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Abstract

In March 2019, a pertussis outbreak occurred in children in a junior school (7–11 years) in England who had been offered pertussis-containing booster vaccine at 40 months of age. In a case–control investigation, we assessed the extent of transmission and any difference in protection afforded to those who had previously received a booster 3- or 5-component acellular pertussis vaccine (aP). We took oral fluid specimens from the students to determine IgG antibodies against pertussis toxin (anti-PT). Parents of students attending the school were sent a questionnaire on pertussis symptoms and vaccination status was retrieved from general practitioner records for all students. Of 381 students, 134 (35.2%) were classified as pertussis cases, 133 by demonstration of significant anti-PT IgG titres and one clinically. There was no significant difference in the risk of pertussis between students receiving 3-component (33.7%) or 5-component (32.3%) aP boosters. However, pertussis infection differed significantly in school year 4, with 22.9%, 50.0%, 23.7% and 38.1% pertussis cases in years 3, 4, 5 and 6, respectively. The proportion of students with incomplete vaccinations recorded was higher than the proportion of those not covered according to the national reported coverage, possibly contributing to sustained transmission within the school.

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/content/10.2807/1560-7917.ES.2021.26.12.2000244
2021-03-25
2024-12-27
/content/10.2807/1560-7917.ES.2021.26.12.2000244
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References

  1. Tan TQ. Pertussis and pertussis syndrome. In: Domachowske J, editor. introduction to clinical infectious diseases: a problem-based approach. Cham: Springer International Publishing; 2019. p. 67-73.
  2. Gopal DP, Barber J, Toeg D. Pertussis (whooping cough). BMJ. 2019;364:l401.  https://doi.org/10.1136/bmj.l401  PMID: 30796107 
  3. Hendrick L, Ward M. P365 Pertussis vaccination: Should we be doing something different? Arch Dis Child. 2019;104(Suppl 3):A302-3.  https://doi.org/10.1136/archdischild-2019-epa.711 
  4. Khetsuriani N, Bisgard K, Prevots DR, Brennan M, Wharton M, Pandya S, et al. Pertussis outbreak in an elementary school with high vaccination coverage. Pediatr Infect Dis J. 2001;20(12):1108-12.  https://doi.org/10.1097/00006454-200112000-00003  PMID: 11740314 
  5. Huang H, Gao P, Gao Z, Wang L, Hao B, Liu Y, et al. A big pertussis outbreak in a primary school with high vaccination coverage in northern China: An evidence of the emerging of the disease in China. Vaccine. 2018;36(52):7950-5.  https://doi.org/10.1016/j.vaccine.2018.11.009  PMID: 30420118 
  6. Sin MA, Zenke R, Rönckendorf R, Littmann M, Jorgensen P, Hellenbrand W. Pertussis outbreak in primary and secondary schools in Ludwigslust, Germany demonstrating the role of waning immunity. Pediatr Infect Dis J. 2009;28(3):242-4.  https://doi.org/10.1097/INF.0b013e31818a5d69  PMID: 19209094 
  7. Public Health England (PHE). The routine immunisation schedule from summer 2016. London: PHE; 2020. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/533829/9699_PHE_2016_Complete_Immunisation_Schedule_SUMMER16_A4_16.pdf
  8. Public Health England (PHE). Green Book. Chapter 24: Pertussis. London: PHE; 2016. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/514363/Pertussis_Green_Book_Chapter_24_Ap2016.pdf
  9. World Health Organization (WHO). Pertussis vaccines: WHO position paper - August 2015. Wkly Epidemiol Rec. 2015;90(35):433-60.
  10. Joint Committee on Vaccination and Immunisation (JCVI). Minutes of the meeting held on Tuesday 17 June 2008. London: JCVI; 2008. Available from: https://webarchive.nationalarchives.gov.uk/20120907200727/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@ab/documents/digitalasset/dh_097413.pdf
  11. World Health Organisation Strategic Advisory Group of Experts (WHO SAGE). WHO SAGE pertussis working group. background paper. Geneva: WHO; 2014. Available from: https://www.who.int/immunization/sage/meetings/2014/april/1_Pertussis_background_FINAL4_web.pdf
  12. Olin P, Rasmussen F, Gustafsson L, Hallander HO, Heijbel H, Ad Hoc Group for the Study of Pertussis Vaccines. Randomised controlled trial of two-component, three-component, and five-component acellular pertussis vaccines compared with whole-cell pertussis vaccine. Lancet. 1997;350(9091):1569-77.  https://doi.org/10.1016/S0140-6736(97)06508-2  PMID: 9393335 
  13. Zepp F, Heininger U, Mertsola J, Bernatowska E, Guiso N, Roord J, et al. Rationale for pertussis booster vaccination throughout life in Europe. Lancet Infect Dis. 2011;11(7):557-70.  https://doi.org/10.1016/S1473-3099(11)70007-X  PMID: 21600850 
  14. Edmunds WJ, Brisson M, Melegaro A, Gay NJ. The potential cost-effectiveness of acellular pertussis booster vaccination in England and Wales. Vaccine. 2002;20(9-10):1316-30.  https://doi.org/10.1016/S0264-410X(01)00473-X  PMID: 11818150 
  15. Amirthalingam G, Gupta S, Campbell H. Pertussis immunisation and control in England and Wales, 1957 to 2012: a historical review. Euro Surveill. 2013;18(38):20587.  https://doi.org/10.2807/1560-7917.ES2013.18.38.20587  PMID: 24084340 
  16. Stevenson M, Beard S, Finn A, Brennan A. Estimating the potential health gain and cost consequences of introducing a pre-school DTPa pertussis booster into the UK child vaccination schedule. Vaccine. 2002;20(13-14):1778-86.  https://doi.org/10.1016/S0264-410X(02)00025-7  PMID: 11906765 
  17. Public Health England (PHE). Laboratory confirmed cases of pertussis (England): annual report for 2018. London: PHE; 2019. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/797712/hpr1419_prtsss-ann.pdf
  18. Edmunds M. Evaluation of symptomatic and asymptomatic transmission of Bordetella pertussis during an outbreak in a secondary boarding school, England, 2018. 12th International Symposium on Bordetella; 9 April 2019, Brussles, Belgium.
  19. Litt DJ, Samuel D, Duncan J, Harnden A, George RC, Harrison TG. Detection of anti-pertussis toxin IgG in oral fluids for use in diagnosis and surveillance of Bordetella pertussis infection in children and young adults. J Med Microbiol. 2006;55(Pt 9):1223-8.  https://doi.org/10.1099/jmm.0.46543-0  PMID: 16914652 
  20. Fry NK, Litt DJ, Duncan J, Vaghji L, Warrener L, Samuel D, et al. Modelling anti-pertussis toxin IgG antibody decay following primary and preschool vaccination with an acellular pertussis vaccine in UK subjects using a modified oral fluid assay. J Med Microbiol. 2013;62(Pt 9):1281-9.  https://doi.org/10.1099/jmm.0.062000-0  PMID: 23722435 
  21. Campbell H, Amirthalingam G, Fry NK, Litt D, Harrison TG, Wagner K, et al. Oral fluid testing for pertussis, England and wales, june 2007-august 2009. Emerg Infect Dis. 2014;20(6):968-75.  https://doi.org/10.3201/eid2006.131069  PMID: 24856627 
  22. Fry NK, Duncan J, Wagner K, Tzivra O, Doshi N, Litt DJ, et al. Role of PCR in the diagnosis of pertussis infection in infants: 5 years’ experience of provision of a same-day real-time PCR service in England and Wales from 2002 to 2007. J Med Microbiol. 2009;58(Pt 8):1023-9.  https://doi.org/10.1099/jmm.0.009878-0  PMID: 19528165 
  23. Wearing HJ, Rohani P. Estimating the duration of pertussis immunity using epidemiological signatures. PLoS Pathog. 2009;5(10):e1000647.  https://doi.org/10.1371/journal.ppat.1000647  PMID: 19876392 
  24. Public Health England (PHE). Childhood vaccination coverage statistics - England 2018-19. London: PHE; 2019. Available from: https://digital.nhs.uk/data-and-information/publications/statistical/nhs-immunisation-statistics/england-2018-19
  25. Kapil P, Merkel TJ. Pertussis vaccines and protective immunity. Curr Opin Immunol. 2019;59:72-8.  https://doi.org/10.1016/j.coi.2019.03.006  PMID: 31078081 
  26. Sheridan SL, Ware RS, Grimwood K, Lambert SB. Number and order of whole cell pertussis vaccines in infancy and disease protection. JAMA. 2012;308(5):454-6.  https://doi.org/10.1001/jama.2012.6364  PMID: 22851107 
  27. Carvalho CFA, Andrews N, Dabrera G, Ribeiro S, Stowe J, Ramsay M, et al. National outbreak of pertussis in England, 2011-2012: a case-control study comparing 3-component and 5-component acellular vaccines with whole-cell pertussis vaccines. Clin Infect Dis. 2020;70(2):200-7.  https://doi.org/10.1093/cid/ciz199  PMID: 31059566 
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