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1.
BMC Infect Dis ; 20(1): 615, 2020 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-32814558

RESUMO

BACKGROUND: The global prevalent ptxP3 strains varies from about 10% to about 50% of circulating B. pertussis population in different areas of China. METHODS: To investigate the difference of vaccination status between different genotypes in the circulating B. pertussis after 10 years of acellular pertussis vaccine (aPV) used in China. The nasopharyngeal swabs and isolates of B. pertussis from these patients were used to perform genotyping of antigen genes. We use antibiotic susceptibility test against erythromycin and sequencing methods for site 2047 of 23S rRNA to determine the resistance status. RESULTS: The ptxP1 allele with erythromycin resistant (ER) B. pertussis infection (total of 449 subjects) consisted of 84.70 to 96.70% from 2012 to 2016 in this study. Vaccinated with co-purified aPV was found in 133(133/403,33.0%), 1(1/9,11.1%) and 2(2/21,9.5%) in ptxP1/fhaB3-ER, ptxP1/fhaB2-ES and ptxP3/fhaB2-ES B. pertussis infected children each, which showed a significant difference (χ2 = 6.87, P = 0.032). CONCLUSIONS: The ptxP3-ES B. pertussis was rare while the ptxP1-ER B. pertussis was steadily increased in Xi'an, China from 2012 to 2016, where co-purified aPV was prevalent used. This pose a hypothesis that the co-purified aPV might protect against ptxP3 strains more efficient, which generated a rare chance for ptxP3 strains to be under the antibiotic pressure and further developed to be erythromycin resistance. A further cohort study and the mechanisms of the additional antigen proteins of co-purified aPV protected against B. pertussis should be consideration.


Assuntos
Bordetella pertussis/efeitos dos fármacos , Bordetella pertussis/genética , Toxina Pertussis/genética , Vacina contra Coqueluche/uso terapêutico , Coqueluche/epidemiologia , Alelos , Antibacterianos/farmacologia , Bordetella pertussis/isolamento & purificação , Pré-Escolar , China/epidemiologia , Farmacorresistência Bacteriana/efeitos dos fármacos , Farmacorresistência Bacteriana/genética , Eritromicina/farmacologia , Genótipo , Humanos , Testes de Sensibilidade Microbiana , Nasofaringe/microbiologia , Vacina contra Coqueluche/imunologia , Prevalência , RNA Ribossômico 23S/genética , Estudos Retrospectivos , Vacinação , Coqueluche/microbiologia , Coqueluche/prevenção & controle
3.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(7): 679-683, 2020 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-32669160

RESUMO

The Chinese and English names of pertussis or whooping cough show the important clinical features of the disease in terms of its course and cough characteristics respectively. In the clinical description of typical pertussis, the meanings of the Chinese and English words are not completely consistent, such as spastic cough versus paroxysmal cough, spasmodic stage/phase versus paroxysmal stage/phase, and "back-hook" versus whoop, and some descriptions in English are not seen in Chinese. This article aims to provide more comprehensive information for the understanding of pertussis by comparing the descriptions of typical clinical manifestations of pertussis in Chinese and English literatures and to put forward suggestions for the diagnosis of pertussis syndrome based on typical clinical manifestations.


Assuntos
Coqueluche , Grupo com Ancestrais do Continente Asiático , Bordetella pertussis , Humanos , Idioma
4.
BMC Infect Dis ; 20(1): 471, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32615931

RESUMO

BACKGROUND: Pertussis is a highly contagious disease of public health interest caused by the bacterium Bordetella pertussis. Although its incidence has decreased substantially after the introduction of a vaccination, the burden of the disease remains high. Although the paroxysmal phase is highly disabling, complications are uncommon and more prevalent in children than in adults. The most frequent neurological complication is encephalopathy, but seizures, paresis, paraplegia, ataxias, aphasias, and decerebration postures have also been described. The complication of decerebration postures has not been previously reported in adults. CASE PRESENTATION: We present a video case of an adult HIV patient with severe coughing paroxysms, post-tussive emesis and syncope, whose workup confirmed the diagnosis of a B. pertussis respiratory infection. During hospitalization, he had fluctuant encephalopathy and post-tussive decerebration postures following paroxysms. He was treated with antibiotic therapy and finally sent home without residual neurological deficits. CONCLUSION: This case illustrates the biological plausibility of neurologic complications of pertussis in adults, which, albeit rare, can cause important morbidities. Future research should explore whether there are differences in the clinical presentation, risk factors and pathophysiology of the disease among adults or interventions aimed at preventing or treating pertussis encephalopathy.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/complicações , Bordetella pertussis/genética , Encefalopatias/complicações , Estado de Descerebração/complicações , HIV , Coqueluche/complicações , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Infecções Oportunistas Relacionadas com a AIDS/virologia , Antibacterianos/uso terapêutico , Bordetella pertussis/isolamento & purificação , Encefalopatias/tratamento farmacológico , Encefalopatias/microbiologia , Estado de Descerebração/tratamento farmacológico , Estado de Descerebração/microbiologia , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Fatores de Risco , Resultado do Tratamento , Coqueluche/tratamento farmacológico , Coqueluche/microbiologia
5.
PLoS One ; 15(7): e0235703, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32678857

RESUMO

INTRODUCTION: Diagnosis of pertussis is challenging especially in infants. Most low and middle-income countries (LMIC) lack resources for laboratory confirmation, relying largely on clinical diagnosis alone for both case management and surveillance. This necessitates robust clinical case definitions. OBJECTIVES: This study assesses the accuracy of clinical case definitions with and without lymphocytosis in diagnosing pertussis in children with severe lower respiratory tract infection (LRTI) in a LMIC setting. METHODS: Children hospitalized with severe LRTI in a South African hospital were prospectively enrolled and evaluated for pertussis using PCR on respiratory samples. Clinical signs and differential white cell counts were recorded. Sensitivity and specificity of pertussis clinical diagnosis using WHO and Global Pertussis Initiative (GPI) criteria; and with addition of lymphocytosis were assessed with PCR as the reference standard. RESULTS: 458 children <10 years were enrolled. Bordetella pertussis infection was confirmed in 32 (7.0%). For WHO criteria, sensitivity was 78.1% (95% CI 60.7-89.2%) and specificity 15.5% (95% CI 12.4-19.3%); for GPI sensitivity was 34.4% (95% CI 20.1-52.1) and specificity 64.8% (95% CI 60.1-69.2%). Area under the curve (AUC) on receiver operating character (ROC) analysis was 0.58 (95% CI 0.46-0.70 for WHO criteria, and 0.72 (95% CI 0.56-0.88) for GPI with highest likelihood ratios of 5.33 and 4.42 respectively. Diagnostic accuracy was highest between five and seven days of symptoms for both criteria. Lymphocytosis had sensitivity of 31.3% (95% CI 17.5-49.3%) and specificity of 70.7% (95% CI 66.1-74.8%) and showed a marginal impact on improving clinical criteria. CONCLUSION: Clinical criteria lack accuracy for diagnosis and surveillance of pertussis. Non-outbreak settings should consider shorter durations in clinical criteria. New recommendations still fall short of what is required for a viable clinical screening test which means the need to improve access to laboratory diagnostic support remains crucial.


Assuntos
Infecções Respiratórias/diagnóstico , Coqueluche/diagnóstico , Área Sob a Curva , Bordetella pertussis/genética , Bordetella pertussis/isolamento & purificação , Criança , Pré-Escolar , DNA Bacteriano/metabolismo , Feminino , Humanos , Lactente , Linfocitose/diagnóstico , Masculino , Reação em Cadeia da Polimerase , Curva ROC , Infecções Respiratórias/microbiologia , Sensibilidade e Especificidade , Coqueluche/microbiologia
7.
BMC Infect Dis ; 20(1): 474, 2020 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-32620085

RESUMO

BACKGROUND: After the introduction of a vaccine against B. pertussis the seasonal pattern with the highest number of infections in the spring to summer months changed. Recent studies from around the world suggest that B. pertussis infections again follow a seasonal pattern with increased incidence in summer.The aim of this study was to investigate whether respiratory infections caused by B. pertussis in the period from January 2008 to December 2018 also seasonally spread in Germany and if so, when the B. pertussis activity peaked. METHODS: We tested 19,031 samples, mainly from Southern Germany, collected in the period from January 2008 to December 2018 using a Multiplex PCR assay. We assessed the number and proportion of samples positive for B. pertussis, stratified by patient's age and month. The seasonal distribution was investigated by plotting the average proportion of positive samples for each month. RESULTS: We observed a B. pertussis seasonality with the highest number of positive samples in the months from June until September. In contrast, testing of samples for B. pertussis was requested most frequently in the period from October until March. The proportion of positive samples increased earlier in adolescents (age 10 to 19) than in other age groups. CONCLUSIONS: We found a seasonality of B. pertussis infections in Germany, which differs from the time when most samples are sent in for testing of B. pertussis. Our study suggests that clinicians should be more aware of B. pertussis infections in the months from June until September to prevent further transmission to vulnerable family members.


Assuntos
Bordetella pertussis/genética , Estações do Ano , Coqueluche/diagnóstico , Coqueluche/epidemiologia , Adolescente , Adulto , Bordetella pertussis/imunologia , Criança , Pré-Escolar , Família , Feminino , Alemanha/epidemiologia , Humanos , Incidência , Lactente , Masculino , Reação em Cadeia da Polimerase Multiplex , Vacina contra Coqueluche/imunologia , Vacina contra Coqueluche/uso terapêutico , Estudos Retrospectivos , Coqueluche/prevenção & controle , Coqueluche/transmissão , Adulto Jovem
8.
Int J Infect Dis ; 96: 422-430, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32387447

RESUMO

OBJECTIVE: To determine the seroprevalence of antibodies against of diphtheria, tetanus, and pertussis among Thai adolescents. METHODS: A cross-sectional study was conducted among Thai adolescents aged 11-20 years who had completed five doses of diphtheria, tetanus, and pertussis (DTP)-containing vaccine during childhood, either diphtheria toxoid, tetanus toxoid, whole-cell pertussis (DTwP) or diphtheria toxoid, tetanus toxoid, acellular pertussis (DTaP) vaccine. Protective antibodies against diphtheria, tetanus, and pertussis were defined as anti-diphtheria toxoid IgG ≥0.1 IU/ml, anti-tetanus toxoid IgG ≥0.1 IU/ml, and anti-Bordetella pertussis toxin IgG ≥5 IU/ml, respectively. RESULTS: Of 220 adolescents (median age 16 years), 45% had received a tetanus toxoid, reduced diphtheria toxoid (Td) booster vaccine during adolescence, and none (0%) had received a tetanus toxoid, reduced diphtheria toxoid, acellular pertussis (Tdap) booster vaccine. Overall, 50%, 99%, and 57% of adolescents demonstrated protective antibodies against diphtheria, tetanus, and pertussis, respectively. The geometric mean concentrations (GMCs) of antibodies against diphtheria (p = 0.06) and tetanus (p < 0.001) were higher among adolescents who had received Td vaccine. Nevertheless, the antibody levels against both diseases waned over time, regardless of Td booster vaccination. Likewise, pertussis antibody levels gradually declined after the fifth childhood dose of DTwP/DTaP vaccine. CONCLUSIONS: Approximately half of these healthy Thai adolescents had not maintained protective antibodies against diphtheria and pertussis. A booster vaccination with diphtheria toxoid and/or acellular pertussis-containing vaccines is a crucial strategy to prevent such diseases in this population.


Assuntos
Anticorpos Antibacterianos/sangue , Difteria/sangue , Tétano/sangue , Coqueluche/sangue , Adolescente , Adulto , Criança , Estudos Transversais , Difteria/epidemiologia , Difteria/prevenção & controle , Vacina contra Difteria, Tétano e Coqueluche/administração & dosagem , Feminino , Humanos , Imunização Secundária , Masculino , Estudos Soroepidemiológicos , Tétano/epidemiologia , Tétano/prevenção & controle , Tailândia/epidemiologia , Coqueluche/epidemiologia , Coqueluche/prevenção & controle , Adulto Jovem
9.
Int J Infect Dis ; 96: 482-488, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32413606

RESUMO

The Global Pertussis Initiative is an expert scientific forum that publishes consensus recommendations concerning pertussis for many regions of the world. Here, we give recommendations for the primary vaccination of infants in those countries where whole-cell pertussis (wP)- and acellular pertussis (aP)-containing combination vaccines are used in parallel. A selective literature review was performed concerning the influence on safety, immunogenicity, and effectiveness of mixing wP- and aP-containing vaccines for primary immunization of infants. In addition, local data were collected from various countries and the results discussed in a face-to-face meeting. Very few data addressing issues of mixing combination vaccines were identified, and no data were available concerning the effectiveness or duration of protection. It was also found that pharmacovigilance data are scarce or lacking in those countries where they would be needed the most. We then identified frequent problems occurring in low- and middle-income countries (LMICs) where both vaccine types are used. Relying on local knowledge, we give practical recommendations for a variety of situations in different settings. Specific needs for additional data addressing these issues were also identified. International bodies, such as the World Health Organization (WHO), as well as vaccine producers should try to find ways to highlight the problems of mixing wP- and aP-containing combination vaccines with robust data. Countries are urged to improve on their pharmacovigilance for vaccines. For practicing physicians, our recommendations offer guidance when wP- and aP-containing vaccines are used in parallel during primary immunization.


Assuntos
Vacina contra Coqueluche/administração & dosagem , Coqueluche/prevenção & controle , Humanos , Pobreza , Vacinação , Coqueluche/economia , Coqueluche/epidemiologia , Organização Mundial da Saúde
10.
PLoS One ; 15(5): e0228606, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32392246

RESUMO

Bordetella pertussis, the causative agent of whopping cough, produces an adenylate cyclase toxin (CyaA) that plays a key role in the host colonization by targeting innate immune cells which express CD11b/CD18, the cellular receptor of CyaA. CyaA is also able to invade non-phagocytic cells, via a unique entry pathway consisting in a direct translocation of its catalytic domain across the cytoplasmic membrane of the cells. Within the cells, CyaA is activated by calmodulin to produce high levels of cyclic adenosine monophosphate (cAMP) and alter cellular physiology. In this study, we explored the effects of CyaA toxin on the cellular and molecular structure remodeling of A549 alveolar epithelial cells. Using classical imaging techniques, biochemical and functional tests, as well as advanced cell mechanics method, we quantify the structural and functional consequences of the massive increase of intracellular cyclic AMP induced by the toxin: cell shape rounding associated to adhesion weakening process, actin structure remodeling for the cortical and dense components, increase in cytoskeleton stiffness, and inhibition of migration and repair. We also show that, at low concentrations (0.5 nM), CyaA could significantly impair the migration and wound healing capacities of the intoxicated alveolar epithelial cells. As such concentrations might be reached locally during B. pertussis infection, our results suggest that the CyaA, beyond its major role in disabling innate immune cells, might also contribute to the local alteration of the epithelial barrier of the respiratory tract, a hallmark of pertussis.


Assuntos
Toxina Adenilato Ciclase/genética , Bordetella pertussis/enzimologia , Imunidade Inata/genética , Coqueluche/genética , Toxina Adenilato Ciclase/metabolismo , Bordetella pertussis/patogenicidade , Calmodulina/metabolismo , Membrana Celular/metabolismo , AMP Cíclico/genética , Células Epiteliais/microbiologia , Humanos , Sistema Respiratório/metabolismo , Sistema Respiratório/microbiologia , Sistema Respiratório/patologia , Coqueluche/microbiologia , Coqueluche/patologia
11.
BMC Infect Dis ; 20(1): 353, 2020 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-32429853

RESUMO

BACKGROUND: The aim of the study was to identify the pathogens, in addition to bordetella pertussis (B. pertussis), which cause pertussis-like syndrome in children and to compare clinical presentation between those with B. pertussis and pertussis-like syndrome. METHODS: A cross-sectional analysis was conducted from March 2016 to September 2018. In total, 281 children with suspected pertussis infections were enrolled in this study. Multi-pathogen detection was performed. RESULTS: In total, 281 children were enrolled including 139 males and 142 females. Among them, 149 (53.0%) were B. pertussis positive, and 72 (15.6%) children tested positive for other pathogens. Mycoplasma pneumoniae (MP, 27 cases) was the most common causative pathogen in pertussis-like syndrome, followed by human rhinovirus (HRV, 23 cases), Streptococcus pneumoniae (SP, 13 cases), Haemophilus influenzae (HI, 12 cases) and parainfluenza virus 3 (Pinf-3, 9 cases). Children in the B. pertussis group had a higher rate of vaccination and longer hospital stay (P < 0.05). B. pertussis was more likely to be detected in winter than other pathogens, but this difference was not significant (P = 0.074). The number of white blood cells, neutrophils and blood platelets was significantly higher in children in the B. pertussis than in the pertussis-like group (P < 0.05). In addition, the percentage of CD3-CD19+ cells was significantly higher in the B. pertussis group (P = 0.018). CONCLUSION: About half of the children with pertussis-like syndrome were B. pertussis positive. MP was the second most common causative pathogen followed by HRV, SP, HI and Pinf-3. Children infected with B. pertussis had longer hospital stay and higher numbers of white blood cells, neutrophil and blood platelets compared with other pathogens.


Assuntos
Bordetella pertussis/genética , Haemophilus influenzae/genética , Mycoplasma pneumoniae/genética , Vírus da Parainfluenza 3 Humana/imunologia , Rhinovirus/genética , Streptococcus pneumoniae/genética , Coqueluche/diagnóstico , Criança , Pré-Escolar , Estudos Transversais , Feminino , Imunofluorescência , Humanos , Lactente , Recém-Nascido , Tempo de Internação , Contagem de Leucócitos , Masculino , Neutrófilos , Contagem de Plaquetas , Reação em Cadeia da Polimerase em Tempo Real , Síndrome , Coqueluche/virologia
12.
Artigo em Inglês | MEDLINE | ID: mdl-32305971

RESUMO

Immunization strategies for the elderly are frequently perceived as comprising only vaccines against influenza, Streptococcus pneumoniae, and herpes zoster. However, besides these vaccines, which are recommended specifically for the elderly, regular booster vaccinations against tetanus, diphtheria, and in some cases pertussis and polio, are recommended in many countries for adults including the elderly. Vaccination recommendations for adults differ greatly between individual countries and coverage data are scarce. A substantial proportion of adults, and particularly of the older age groups, do not have protective antibody concentrations against diphtheria, whereas tetanus-specific antibody concentrations are generally higher. Protection against pertussis is unsatisfactory in all adults, and development of improved vaccines is ongoing. Future vaccination strategies should include regular and well-documented booster shots throughout life, as post-booster antibody concentrations correlate with pre-booster antibody concentrations.


Assuntos
Difteria/prevenção & controle , Encefalite Transmitida por Carrapatos/prevenção & controle , Fatores Imunológicos/uso terapêutico , Tétano/prevenção & controle , Vacinas/uso terapêutico , Coqueluche/prevenção & controle , Anticorpos Antibacterianos , Vacina contra Difteria, Tétano e Coqueluche/uso terapêutico , Humanos , Imunização Secundária , Vacinação , Vacinas Combinadas , Vacinas Virais/uso terapêutico
13.
Int J Infect Dis ; 95: 282-287, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32278108

RESUMO

OBJECTIVES: Pertussis is a debilitating vaccine-preventable infection. The aim of this study was to determine susceptibility and exposure to pertussis in Lao PDR in different age groups and subpopulations. METHODS: A total 3072 serum samples were obtained from different cohorts: children with documented vaccination, pre-schoolers, schoolchildren, blood donors, healthcare workers (HCWs), and pregnant women and paired cord blood. Samples were tested for anti-pertussis toxin IgG antibodies. A history of Bordetella pertussis exposure was defined according to antibody titres. Four hundred and seventy-five throat swabs and nasopharyngeal aspirates were analysed by PCR for the presence of B. pertussis in symptomatic children at the Children's Hospital in Vientiane. RESULTS: Overall pertussis seroprevalence was 57.5%. The prevalence of titres indicating acute infection or recent vaccination or infection/vaccination within the last 12 months ranged from 7.4% (100/1356) in adults to 21.4% (25/117) in pre-schoolers (age 1-5 years). B. pertussis was detected in 1.05% (5/475) of children with respiratory symptoms in Vientiane Capital. CONCLUSIONS: It is suggested that routine childhood vaccination, in particular outreach, as well as vaccination of HCWs should be strengthened. A childhood booster and vaccination of pregnant mothers should be considered. There is also a need to improve reporting and to introduce pertussis testing in at least one central facility.


Assuntos
Bordetella pertussis , Coqueluche/epidemiologia , Adolescente , Adulto , Idoso , Anticorpos Antibacterianos/sangue , Bordetella pertussis/imunologia , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Sangue Fetal , Pessoal de Saúde , Humanos , Imunização Secundária , Lactente , Recém-Nascido , Laos/epidemiologia , Masculino , Pessoa de Meia-Idade , Vacina contra Coqueluche/administração & dosagem , Vacina contra Coqueluche/imunologia , Gravidez , Prevalência , Estudos Soroepidemiológicos , Coqueluche/prevenção & controle , Adulto Jovem
14.
PLoS One ; 15(4): e0231570, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32324790

RESUMO

BACKGROUND: Pertussis is frequently reported to be more common in females than in males. However, the variability of the sources of these observations makes it difficult to estimate the magnitude and consistency of the sex differences by age. To address this question, we used meta-analytic methods to analyze pertussis national incidence rates by sex and age group from nine countries between the years 1990 and 2017. METHODS: For each age group, we used meta-analytic methods to combine the female to male incidence rate ratios (RRs) by country and year. Meta-regression was performed to assess the relative contributions of age, country and time-period to the variation in the incidence RRs. RESULTS: The pooled female to male incidence RRs (with 95% CI) for ages 0-1, 1-4, 5-9 and 10-14, were 1.03 (1.01-1.06), 1.16 (1.14-1.17), 1.18 (1.15-1.22), 1.15 (1.11-1.18) respectively. For the ages 15-44, 45-64 and 65+ they were 1.65 (1.58-1.72), 1.59 (1.53-1.66), 1.20 (1.16-1.24), respectively. While there were some differences between the countries, the directions were consistent. When including age, country and time in meta-regression analyses, almost all the variation could be attributed to the differences between the age groups. CONCLUSIONS: The consistency of the excess pertussis incidence rates in females, particularly in infants and very young children, is unlikely to be due to differences in exposure. Other factors that impact on the immune system, including chromosomal differences and hormones, should be further investigated to explain these sex differences. Future studies should consider sex for better understanding the mechanisms affecting disease incidence, with possible implications for management and vaccine development.


Assuntos
Caracteres Sexuais , Coqueluche/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Masculino , Pessoa de Meia-Idade , Adulto Jovem
15.
Curr Opin Pulm Med ; 26(3): 197-202, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32149751

RESUMO

PURPOSE OF REVIEW: Mass gathering events bring people from across all continents increasing the risk of spread of aerosol transmissible respiratory tract infections. Respiratory tract infections for instance in pilgrims attending the world's largest recurring annual pilgrimage, the Hajj are common. We review recent literature on viral and bacterial infectious diseases with special focus on the Hajj. RECENT FINDINGS: The prevalence of bacterial and viral infections continue to increase, because of the acquisition of rhinovirus, coronaviruses (229E, HKU1, OC43), influenza A H1N1, Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus during Hajj. Whilst MERS-CoV continues to circulate in the Middle East, no cases of MERS-CoV have yet been identified in pilgrims during Hajj. SUMMARY: Respiratory tract infections are a major cause of morbidity in pilgrims attending mass gathering events. The management of severe respiratory infections should consider investigation and empirical coverage for the most likely agents based on syndromic surveillance data from hosting country and /or other relevant exposure history during events. Pneumococcal and Pertussis vaccines should be recommended for Hajj pilgrims.


Assuntos
Infecções por Coronavirus/transmissão , Influenza Humana/transmissão , Islamismo , Sarampo/transmissão , Pneumonia Pneumocócica/transmissão , Infecções Respiratórias/transmissão , Viagem , Tuberculose/transmissão , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/transmissão , Coronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Haemophilus/epidemiologia , Infecções por Haemophilus/transmissão , Humanos , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Sarampo/epidemiologia , Sarampo/prevenção & controle , Oriente Médio/epidemiologia , Infecções por Picornaviridae/epidemiologia , Infecções por Picornaviridae/transmissão , Vacinas Pneumocócicas/uso terapêutico , Pneumonia Pneumocócica/epidemiologia , Pneumonia Pneumocócica/prevenção & controle , Prevalência , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/prevenção & controle , Streptococcus pneumoniae , Tuberculose/epidemiologia , Viroses/epidemiologia , Viroses/transmissão , Coqueluche/epidemiologia , Coqueluche/prevenção & controle , Coqueluche/transmissão
16.
Klin Lab Diagn ; 65(2): 90-94, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32159305

RESUMO

A research objective - to study the possibility of using the ELISA Anti-K enzyme immunoassay system to evaluate anti-pertussis immunity. А comparative assessment of the content of co-crank antibodies in the blood serum of adults, pregnant women and children 6 years old in the agglutination test, in the test system "Anti-K ELISA" and test systems of foreign production was carried out. The "Anti-K" IFA test system makes it possible to detect the level of specific antibodies to both the whole cell and cell-free pertussis component of the vaccine at any stage of the vaccination cycle. This diagnostic test can be used to determine the tactics of immunization, and to assess population immunity.


Assuntos
Anticorpos Antibacterianos/análise , Ensaio de Imunoadsorção Enzimática , Técnica Indireta de Fluorescência para Anticorpo , Coqueluche/imunologia , Adulto , Testes de Aglutinação , Criança , Feminino , Humanos , Imunidade , Vacina contra Coqueluche , Gravidez , Vacinação
17.
Sci Total Environ ; 719: 137510, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32135321

RESUMO

Pertussis has resurged in many countries over recent years, especially among adolescents and adults. This study assessed the effect of weather variability on resurging pertussis among different age groups in Jinan, China. Data on weekly pertussis notifications by age group and weather factors (mean temperature (MeanT), mean temperature standard deviation within a week (MeanT SD), diurnal temperature range (DTR) and relative humidity (RH)) were collected between 2013 and 2017. Distributed lag non-linear models (DLNMs) and regression tree models were used to examine the non-linear association between weather variability and pertussis infections. The 2-weeks cumulative relative risk (RR) of pertussis infections was 4.46 (95% confidence interval (CI): 2.33-9.51) in 0-4 age group, 6.25 (95% CI: 1.38-22.76) in 5-9 age group and 10.11 (95% CI: 2.83-39.07) in 10+ age group when MeanT was at 30.0 °C. MeanT SD (RR range in the three age groups: 2.82-5.83), DTR (RR range: 6.33-11.56) and RH (RR range: 2.02-7.43) also exert significant influence, with the highest risks at 10+ age group. Regression tree models showed the interactive effects of weather variability. The mean pertussis infections increased by over 1.7-fold in 0-4 years group when MeanT ≥14 °C, RH ≥57% and DTR ≥10 °C; by over 2.3-fold in 5-9 years group when MeanT ≥20 °C and MeanT SD ≥3 °C; by 2.0-fold in 10+ years group when MeanT ≥0.7 °C, DTR ≥8.3 °C and RH ≥74%. The study found significantly different associations between weather variability and pertussis infections by age group, and appeared to be stronger in 10+ years group. Continuing climate change, together with other risk factors such as low antibody levels among adolescents and adults, may facilitate pertussis resurgence. This supports previous suggestions of carefully reconsidering current vaccination programme to effectively curb the resurgence of pertussis.


Assuntos
Coqueluche , Pré-Escolar , China , Mudança Climática , Humanos , Temperatura , Tempo (Meteorologia)
18.
Int J Infect Dis ; 93: 224-230, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32045697

RESUMO

OBJECTIVES: Bordetella pertussis is a highly contagious respiratory agent and is the causative pathogen of pertussis, which primarily affects children. Current diagnostic techniques for this pathogen have a variety of limitations including a long culture time, low bacterial load, and lack of specificity. METHODS: This article reports the development of a one-tube nested quantitative real-time PCR assay using the locked nucleic acid (LNA) technique (LNA-OTN-q-PCR), targeting the BP485 gene and using a simple inexpensive extraction method. A total of 130 clinical samples from patients with clinically suspected pertussis, collected from the Children's Hospital of Hebei, China, were tested by LNA-OTN-q-PCR assay. RT-PCR and two-step semi-nested PCR assays were performed in parallel for comparison. RESULTS: Only strains of B. pertussis were identified as positive, whereas all of the remaining strains were appropriately identified as negative by the LNA-OTN-q-PCR assay. A single copy per reaction can be detected by the LNA-OTN-q-PCR assay. Additionally, the sensitivity of this method was 100 times that of the RT-PCR assay (100 copies per reaction). Sixty-three of the 130 clinical samples were detected positive by LNA-OTN-q-PCR assay; in contrast, RT-PCR was able to detect only 41 positive samples. Following this, all 63 samples were positively identified by two-step semi-nested PCR. Compared with the two-step semi-nested PCR assay, both the specificity and sensitivity of the LNA-OTN-q-PCR assay using purified DNA and crude extract were 100%. CONCLUSIONS: This assay was able to detect B. pertussis infection with high sensitivity and specificity. This test shows great potential as a promising technique to detect B. pertussis in both clinical laboratories and public health settings.


Assuntos
Bordetella pertussis/isolamento & purificação , Oligonucleotídeos , Reação em Cadeia da Polimerase em Tempo Real/métodos , Coqueluche/diagnóstico , Bordetella pertussis/genética , Criança , China , DNA Bacteriano , Feminino , Humanos , Masculino , Sensibilidade e Especificidade , Coqueluche/microbiologia
20.
BMC Infect Dis ; 20(1): 136, 2020 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-32054444

RESUMO

BACKGROUND: Infants < 3 months of age are at highest risk for developing severe complications after pertussis. The majority of pregnant women has low concentrations of pertussis-specific antibodies and thus newborns are insufficiently protected by maternally transferred antibodies. Acellular pertussis vaccination during pregnancy was recently implemented in various countries. Here, we assessed the evidence for safety and effectiveness of pertussis vaccination during pregnancy. METHODS: We searched Medline, Embase, and ClinicalTrials.gov from January 1st 2010 to January 10th 2019. We assessed risk of bias (ROB) using the Cochrane ROB tool and ROBINS-I. We evaluated the quality of evidence using the GRADE approach. RESULTS: We identified 1273 articles and included 22 studies (14 for safety; 8 for effectiveness), comprising 1.4 million pregnant women in safety studies and 855,546 mother-infant-pairs in effectiveness studies. No significant differences between vaccinated and unvaccinated women and their infants were observed for safety outcomes with the exception of fever and chorioamnionitis. Compared to no vaccination, three studies showed a significantly increased relative risk for the presence of the ICD-9 code for chorioamnionitis in electronic patient data after pertussis vaccination. However, no study reported an increased risk for clinical sequelae of chorioamnionitis after vaccination during pregnancy, such as preterm birth or neonatal intensive care unit admission. Vaccine effectiveness against pertussis in infants of immunized mothers ranged from 69 to 91% for pertussis prevention, from 91 to 94% for prevention of hospitalization and was 95% for prevention of death due to pertussis. Risk of bias was serious to critical for safety outcomes and moderate to serious for effectiveness outcomes. GRADE evidence quality was moderate to very low, depending on outcome. CONCLUSION: Although an increased risk for a diagnosis of fever and chorioamnionitis was detected in pregnant women after pertussis vaccination, there was no association with a higher frequency of clinically relevant sequelae. Vaccine effectiveness for prevention of infant pertussis, hospitalization and death is high. Pertussis vaccination during pregnancy has an overall positive benefit-risk ratio. In view of the overall quality of available evidence ongoing surveillance of chorioamnionitis and its potential sequelae is recommended when pertussis vaccination in pregnancy is implemented. TRIAL REGISTRATION: PROSPERO CRD42018087814, CRD42018090357.


Assuntos
Bordetella pertussis , Vacinas contra Difteria, Tétano e Coqueluche Acelular/efeitos adversos , Gestantes , Vacinação/efeitos adversos , Coqueluche/epidemiologia , Coqueluche/prevenção & controle , Adolescente , Adulto , Criança , Corioamnionite/etiologia , Vacinas contra Difteria, Tétano e Coqueluche Acelular/uso terapêutico , Feminino , Febre/etiologia , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Gravidez , Nascimento Prematuro/etiologia , Risco , Resultado do Tratamento , Coqueluche/microbiologia , Adulto Jovem
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