bordetella pertussis y VRS en lactantes ingresados en el hospital. Material y métodos Estudio analítico de casos y controles emparejados durante los años 2008 a 2011. Se incluyeron como casos los niños ingresados con tos ferina confirmada mediante reacción en cadena de la polimerasa (PCR) en aspirado nasofaríngeo, y como controles pacientes con infección respiratoria aguda por VRS detectados por inmunocromatografía en aspirado nasal y emparejados en función de la edad, el sexo y el periodo de ingreso (1:2). Se compararon variables demográficas, clínicas, analíticas y parámetros de gravedad. Resultados Se incluyeron 78 pacientes (26 casos de tos ferina y 52 controles VRS positivos). Las características sociodemográficas fueron similares en ambos grupos. Los casos tuvieron más días de síntomas previos al ingreso, mayor estancia hospitalaria y mayor frecuencia de ambiente epidémico familiar. Los casos de tos ferina presentaron con mayor frecuencia apneas, cianosis y leucocitosis, con mayor porcentaje de linfocitos, mientras que en las infecciones por VRS la fiebre, los vómitos y el tiraje fueron más frecuentes. No hubo diferencias en el resto de síntomas. CONCLUSIONES: La presentación clínica de la tos ferina en lactantes es similar a la infección por VRS, aunque existen algunas características que pueden ayudar a diferenciar ambos cuadros clínicos

INTRODUCTION: An increase in cases of pertussis, mainly in young infants, has been reported in the last few years. The clinical presentation of this disease is very similar to that produced by respiratory syncytialvirus (RSV), which makes the diagnosis difficult. OBJECTIVE: To compare the clinical and epidemiological characteristics between Bordetella pertussis and RSV infections in infants admitted to hospital. MATERIAL AND METHODS: An analytical matched case-control study was conducted during the period 2008-2011. Cases were defined as infants admitted with pertussis confirmed by PCR in nasopharyngeal aspirate. Each case was matched by age, sex and date of admission to two controls defined as patients with RSV infection detected by immunochromatography in nasal aspirate. Demographic, clinical, laboratory data were compared. RESULTS: Seventy eight patients (26 cases of pertussis and 52 controls RSV+) were included. Sociodemographic characteristics were similar in both groups. Cases had more days of symptoms prior to admission, longer hospital stays, and increased frequency of epidemic family environment. Apnoea and cyanosis were more frequent. Cases of pertussis were more likely to have apnoea, cyanosis, and lymphocytosis while RSV infections had more frequent fever, vomiting and respiratory distress. CONCLUSIONS: The clinical presentations of pertussis and RSV infection are similar, but there are some characteristics that can help to distinguish between them