title: Seroprevalence of pertussis in China: need to improve vaccination strategies.
abstract: Pertussis remains an important cause of infant death worldwide and is an ongoing public health concern even in countries with high vaccination coverage. A cross-sectional seroepidemiological study was undertaken to estimate true incidence rates and gain further insight into the epidemiology and burden of pertussis in China. During 2011, a total of 1080 blood samples were obtained from healthy individuals between 0 and 86 y of age in Zhengzhou, Central China. Serum IgG antibodies against pertussis toxin (PT) and filamentous hemagglutinin (FHA) were measured quantitatively using ELISA. The results showed that the geometric mean titers of PT and FHA IgG were 6.48 IU/mL (95% CI: 5.70-7.41 IU/mL) and 11.39 IU/mL (95% CI: 10.22-12.87 IU/mL) among subjects less than 4 y of age, indicating that pertussis antibody levels were low despite high vaccination coverage. Of the 850 subjects≥4 y of age, 56 (6.6%) had anti-PT IgG titers above 30 IU/mL, and 11 (1.3%) had antibodies titers above 80 IU/mL. The estimated age-specific incidence of infection with B. pertussis revealed a peak incidence in the 31 to 40 y age group, followed by the 41 to 60 y age group. Taken together, these results indicate that pertussis is common in Chinese subjects in Zhengzhou, especially in adults, suggesting that the disease burden is underestimated in China. Therefore, our study stresses the importance of strengthening the diagnostic capacity and improving surveillance system for delineating current epidemiological profiles of pertussis. Most importantly, it may be advisable to re-evaluate the current Chinese pertussis immunization schedule and implement to booster doses for older children, adolescents and adults.
authors.affiliation: Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products; National Institutes of Food and Drug Control; Beijing, PR China.
authors.forename: Yinghua
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products; National Institutes of Food and Drug Control; Beijing, PR China.
authors.forename: Lichan
authors.initials: L
authors.lastname: Wang
authors.affiliation: Center for Disease Control and Prevention of Henan Province; Zhengzhou, Henan PR China.
authors.forename: Jin
authors.initials: J
authors.lastname: Xu
authors.affiliation: Zhengzhou ETEBIO Technology co., LTD.; Zhengzhou, Henan PR China.
authors.forename: Xinjian
authors.initials: X
authors.lastname: Wang
authors.affiliation: Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products; National Institutes of Food and Drug Control; Beijing, PR China.
authors.forename: Chen
authors.initials: C
authors.lastname: Wei
authors.affiliation: Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products; National Institutes of Food and Drug Control; Beijing, PR China.
authors.forename: Peng
authors.initials: P
authors.lastname: Luo
authors.affiliation: Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products; National Institutes of Food and Drug Control; Beijing, PR China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Ma
authors.affiliation: Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products; National Institutes of Food and Drug Control; Beijing, PR China.
authors.forename: Qiming
authors.initials: Q
authors.lastname: Hou
authors.affiliation: Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products; National Institutes of Food and Drug Control; Beijing, PR China.
authors.forename: Junzhi
authors.initials: J
authors.lastname: Wang
mesh_terms: D018829:Adhesins, Bacterial / Q000276:immunology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D037342:Pertussis Toxin / Q000276:immunology; D010567:Pertussis Vaccine / Q000008:administration & dosage*; D016036:Seroepidemiologic Studies; D014611:Vaccination / Q000379:methods* / Q000706:statistics & numerical data*; D010566:Virulence Factors, Bordetella / Q000276:immunology; D014917:Whooping Cough / Q000453:epidemiology* / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D018829:Adhesins, Bacterial; D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D010567:Pertussis Vaccine; D010566:Virulence Factors, Bordetella; C065273:filamentous hemagglutinin adhesin, Bordetella pertussis; D037342:Pertussis Toxin
keywords: China; infectious disease; pertussis; seroepidemiology; vaccination
references.citation: Epidemiol Infect. 2008 Jul;136(7):895-902
references.pmid: 17678562
references.citation: Euro Surveill. 2013 Feb 28;18(9):
references.pmid: 23470020
references.citation: Eur J Clin Microbiol Infect Dis. 2000 Feb;19(2):77-88
references.pmid: 10746492
references.citation: Vaccine. 2012 Jan 11;30(3):544-51
references.pmid: 22119924
references.citation: J Infect. 2011 Dec;63(6):441-6
references.pmid: 21864569
references.citation: Hum Vaccin. 2011 Feb;7(2):272-5
references.pmid: 21307651
references.citation: Clin Infect Dis. 1999 Jun;28(6):1230-7
references.pmid: 10451158
references.citation: J Pediatr. 2012 Dec;161(6):1091-6
references.pmid: 22819634
references.citation: J Infect Dis. 1994 Sep;170(3):705-8
references.pmid: 8077734
references.citation: Pediatr Infect Dis J. 2005 May;24(5 Suppl):S58-61
references.pmid: 15876927
references.citation: Vaccine. 2012 May 21;30(24):3566-71
references.pmid: 22475863
references.citation: J Infect Dis. 1996 Oct;174(4):896
references.pmid: 8843241
references.citation: J Infect Dis. 1990 Mar;161(3):480-6
references.pmid: 2313126
references.citation: Vaccine. 1993;11(8):866-72
references.pmid: 8356847
references.citation: BMC Infect Dis. 2012 Jun 20;12:138
references.pmid: 22892100
references.citation: Pediatr Infect Dis J. 2005 May;24(5 Suppl):S87-92
references.pmid: 15876934
references.citation: Eur J Clin Microbiol Infect Dis. 2011 Mar;30(3):307-12
references.pmid: 21069406
references.citation: Vaccine. 2000 Apr 28;18(21):2173-6
references.pmid: 10717335
references.citation: Vaccine. 2009 Mar 18;27(13):1932-7
references.pmid: 19368774
references.citation: Clin Infect Dis. 2012 Jun;54(12):1730-5
references.pmid: 22423127
references.citation: N Engl J Med. 2007 Jan 11;356(2):110-3
references.pmid: 17215528
references.citation: Pediatr Infect Dis J. 2011 Jul;30(7):593-6
references.pmid: 21422963
references.citation: Clin Vaccine Immunol. 2009 Mar;16(3):303-11
references.pmid: 19109448
references.citation: Clin Infect Dis. 2012 Feb 1;54(3):318-27
references.pmid: 22156850
references.citation: Epidemiol Infect. 2009 Apr;137(4):485-94
references.pmid: 18694528
references.citation: PLoS Negl Trop Dis. 2012 Jan;6(1):e1460
references.pmid: 22253937
references.citation: J Infect. 1991 Mar;22(2):191-9
references.pmid: 2026895
references.citation: Infect Immun. 1998 Feb;66(2):594-602
references.pmid: 9453614
references.citation: Infect Immun. 1990 Jan;58(1):7-16
references.pmid: 2294058
references.citation: JAMA. 2012 Nov 28;308(20):2126-32
references.pmid: 23188029
references.citation: Clin Infect Dis. 2010 May 15;50(10):1339-45
references.pmid: 20370464
references.citation: N Engl J Med. 2012 Aug 30;367(9):785-7
references.pmid: 22894554
references.citation: Pediatr Infect Dis J. 2005 May;24(5 Suppl):S83-6
references.pmid: 15876933
references.citation: Clin Infect Dis. 2004 Dec 1;39(11):1572-80
references.pmid: 15578353
references.citation: JAMA. 2006 Feb 22;295(8):871-2
references.pmid: 16493092
references.citation: Emerg Infect Dis. 2002 Aug;8(8):859-61
references.pmid: 12141975
references.citation: Clin Infect Dis. 1999 Jun;28 Suppl 2:S124-30
references.pmid: 10447030
references.citation: Vaccine. 2012 Nov 26;30(50):7174-8
references.pmid: 23084855
references.citation: Clin Infect Dis. 2007 Jan 1;44(1):149-50; author reply 150-1
references.pmid: 17143835
references.citation: Vaccine. 2007 Nov 7;25(45):7866-72
references.pmid: 17919788
references.citation: J Clin Microbiol. 2000 Feb;38(2):800-6
references.pmid: 10655388
references.citation: Epidemiol Infect. 2005 Feb;133(1):159-71
references.pmid: 15724723
references.citation: Vaccine. 2000 Nov 8;19(6):637-43
references.pmid: 11090715
references.citation: Pediatr Infect Dis J. 1995 Jun;14(6):517-21
references.pmid: 7667057
references.citation: Dtsch Arztebl Int. 2011 Nov;108(45):771-9; quiz 780
references.pmid: 22163258