Bordetella pertussis strains with increased toxin production associated with pertussis resurgence.

Bordetella pertussis strains with increased toxin production associated with pertussis resurgence.
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DOI:
10.3201/eid1508.081511
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发表时间:
2009-08
影响因子:
11.8
通讯作者:
Mertsola J
Mertsola J
中科院分区:
医学2区
文献类型:
--
作者:
Mooi FR;van Loo IH;van Gent M;He Q;Bart MJ;Heuvelman KJ;de Greeff SC;Diavatopoulos D;Teunis P;Nagelkerke N;Mertsola J

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A more virulent strain of the disease is emerging. Before childhood vaccination was introduced in the 1940s, pertussis was a major cause of infant death worldwide. Widespread vaccination of children succeeded in reducing illness and death. In the 1990s, a resurgence of pertussis was observed in a number of countries with highly vaccinated populations, and pertussis has become the most prevalent vaccine-preventable disease in industrialized countries. We present evidence that in the Netherlands the dramatic increase in pertussis is temporally associated with the emergence of Bordetella pertussis strains carrying a novel allele for the pertussis toxin promoter, which confers increased pertussis toxin (Ptx) production. Epidemiologic data suggest that these strains are more virulent in humans. We discuss changes in the ecology of B. pertussis that may have driven this adaptation. Our results underline the importance of Ptx in transmission, suggest that vaccination may select for increased virulence, and indicate ways to control pertussis more effectively.
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