Pertussis

2018 ◽  
Keyword(s):  
Public Health ◽  
Disease Ecology ◽  
Evolutionary Biology ◽  
Expert Knowledge ◽  
Whooping Cough ◽  
Vaccine Coverage ◽  
The United States ◽  
Vaccine Preventable Diseases ◽  
Treatment And Prevention ◽  
Evolutionary Epidemiology

Pertussis, or whooping cough, is a respiratory disease caused primarily by infection with the bacterium Bordetella pertussis. It remains one of the leading causes of death among vaccine-preventable diseases worldwide and recent years have seen its alarming re-emergence in many regions (including the United States and much of Europe), despite sustained high levels of vaccine coverage. The causes of the resurgence remain contentious, in part due to inherent complexities of the pathogen’s biology, in part due to pronounced variation in the treatment and prevention strategies between different countries and regions, and in part due to long-standing disagreement among scientific researchers studying pertussis. This edited volume brings together expert knowledge from disparate fields with the overall aim of synthesizing the current understanding of this critically important, global pathogen. Pertussis: Epidemiology, Immunology, and Evolution is an advanced text suitable for graduate-level students taking courses in evolutionary epidemiology, disease ecology, and evolutionary biology, as well as academics, public health officials, and researchers in these fields. It also offers a very useful introduction to a wider audience of public health practitioners, microbiologists, epidemiologists, medical professionals, and vaccine biologists

scholarly journals Improving the accuracy of ACIR data and increasing vaccination rates

2019 ◽  
Vol 43 ◽  
Author(s):  
Thaïs A Miles ◽  
Linda V Granger ◽  
Colleen L Gately
Keyword(s):  
Public Health ◽  
Quality Improvement ◽  
Vaccine Coverage ◽  
Health Unit ◽  
Quality Improvement Activity ◽  
Childhood Immunisation ◽  
Central Coast ◽  
Vaccine Preventable Diseases ◽  
Vaccination Rates

Immunisation at the earliest appropriate age and high levels of vaccine coverage at milestone ages are important in preventing the spread of vaccine-preventable diseases. At the Central Coast Public Health Unit, the authors sought to determine if follow-up of children said by the Australian Childhood Immunisation Register (ACIR) to be overdue for vaccination improved both of these factors. In a quality improvement activity, monthly ACIR lists of overdue Central Coast children aged 9 to 10 months of age were examined. The study alternated three months of intervention with three months of no intervention. The intervention was designed to find evidence of vaccination, first from the last known provider, and then if this was unsuccessful, from the parent. If no information was available, a letter was sent to the parents. If the child was indeed vaccinated, the register was updated. If the child was missing any vaccinations, the parent(s) were encouraged to complete the schedule. On reviewing routinely-published quarterly ACIR data at three-monthly intervals for 24 months after the intervention (or non-intervention), timeliness of vaccination improved in the intervention cohort. Central Coast fully vaccinated rates diverged from NSW rates during the study. In addition, the ACIR quarters that contained two out of three months of intervention rather than one out of three months of intervention had the highest rates of fully vaccinated children. The authors concluded that the intervention improved both timeliness of vaccination and the proportion of fully vaccinated children.

scholarly journals Getting personal: how vaccination exemptions shape herd immunity

2018 ◽  
Author(s):  
Emma R Nedell ◽  
Romain Garnier ◽  
Saad B Omer ◽  
Shweta Bansal
Keyword(s):  
Policy Change ◽  
Spatial Clustering ◽  
Vaccine Coverage ◽  
Herd Immunity ◽  
The United States ◽  
Vaccine Preventable Diseases ◽  
Vaccination Rates ◽  
Before And After ◽  
Exemption Policy ◽  
Epidemiological Effects

Background: State-mandated school entry immunization requirements in the United States play an important role in achieving high vaccine coverage and preventing outbreaks of vaccine-preventable diseases. Most states allow non-medical exemptions that let children remain unvaccinated on the basis of personal beliefs. However, the ease of obtaining such exemptions varies, resulting in a patchwork of state vaccination exemption laws, contributing to heterogeneity in vaccine coverage across the country. In this study, we evaluate epidemiological effects and spatial variations in non-medical exemption rates in the context of vaccine policies. Methods and Findings: We first analyzed the correlation between non-medical exemption rates and vaccine coverage for three significant childhood vaccinations and found that higher rates of non-medical exemptions were associated with lower vaccination rates of school-aged children in all cases. We then identified a subset of states where exemption policy has recently changed and found that the effects on statewide non-medical exemption rates varied widely. Focusing further on Vermont and California, we illustrated how the decrease in non-medical exemptions due to policy change was concurrent to an increase in medical exemptions (in CA) or religious exemptions (in VT). Finally, a spatial clustering analysis was performed for Connecticut, Illinois, and California, identifying clusters of high non-medical exemption rates in these states before and after a policy change occurred. The clustering analyses show that policy changes affect spatial distribution of non-medical exemptions within a state. Conclusions: Our work suggests that vaccination policies have significant impacts on patterns of herd immunity. Our findings can be used to develop evidence-based vaccine legislation.

scholarly journals Disentangling bacterial invasiveness from lethality in an experimental host-pathogen system

2018 ◽  
Author(s):  
Tommaso Biancalani ◽  
Jeff Gore
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Mortality Rate ◽  
Serratia Marcescens ◽  
Salmonella Enterica ◽  
Disease Ecology ◽  
Evolutionary Biology ◽  
Host Population ◽  
Infection Process ◽  
Laboratory Population ◽  
Treatment And Prevention

ABSTRACTQuantifying virulence remains a central problem in human health, pest control, disease ecology, and evolutionary biology. Bacterial virulence is typically quantified by theLT50(i.e.the time taken to kill 50% of infected hosts), however, such an indicator cannot account for the full complexity of the infection process, such as distinguishing between the pathogen’s ability to colonize vs. kill the hosts. Indeed, the pathogen needs to breach the primary defenses in order to colonize, find a suitable environment to replicate, and finally express the virulence factors that cause disease. Here, we show that two virulence attributes, namely pathogen lethality and invasiveness, can be disentangled from the survival curves of a laboratory population ofCaenorhabditis elegansnematodes exposed to three bacterial pathogens:Pseudomonas aeruginosa,Serratia marcescensandSalmonella enterica. We first show that the host population eventually experiences a constant mortality rate, which quantifies the lethality of the pathogen. We then show that the time necessary to reach this constant-mortality rate regime depends on the pathogen growth rate and colonization rate, and thus determines the pathogen invasiveness. Our framework reveals thatSerratia marcescensis particularly good at the initial colonization of the host, whereasSalmonella entericais a poor colonizer yet just as lethal once established.Pseudomonas aeruginosa, on the other hand, is both a good colonizer and highly lethal after becoming established. The ability to quantitatively characterize the ability of different pathogens to perform each of these steps has implications for treatment and prevention of disease and for the evolution and ecology of pathogens.

scholarly journals From Vaccine to Pathogen: Modeling Sabin 2 Vaccine Virus Reversion and Evolutionary Epidemiology

2020 ◽  
Author(s):  
Wesley Wong ◽  
Jillian Gauld ◽  
Michael Famulare
Keyword(s):  
Evolutionary Biology ◽  
Vaccine Coverage ◽  
Genetic Load ◽  
Population Level ◽  
Vaccine Virus ◽  
Transmission Risk ◽  
Transmission Model ◽  
High Coverage ◽  
Wild Poliovirus ◽  
Evolutionary Epidemiology

AbstractThe oral poliovirus vaccines (OPV) are one of most effective disease eradication tools in public health. However, the Sabin 2 vaccine strain can revert attenuation and cause outbreaks of circulating, vaccine-derived poliovirus (cVDPV2) that are clinically indistinguishable from wild poliovirus (WPV). Accurately assessing cVDP2 risk requires disentangling the complex interaction between epidemiology and evolutionary biology. Here, we developed a Sabin 2 reversion model that simulates the reversion of Sabin 2 to WPV based on the clinical differences in shedding duration and infectiousness between individuals vaccinated with Sabin 2 and those infected with wild poliovirus. Genetic reversion is informed by a canonical reversion pathway defined by three gatekeeper mutations (A481G, U2909C, and U398C) and the accumulation of genetic load from deleterious nonsynonymous mutations. Our model captures essential aspects of both phenotypic and molecular evolution and simulates transmission using a multiscale transmission model that consolidates the relationships among immunity, susceptibility, and transmission risk. We show that despite the rapid reversion of Sabin 2, cVDPV2 outbreaks can be controlled by maintaining high levels of population-level immunity and sanitation. Supplementary immunization activities must maintain high vaccine coverage to prevent future cVDPV2 outbreaks in the targeted intervention zone, but declining global immunity against Sabin 2 makes them increasingly risky to implement in poor sanitation regions regardless of historical immunization activity. A combined strategy of assessing and improving sanitation levels in conjunction with high coverage vaccination campaigns will limit future cVDPV2 emergence and spread.Significance StatementSince the withdrawal of the Sabin 2 oral poliovirus vaccine (OPV2), circulating vaccine-derived poliovirus outbreaks caused by the genetic reversion of Sabin 2 vaccine virus (cVDPV2) have been increasing in frequency. The current strategies for combating cVDPV2 involve supplemental immunization activities with monovalent Sabin 2 oral poliovirus (mOPV2), which can inadvertently seed future cVDPV2 outbreaks. Accurately assessing future cVDPV2 outbreak risk following mass mOPV2 campaigns is critical poliovirus eradication efforts but must consider the interaction between genetic reversion and epidemiological transmission. We developed an evolutionary epidemiology model to integrate Sabin 2 genetic reversion and transmission into a single framework to evaluate their relative contribution to cVDPV2 outbreaks and inform future intervention strategies.

scholarly journals Cost of Public Health Response and Outbreak Control With a Third Dose of Measles-Mumps-Rubella Vaccine During a University Mumps Outbreak—Iowa, 2015–2016

2018 ◽  
Vol 5 (10) ◽  
Author(s):  
Mona Marin ◽  
Tricia L Kitzmann ◽  
Lisa James ◽  
Patricia Quinlisk ◽  
Wade K Aldous ◽  
...  
Keyword(s):  
Public Health ◽  
Vaccine Coverage ◽  
The United States ◽  
Mmr Vaccine ◽  
Public Health Response ◽  
University Of Iowa ◽  
Outbreak Control ◽  
Response Planning ◽  
Health Response ◽  
The University

Abstract Background The United States is experiencing mumps outbreaks in settings with high 2-dose measles-mumps-rubella (MMR) vaccine coverage, mainly universities. The economic impact of mumps outbreaks on public health systems is largely unknown. During a 2015–2016 mumps outbreak at the University of Iowa, we estimated the cost of public health response that included a third dose of MMR vaccine. Methods Data on activities performed, personnel hours spent, MMR vaccine doses administered, miles traveled, hourly earnings, and unitary costs were collected using a customized data tool. These data were then used to calculate associated costs. Results Approximately 6300 hours of personnel time were required from state and local public health institutions and the university, including for vaccination and laboratory work. Among activities demanding time were case/contact investigation (36%), response planning/coordination (20%), and specimen testing and report preparation (13% each). A total of 4736 MMR doses were administered and 1920 miles traveled. The total cost was >$649 000, roughly equally distributed between standard outbreak control activities and third-dose MMR vaccination (55% and 45%, respectively). Conclusions Public health response to the mumps outbreak at the University of Iowa required important amounts of personnel time and other resources. Associated costs were sizable enough to affect other public health activities.

scholarly journals Measuring the Success of the US COVID-19 Vaccine Campaign—It’s Time to Invest in and Strengthen Immunization Information Systems

2021 ◽  
pp. e1-e3
Author(s):  
Jade Benjamin-Chung ◽  
Arthur Reingold
Keyword(s):  
Public Health ◽  
Information Systems ◽  
Vaccine Coverage ◽  
Herd Immunity ◽  
The United States ◽  
Time Estimates ◽  
The Us ◽  
Control And Prevention ◽  
Public Health Officials ◽  
State And Local

With the recent US Food and Drug Administration approval of the Pfizer-BioNTech and Moderna SARS-CoV-2 vaccines, the United States has begun COVID-19 vaccine dissemination. The vaccination program is historic in its massive scope and complexity. It requires accurate, real-time estimates of vaccine coverage to assess progress toward achieving herd immunity. Under Operation Warp Speed, the US Centers for Disease Control and Prevention (CDC) has constructed a federal database, or “data lake,” to monitor vaccine coverage nationwide and ensure that recipients receive both of the necessary doses. The data lake will be managed separately from existing state and local immunization information systems (IISs), which house vaccine data in all 50 states, five cities, the District of Columbia, and eight territories. In an open letter to the Director of the CDC in late 2020, four organizations representing immunization managers and public health officials expressed concerns about the plan to include vaccine recipients’ personal identifier information in the data lake.1 They also urged stronger coordination with IISs. (Am J Public Health. Published online ahead of print Feburary 18, 2021: e1–e3. https://doi.org/10.2105/AJPH.2021.306177 )

scholarly journals Characterizing the innate and adaptive responses of immunized mice toBordetella pertussisinfection usingin vivoimaging and transcriptomic analysis

2019 ◽  
Author(s):  
Dylan T. Boehm ◽  
Melinda E. Varney ◽  
Ting Y. Wong ◽  
Evan S. Nowak ◽  
Emel Sen-Kilic ◽  
...  
Keyword(s):  
Gene Expression ◽  
Vaccine Development ◽  
Whooping Cough ◽  
Vaccine Coverage ◽  
Expression Profiles ◽  
Gene Expression Profiles ◽  
The United States ◽  
Neutrophil Recruitment ◽  
Cell Vaccine ◽  
Immunization Group

AbstractBordetella pertussis(B. pertussis) is the causative agent of pertussis (whooping cough). Since the 1990s, pertussis has re-emerged in the United States despite an estimated 95% vaccine coverage. Our goal was to characterize neutrophil responses and gene expression profiles of murine lungs in the context of vaccination andB. pertussischallenge. We utilized a bioluminescent neutrophil mouse model (NECre luc) to track neutrophil recruitment. NECre luc mice were immunized with whole cell vaccine (WCV), acellular vaccine (ACV), or a truncated adenylate cyclase toxoid (RTX) vaccine. Neutrophil recruitment was measured in live mice across time and corroborated by flow cytometry and other data. WCV immunized mice showed signs of neutrophilia in response toB. pertussischallenge. Mice immunized with either ACV or WCV cleared the challenge infection; however immunization with RTX alone was not protective. RNA sequencing revealed distinctive gene expression profiles for each immunization group. We observed an increase in expression of genes associated with responses to infection, and changes in expression of distinct genes in each vaccine group, providing a complex view of the immune response toB. pertussisinfection in mice. This study suggests that combination of immunological analysis with transcriptomic profiling can facilitate discovery of pre-clinical correlates of protection for vaccine development.

scholarly journals Vaccine Regulation, Licensing and Approval in USA

2021 ◽  
pp. 664-673
Author(s):  
S. Shashank ◽  
M. P. Venkatesh
Keyword(s):  
Public Health ◽  
Public Perception ◽  
Vaccine Development ◽  
The United States ◽  
Vaccine Preventable Diseases ◽  
System A ◽  
The Us ◽  
Recent Developments ◽  
Community Protection ◽  
Us Fda

Vaccines are the foremost effective public and personal preventive health interventions, leading to vital reductions in vaccine-preventable diseases and in substantial price savings to the United States health care system. A vaccine is a biological preparation that will increase the immunity to a particular illness. Vaccine development is commonly found to be difficult and needs sharp understanding and information of recent developments by physicians and experts to confirm that safe and effective vaccines are manufactured with minimum risk. A strict regulative method to see the safety, efficacy, and quality should be achieved throughout the event of vaccine development for its authorization. The Office of Vaccines Research and Review at the CBER of the US-FDA is the federal administrative body charged with guaranteeing the safety, purity, and efficacy of vaccines within US. The licensing rules are published in the Title 21 CFR Part 60. Current authority for the regulation of vaccines is in Section 351(a) of the Public Health Service Act (PHS). Vaccine licensure, development of recommendations to be used, and implementation of these recommendations resulting in uptake, community protection, and result on illness burden represent a posh system that needs collaboration within the areas of basic science, public health, vaccine delivery and outcome observance, and public perception.

scholarly journals Vaccine-Induced Cellular Immunity against Bordetella pertussis: Harnessing Lessons from Animal and Human Studies to Improve Design and Testing of Novel Pertussis Vaccines

Vaccines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 877
Author(s):  
Anja Saso ◽  
Beate Kampmann ◽  
Sophie Roetynck
Keyword(s):  
Whooping Cough ◽  
Vaccine Coverage ◽  
Current Knowledge ◽  
Herd Immunity ◽  
Cell Mediated Immunity ◽  
Improve Design ◽  
Vaccine Preventable Diseases ◽  
Key Factor ◽  
Cellular Immune ◽  
Design And Testing

Pertussis (‘whooping cough’) is a severe respiratory tract infection that primarily affects young children and unimmunised infants. Despite widespread vaccine coverage, it remains one of the least well-controlled vaccine-preventable diseases, with a recent resurgence even in highly vaccinated populations. Although the exact underlying reasons are still not clear, emerging evidence suggests that a key factor is the replacement of the whole-cell (wP) by the acellular pertussis (aP) vaccine, which is less reactogenic but may induce suboptimal and waning immunity. Differences between vaccines are hypothesised to be cell-mediated, with polarisation of Th1/Th2/Th17 responses determined by the composition of the pertussis vaccine given in infancy. Moreover, aP vaccines elicit strong antibody responses but fail to protect against nasal colonisation and/or transmission, in animal models, thereby potentially leading to inadequate herd immunity. Our review summarises current knowledge on vaccine-induced cellular immune responses, based on mucosal and systemic data collected within experimental animal and human vaccine studies. In addition, we describe key factors that may influence cell-mediated immunity and how antigen-specific responses are measured quantitatively and qualitatively, at both cellular and molecular levels. Finally, we discuss how we can harness this emerging knowledge and novel tools to inform the design and testing of the next generation of improved infant pertussis vaccines.

Spatial Clustering of Vaccine Exemptions on the Risk of a Measles Outbreak

PEDIATRICS ◽  
2021 ◽  
Vol 149 (1) ◽  
Author(s):  
Ashley Gromis ◽  
Ka-Yuet Liu
Keyword(s):  
Large Scale ◽  
Spatial Clustering ◽  
Vaccine Coverage ◽  
Herd Immunity ◽  
The United States ◽  
Vaccine Preventable Diseases ◽  
Measles Outbreak ◽  
Measles Outbreaks ◽  
Lower Population ◽  
Local Herd

OBJECTIVES Areas of increased school-entry vaccination exemptions play a key role in epidemics of vaccine-preventable diseases in the United States. California eliminated nonmedical exemptions in 2016, which increased overall vaccine coverage but also rates of medical exemptions. We examine how spatial clustering of exemptions contributed to measles outbreak potential pre- and postpolicy change. METHODS We modeled measles transmission in an empirically calibrated hypothetical population of youth aged 0 to 17 years in California and compared outbreak sizes under the observed spatial clustering of exemptions in schools pre- and postpolicy change with counterfactual scenarios of no postpolicy change increase in medical exemptions, no clustering of exemptions, and lower population immunization levels. RESULTS The elimination of nonmedical exemptions significantly reduced both average and maximal outbreak sizes, although increases in medical exemptions resulted in more than twice as many infections, on average, than if medical exemptions were maintained at prepolicy change levels. Spatial clustering of nonmedical exemptions provided some initial protection against random introduction of measles infections; however, it ultimately allowed outbreaks with thousands more infections than when exemptions were randomly distributed. The large-scale outbreaks produced by exemption clusters could not be reproduced when exemptions were distributed randomly until population vaccination was lowered by >6 percentage points. CONCLUSIONS Despite the high overall vaccinate rate, the spatial clustering of exemptions in schools was sufficient to threaten local herd immunity and reduce protection from measles outbreaks. Policies strengthening vaccine requirements may be less effective if alternative forms of exemptions (eg, medical) are concentrated in existing low-immunization areas.

Sign in / Sign up

Export Citation Format

Share Document