The contribution of vaccination to global health, from the past to the present: mandatory or social duty?

Vaccines have saved millions of lives and reduced the severity of many infections, but today the reduction in vaccine coverage has been reflected in the resurgence of epidemics of mumps, whooping cough, measles and chickenpox. This has happened because many people do not recognize the effectiveness of vaccination and fear the side effects, in other words, the main concern is the safety of the vaccines. As a consequence, the greater responsibility of the individual and respect for his will can lead authorities to less vigorously promote the “duty of vaccination”, which is also a social duty. Unfortunately, however, the attitude of individuals is guided by their beliefs about health, which are often supported by an erroneous perception of risk arising from false news.

Genome characteristic of Bordetella parapertussis isolated from Iran

Pertussis also known as whooping cough is a respiratory infection in humans particularly in infants and usually caused by Bordetella pertussis. However, Bordetella parapertussis can also cause a similar clinical syndrome. During 2012 to 2015, from nasal swabs sent from different provinces to the pertussis reference laboratory of Pasture Institute of Iran for pertussis confirmation, seven B. parapertussis isolates were identified by bacterial culture, biochemical tests, and the presence of IS1001 insertion in the genome by real-time PCR. Furthermore, the expression of pertactin (Prn) as one the major virulence factor for bacterial adhesion was investigated using western blot. Moreover, the genomic characteristic of one recently collected isolate, IRBP134, from a seven-month infant was investigated using Illumina NextSeq sequencing protocol. The results revealed the genome with G+C content 65% and genome size 4.7 Mbp. A total of 81 single nucleotide polymorphisms (SNPs) and 13 short insertion and deletions were found in the genome compared to the B. parapertussis 12822 as a reference genome showing ongoing evolutionary changes in our isolate. A phylogeny relationship of IRBP134 was also investigated using global B. parapertussis available genomes.

Pertussis in Children: Clinical and Epidemiological Features, the Possibilities of Vaccine Preventio

Relevance. Despite the specific immunization carried out, pertussis still has great medical and social significance for pediatricians, since it continues to remain a common bacterial infection, involving children of different age groups in the epidemic process. The lack of persistent immunity to whooping cough, combined with a high susceptibility index, contributes to an increase in the incidence among schoolchildren and adolescents, who are diagnosed only during epidemiological and laboratory examinations, and who, in most cases, serve as sources of infection for young children. Aim. To study the clinical and epidemiological features of whooping cough in children aged 0 to 14 years hospitalized in an infectious diseases hospital under conditions of mass vaccine prevention, as well as to identify the features of the disease in vaccinated people using the example of an outbreak of the disease in an organized group. Materials and methods. A retrospective analysis of 164 case histories of children diagnosed with Pertussis hospitalized in the infectious hospital of the Regional Interdistrict Children’s Clinical Hospital № 1 in Krasnoyarsk in 2015–2019, as well as 25 outpatient records of patients identified during the epidemiological investigation of the focus of infection in December 2019 was carried out. For the etiological interpretation of the diagnosis of whooping cough, a comprehensive laboratory examination was carried out using bacteriological, serological and molecular genetic research methods. Results. According to official statistics, in the Krasnoyarsk territory in 2019, among children with pertussis, patients aged 7 to 17 prevailed (38,7%). At the same time, in the age structure of patients hospitalized in a hospital, the primary importance was occupied by children of the first year of life, unvaccinated against this disease. Most of them were diagnosed with a moderate form of the disease with frequent development of complications from the respiratory and nervous systems. At the same time, among schoolchildren and adolescents, as a rule, who have received a completed course of vaccination, there is an atypical, erased course of the disease, while the difficulties of its diagnosis lead to a high incidence of pertussis in children of the first year of life who have not yet been protected by vaccination. Conclusions. Despite the high coverage of decreed groups with preventive vaccinations against whooping cough in the Krasnoyarsk territory, an assessment of the state of specific immunity based on the results of a serological survey conducted in 2019 revealed 50.6% of seronegative individuals already at the age of 3–4 years, which confirms the need to improve the schemes immunization against this disease; and inclusion of pertussis vaccination in the regional immunization schedule.

Genomic dissection of the microevolution of Australian epidemic Bordetella pertussis

Whooping cough (pertussis) is a highly contagious respiratory disease caused by the bacterium Bordetella pertussis. Despite high vaccine coverage, pertussis has re-emerged in many countries and caused two large epidemics in Australia since 2007. Here, we undertook a genomic and phylogeographic study of 385 Australian B. pertussis isolates collected from 2008 to 2017. The Australian B. pertussis population was found to be composed of mostly ptxP3 strains carrying different fim3 alleles, with ptxP3-fim3A genotype expanded far more than ptxP3-fim3B. Within the former, there were six co-circulating epidemic lineages (EL1 to EL6). The multiple ELs emerged, expanded, and then declined at different time points over the two epidemics, likely driven by immune selection from pertussis vaccination and natural infection in addition to local and global transmission events. Both hard and soft selective sweeps through vaccine selection pressures determined the current B. pertussis population dynamics. Relative risk analysis found that once a new B. pertussis lineage emerged, it was more likely to spread locally within the first 1.5 years. However, after 1.5 years, any new lineage was likely to expand to a wider region and became no longer spatially structured across the country. Phylogenetic analysis revealed the expansion of ptxP3 strains was also associated with replacement of the type III secretion system allele bscI1 with bscI3. This study advanced our understanding of the epidemic population structure and spatial and temporal dynamics of B. pertussis in a highly immunised population.

Prapration of Tablet from Pencil Cactus for Treatment of Piles by Direct Compression method

The intention of current review is to make available upto-date information on morphology, ecological biodiversity, medicinal uses, phytochemistry and pharmacological activities on different parts of Euphorbia tirucalli (E. tirucalli). This plant has a number of medicinal uses. Latex of E. tirucalli is vesicant and rubefacient which is used for rheumatism, warts, cough, asthma, ear-ache, tooth-ache and neuralgia. It acts as a purgative in small doses while in big doses it is bitter irritant and emetic. Milky juice is alexiteric, carminative and purgative. It is useful in whooping cough is used in treatment of piles. gonorrhea, asthma, leprosy, dropsy, dyspepsia, enlargement of spleen, colic, jaundice and stone in bladder. The fresh milky juice is good alternative in syphilis and a good application in neuralgia. A decoction of branches is used in gastralgia and colic. Bark is used in treatment of fractures. Poultices prepared from the stem are useful to repair the broken bones. Boiled root liquid acts as an emetic in cases of snake-bite and for infertility in women. The wood is used for rafters, toys and veneering purposes. It is also useful against leprosy and foot paralysis subsequent to childbirth. E. tirucalli is reported to have euphol, β-sitosterol, euphorbol hexacosonate, cycloeuphordenol, cyclotirucanenol, tirucalicine, tri-methyl ellagic acid, gallic acids, terpenic alcohol. genotoxic/mutagenic, hepatoprotective, insect repellants, immunomodulatory, larvicidal, molluscicidal/ovicidal/piscicidal, myelopoiesis, proteolytic/chitinolytics pharmacological activities. There is a need to isolate dynamic constituents, their biological trial, molecular mechanisms, experimental protection and legalization of therapeutic uses of E. tirucalli. The collected information will be helpful to locate up study protocol for expansion in curative and treat a variety used in treatment of piles., isoeuphorol, taraxasterol, tirucallol, euphorone, euphorcinol, euphorbins, 12-deoxy4βhydroxyphorbol-13-phenyl acetate-20-acetate, 12, 20- dideoxyphorbol-13-isobutyrate, glut-5-en-3-β-ol, 3,3′- diO-methylellagic acid, euphorbin-A (polyphenol), tirucallin-A (7) (tannin), tirucallin-B (11), euphorbin-F (14) (dimers), cycloartenol, 24- methylenecycloartenol, ingenol triacetate, 12-deoxy-4β-hydroxyphorbol- 13- phenyl acetate-20-acetate, taraxerone, euphorginol, taraxerol, campesterol, stigmasterol, palmitic acid, linoleic acid, β-amyrin, etc. Active phytoconstituents. E. tirucalli have possessed activity in humanly mphocytes, analgesic, anthelmintics, antiarthritic, antibacterial/antifungal/antimicrobial Antihemerrhoids. Keywords: Euphorbia tirucalli Morphology Ecological biodiversity Medicinal uses Phytochemistry Anticance antihemerrhoids

Community-Acquired Pneumonia Requiring Hospitalization among French Guianese Children

Community-acquired pneumonia remains a leading cause of hospitalizations among children worldwide. The diagnosis is based on the history, the physical examination results in children with fever plus respiratory signs and symptoms, and chest radiography. The microbiological etiology is confirmed by viral testing and hemocultures. The most likely etiology depends on the age of the child. The features of childhood pneumonia vary between countries and territories. The purpose of this study was to describe the epidemiological characteristics and current microbial ecology of community-acquired pneumonia in children in French Guiana. We performed a retrospective, descriptive, and monocentric study between January 1, 2015, and December 31, 2017, in the pediatric ward of the Cayenne Hospital in French Guiana. The studied population was aged from 0 to 15 years and 3 months and hospitalized for acute community-acquired pneumonia. A total of 415 patients (mean age 3.62 years) were included. A pathogen was identifiable in 22.4% of cases, including bacteria in 61.3%, viruses in 43%, and coinfections in 14%. The main pathogens were respiratory syncytial virus (31.2%), Streptococcus pneumoniae (20.4%), Haemophilus influenzae (11.8%), and Mycoplasma pneumoniae (10.8%). The burden of hospitalization for children with community-acquired pneumonia was highest among less than 2 years, in whom respiratory viruses were the most commonly detected causes of pneumonia. The share of vaccine-preventable diseases (S. pneumoniae, H. influenzae, and influenza) remains high. With the vaccination requirement imposed since 1 January 2018 against pneumococcus, Haemophilus influenzae, and whooping cough and the possibility of practicing multiplex PCR in our hospital, it will be interesting to study the impact of this law enforcement on new child generations and compare these new data to our study.

On Characterization of Optimal Control Model of Whooping Cough

Whooping cough is a vaccine avoidable public health problem which is caused by bacterium Bordetella Pertussis and it is a highly contagious disease of the respiratory system. In this paper, an SIR epidemiological model of whooping cough with optimal control strategy was formulated to control the transmission. The model was characterized to obtain the disease free and the endemic equilibrium points. Finally, the simulation was carried out using the Forward-backward sweep method by incorporating the Runge Kutta method to check the validity and the result obtained was an improvement over the existing results.

The Incidence of Bordetella Pertussis Infections in Jahrom City, Southern Iran

Background: Bordetella Pertussis, known as the causative agent of whooping cough, is one of the leading causes of recurrent persistent cough at all ages, even in vaccinated individuals. Methods: A total number of 110 patients coughing for at least two weeks who were admitted to clinical centers in Jahrom, Iran, were included in this cross-sectional study. For this purpose, blood samples were collected from these individuals at two stages, i.e., at the beginning of the study and on the 21st day. Afterward, anti-pertussis toxin (PT) immunoglobulin G (IgG) was measured in serum samples via the enzyme-linked immunosorbent assay (ELISA). The given cases were further evaluated in terms of age, gender, occupation, place of living, and family size.Results: Out of 110 patients recruited in this study, 77 cases were female (70%). Also, only seven patients were shown to be serologically positive (6.4%). Moreover, no significant association was observed between pertussis incidence rate and the study variables, namely, age, gender, occupation, residency area (urban or rural), and family size (p>0.05).Conclusions: This study aimed to emphasize pertussis occurrence in individuals who merely present persistent cough without typical symptoms. This requires the physicians to conduct more precise assessments along with more rapid diagnostic methods.

The role of four cholesterol-recognition motifs localized between amino acid residues 400-550 in regulating translocation and lytic activity of Adenylate Cyclase Toxin

Adenylate Cyclase Toxin (ACT or CyaA) is an important virulence factor secreted by Bordetella pertussis, the bacterium causative of whooping cough, playing an essential role in the establishment of infection in the respiratory tract. ACT is a pore-forming cytolysin belonging to the RTX (Repeats in ToXin) family of leukotoxins, capable of permeabilizing several cell types and pure lipid vesicles. Besides, the toxin delivers its N-terminal adenylate cyclase domain into the target cytosol, where catalyzes the conversion of ATP into cAMP, which affects cell signalling. In this study we have made two major observations. First, we show that ACT binds free cholesterol, and identify in its sequence 38 potential cholesterol-recognition motifs. Second, we reveal that four of those motifs are real, functional cholesterol-binding sites. Mutations of the central phenylalanine residues in said motifs have an important impact on the ACT lytic and translocation activities, suggesting their direct intervention in cholesterol recognition and toxin functionality. From our data a likely transmembrane topology can be inferred for the ACT helices constituting the translocation and the hydrophobic regions. From this topology a simple and plausible mechanism emerges by which ACT could translocate its AC domain into target cells, challenging previous views in the field. Blocking the ACT-cholesterol interactions might thus be an effective approach for inhibiting ACT toxicity on cells, and this could help in mitigating the severity of pertussis disease in humans.