Breaking News
April 21, 2018 - Academia and high tech companies join forces to increase production capacity for microfluidic systems
April 21, 2018 - Developing cooking skills as young adult may have long-term health benefits
April 21, 2018 - Study compares survival outcomes of different drugs for type 2 diabetes
April 21, 2018 - More Than 40 Percent of Americans Breathe Dirty Air: Report
April 21, 2018 - Obstructive sleep apnea – Genetics Home Reference
April 21, 2018 - More evidence shows exposure to traffic and outdoor air pollution increases risk of asthma
April 21, 2018 - Novel gold nanoparticle technology could guide cancer treatment in real-time
April 21, 2018 - News coverage of Ebola impacted public’s perception on disease and survivors
April 21, 2018 - S.Africa’s DIY battle against HIV
April 21, 2018 - Children with autism have gastrointestinal and immune system deregulation, research finds
April 21, 2018 - Human brain processes sight and sound in the same way, shows study
April 21, 2018 - Evolutionary history of tumor helps predict severity of prostate cancer
April 21, 2018 - Pepper plant metabolizes antibiotic in personal care products
April 21, 2018 - Tradeshow Talks with Integra
April 21, 2018 - EPFL becomes part of Chan Zuckerberg’s project to develop Human Cell Atlas
April 21, 2018 - Pfizer Announces Positive Topline Results From Phase 3 ATTR-ACT Study Of Tafamidis In Patients With Transthyretin Cardiomyopathy
April 21, 2018 - Breaking through the HIV vaccine ‘logjam’
April 21, 2018 - IntelliCyt introduces new QSol buffer to enable robust, consistent sampling
April 21, 2018 - Scientists publish comprehensive lineage tree of whole adult animal in Science journal
April 21, 2018 - Innovative method based on FluidFM technology could revolutionize biological research
April 21, 2018 - Americans world’s biggest TV addicts, watching four hours a day
April 21, 2018 - Investigational drug may help increase protein levels in babies with spinal muscular atrophy
April 21, 2018 - Study shows distinctions between age groups in predicting and responding to stress at home
April 21, 2018 - Aziyo Biologics, BIOTRONIK enter into US co-distribution agreement
April 21, 2018 - Opiate Use Linked to Early Mortality in IBD Patients
April 21, 2018 - Online ads help pregnant smokers quit
April 21, 2018 - Opioid pain medications may not be safe for hemodialysis patients
April 21, 2018 - Rare variants in non-coding DNA inherited from parents heighten autism risk
April 21, 2018 - A needleless glucose monitor for diabetes patients
April 21, 2018 - BD introduces new informatics and automation solutions for clinical laboratories
April 21, 2018 - Turn Chores Into a Fitness Routine
April 21, 2018 - DNA methylation plays key role in stem cell differentiation
April 21, 2018 - Scientists find link between soil metals and cancer mortality
April 21, 2018 - Experts discuss implications of low calcium intake in global population
April 21, 2018 - GNA Biosolutions to display Pharos V8 Laser PCR instrument at Analytica trade fair
April 21, 2018 - People with vitamin D deficiency may be at greater risk of diabetes
April 21, 2018 - Study findings could open new possibilities for treating cancer with adenovirus
April 21, 2018 - People who use medical marijuana have higher rates of prescription drug use, study finds
April 21, 2018 - Study debunks ‘myth’ that strenuous exercise dampens immunity
April 21, 2018 - FDA approves marijuana based medication for epilepsy treatment
April 21, 2018 - Researchers find novel genes for longevity in mammals
April 21, 2018 - GNA Biosolutions and project partners launch new research project to develop TB diagnostic platform for POC applications
April 21, 2018 - $2 million funding boosts progress of UAB biomedical startup
April 21, 2018 - Scientists identify gene responsible for evolution of recombination rates
April 21, 2018 - UConn researchers develop new composite for healing broken load-bearing bones
April 21, 2018 - Study examines how higher-order gene combinations help maintain normal cell physiology
April 21, 2018 - Study challenges use of whole-brain radiation for small-cell lung cancer patients with brain metastases
April 21, 2018 - Researchers discover blood biomarkers that may help detect, confirm mild traumatic brain injury
April 21, 2018 - People who become physically active after heart attack more likely to live longer, shows research
April 21, 2018 - CPRIT awards $2 million grant to push forward breast cancer research in West Texas
April 21, 2018 - Unhealthy diet damages the development of immature fat cells, study shows
April 21, 2018 - Consumption of protein supplements with meals may provide better weight control
April 21, 2018 - 4 Types of Foods to Help Boost Your Memory
April 21, 2018 - How did gonorrhea become a drug-resistant superbug?
April 21, 2018 - DePuy Synthes announces clinical results related to use of CORAIL Hip System Femoral Stems
April 21, 2018 - New initiative launched to support goals of Human Cell Atlas
April 20, 2018 - Teen patient gets a new lease on life
April 20, 2018 - Cancer Australia launches new framework to improve outcomes for lung cancer patients
April 20, 2018 - ‘Gut-on-a-chip’ model recreates intestinal matrix critical for nutrient absorption
April 20, 2018 - Researchers develop new drug-testing platform for epilepsy
April 20, 2018 - FDA Alert: NxtGen Botanicals Maeng Da Kratom by NGB Corp.: Recall
April 20, 2018 - Pelizaeus-Merzbacher-like disease type 1 – Genetics Home Reference
April 20, 2018 - Tick-borne diseases reach epidemic levels, panel says
April 20, 2018 - A potential “male pill” without side effects
April 20, 2018 - Researchers discover new information related to rare form of leukemia
April 20, 2018 - Researchers find crucial links between dopamine and avoidance behavior
April 20, 2018 - UGA scientist creates system for efficient detection of foodborne pathogens
April 20, 2018 - Social Support of Autonomy Tied to Better Glycemic Control in DM
April 20, 2018 - Study reports use of nutritional ketosis with mobile app intervention could reverse Type 2 diabetes
April 20, 2018 - New microscopy techniques allow quasi-biochemical studies on living T cells
April 20, 2018 - Study shows connection between muscular strength and brain health
April 20, 2018 - Ecolab introduces Life Sciences cleanroom program in North America
April 20, 2018 - Normal weight people with fat belly may have more chance of heart problems
April 20, 2018 - Male fruit flies like sex and alcohol
April 20, 2018 - Meditation could help reduce anxiety levels and some heart health risk factors
April 20, 2018 - Improving job prospects unlikely to control opioid epidemic
April 20, 2018 - Skin Sensor Might Someday Track Alcoholics’ Booze Intake
April 20, 2018 - The relevance of GABA for diabetes highlighted in two new studies
April 20, 2018 - Novel method enables fast and noninvasive assessment of tumor status
April 20, 2018 - IU psychologist receives NIH grant to study earliest phases of language learning in children
Decades-long trends, not flawed vaccine, explain resurgent whooping cough

Decades-long trends, not flawed vaccine, explain resurgent whooping cough

image_pdfDownload PDFimage_print
Gram stain of the bacteria Bordetella pertussis. Credit: CDC

Researchers and public health officials have struggled to explain the resurgence of whooping cough in the United States since the late 1970s, and the suspected shortcomings of the current generation of vaccines are often blamed.

But a new University of Michigan-led study concludes that the resurgence of the highly contagious respiratory disease is the result of factors—including a phenomenon known as the honeymoon period—that began in the middle of the last century, long before the latest vaccines were introduced in the late 1990s.

“Conventional wisdom is that the current vaccine is the problem, but that’s not consistent with what we see,” said Aaron King, a U-M infectious disease ecologist and applied mathematician.

King and colleagues from the Institut Pasteur, the University of Georgia and Queens University concluded that natural population turnover, incomplete vaccination coverage, and slowly waning protection from a highly effective yet imperfect vaccine best explain the resurgence of whooping cough. The disease can be fatal to infants and is also known as pertussis.

“This resurgence is the predictable consequence of rolling out a vaccine that isn’t quite perfect and not hitting everybody in the population with that vaccine,” said King, a professor in the U-M Department of Ecology and Evolutionary Biology and in the mathematics department.

The team’s findings are scheduled for publication March 28 in Science Translational Medicine. The first author of the paper is Matthieu Domenech de Cellès, formerly a U-M postdoctoral researcher under King, now at the Institut Pasteur in Paris.

“Our results are important because they show that recent trends in pertussis are not necessarily caused by recent changes in epidemiology or biology,” said Domenech de Cellès.

“Rather, the contemporary epidemiology of pertussis may be interpreted as a legacy of longstanding immunization practices. It’s an important shift of perspective, which makes pertussis a complex but exciting system to study.”

The researchers used disease-transmission models and 16 years of age-stratified pertussis incidence data from Massachusetts, along with statistical methods for extracting information from the data. The authors say their results apply to the rest of the United States and to Western Europe.

According to the study, the introduction of the first pertussis vaccine in the late 1940s led to a honeymoon period, a time of very low disease incidence following the start of a vaccination program. The return of pertussis in recent decades signals the end of that honeymoon period, according to the researchers.

In the pre-vaccine era, whooping cough was a very common childhood disease in the United States. Most kids were exposed to Bordetella pertussis, the bacterium that causes it, and their immune systems mounted a strong response that provided long-lasting immunity. As a result of those naturally acquired infections, most adult Americans were immune to pertussis.

Routine vaccination with a whole-cell pertussis vaccine quickly led to a 100-fold reduction in incidence. Actually, two factors accounted for that sharp drop-off: children protected by the new vaccine and adults with natural immunity acquired in the pre-vaccine era.

But as the decades passed, the number of American adults with naturally acquired pertussis immunity gradually declined as that older group died out.

Concurrently, the number of pertussis-susceptible U.S. adults was on the rise, setting the stage for the resurgence. The susceptible adults included people who were not vaccinated as children and who also avoided naturally acquired pertussis infections.

The mathematical model that best fit the 1990-2005 Massachusetts incidence data was one that explains the current resurgence “as a legacy of incomplete vaccination with effective, but imperfect, vaccines against a background of slow demographic turnover, i.e., as an end-of-honeymoon effect,” the authors wrote.

The modeling study also supports the idea that protection from the pertussis vaccine gradually wanes over time—though it lasts a lot longer than many experts believed.

Some critics of the current acellular pertussis vaccine say it wears off after five to seven years. But the new study “suggests that current pertussis vaccines provide lifelong protection to 55 percent of people and protect 90 percent of people for more than a decade,” said study co-author Pejman Rohani, a population ecologist at the University of Georgia’s Odum School of Ecology.”Furthermore, our models explain that patterns of pertussis incidence previously attributed to rapid vaccine waning are actually consistent with higher contact rates once children enter school.”

Though the current vaccine is effective at reducing levels of the pertussis pathogen circulating in the population, routine vaccination alone will never be sufficient to eradicate the bacterium, the researchers conclude.

In infants, pertussis causes violent, gasping coughing spells and can lead to life-threatening complications. People with whooping cough usually spread the disease by coughing or sneezing while in close contact with others. Parents, older siblings or other caregivers can give whooping cough to babies without even knowing they have the disease.

The modeling study identified primary school children and teenagers as the “core transmission group” mainly responsible for spreading the disease. In one simulation, a booster vaccination effort focused on children ages 5 to 10 or 10 to 20 led to a drop in infant cases of about 25 percent.

“The overwhelming amount of transmission is happening in those age groups,” King said. “So, we have to make sure that kids are getting vaccinated before they go to school. That’s going to have the biggest impact.”

The U.S. Centers for Disease Control and Prevention recommends a series of five pertussis shots for children under 7. Additional shots are recommended for older children and for some adults.

Pertussis is responsible for 195,000 infant deaths each year worldwide, mostly in the developing world. There were 17,972 reported pertussis cases in the United States in 2016, including six infant deaths, according to the CDC.


Explore further:
Resurgence of whooping cough may owe to vaccine’s inability to prevent infections

More information:
M. Domenech de Cellès el al., “The impact of past vaccination coverage and immunity on pertussis resurgence,” Science Translational Medicine (2018). stm.sciencemag.org/lookup/doi/ … scitranslmed.aaj1748

Journal reference:
Science Translational Medicine

Provided by:
University of Michigan

About author

Related Articles