Increased population prevalence of low pertussis toxin antibody levels in young children preceding a record pertussis epidemic in Australia.

Increased population prevalence of low pertussis toxin antibody levels in young children preceding a record pertussis epidemic in Australia.
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DOI:
10.1371/journal.pone.0035874
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发表时间:
2012
期刊:
影响因子:
3.7
通讯作者:
McVernon J
McVernon J
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Campbell P;McIntyre P;Quinn H;Hueston L;Gilbert GL;McVernon J

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使用百日咳毒素IgG抗体(IgG-PT)的横断面血清学调查越来越多地被用于估计独立于报告偏倚的近期感染趋势。我们比较了年龄特异性血清阳性率的各种水平的IgG-PT的横断面调查,使用系统收集的残留血清从澳大利亚诊断实验室在1997/8,2002年和2007年参考百日咳疫苗接种时间表和流行周期的变化,如疾病通知所衡量的。高水平(≥62.5 EU/ml)IgG-PT患病率从1997/98年的19%(95% CI 16-22%)逐渐下降至2002年的12%(95% CI 11-14%)和2007年的5%(95% CI 4-6%),与每次采集前一年的百日咳通知模式一致。与此同时,无法检测到的(<5 EU/ml)水平从17% 1997/1998年(95%置信区间14-20%)至38%(95%CI 36-40%),但在1-4岁儿童中,从1997/98年的25%(95%CI 17-34%)增至2007年的62%(95%CI 56-68%)。这一变化是在2003年停止18个月的加强剂量之后发生的,并且是在2008年以来百日咳病例报告之前发生的。高水平IgG-PT的人群血清阳性率被认为是一个可靠的指标,随着时间的推移,在不同的诊断实践的国家内和国家之间,特别是在未免疫的年龄组百日咳疾病的活动。我们的新发现表明,不可检测的IgG-PT的患病率增加是免疫力减弱的指标,可用于引入无细胞疫苗和/或时间表变化后的人群水平监测。
Cross-sectional serosurveys using IgG antibody to pertussis toxin (IgG-PT) are increasingly being used to estimate trends in recent infection independent of reporting biases. We compared the age-specific seroprevalence of various levels of IgG-PT in cross-sectional surveys using systematic collections of residual sera from Australian diagnostic laboratories in 1997/8, 2002 and 2007 with reference to both changes in the pertussis vaccine schedule and the epidemic cycle, as measured by disease notifications. A progressive decline in high-level (≥62.5 EU/ml) IgG-PT prevalence from 19% (95% CI 16–22%) in 1997/98 to 12% (95% CI 11–14%) in 2002 and 5% (95% CI 4–6%) in 2007 was consistent with patterns of pertussis notifications in the year prior to each collection. Concomitantly, the overall prevalence of undetectable (<5 EU/ml) levels increased from 17% (95% CI 14–20%) in 1997/98 to 38% (95% CI 36–40%) in 2007 but among children aged 1–4 years, from 25% (95% CI 17–34%) in 1997/98 to 62% (95% CI 56–68%) in 2007. This change followed withdrawal of the 18-month booster dose in 2003 and preceded record pertussis notifications from 2008 onwards. Population seroprevalence of high levels of IgG-PT is accepted as a reliable indicator of pertussis disease activity over time within and between countries with varying diagnostic practices, especially in unimmunised age groups. Our novel findings suggest that increased prevalence of undetectable IgG-PT is an indicator of waning immunity useful for population level monitoring following introduction of acellular vaccines and/or schedule changes.
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发表时间: 2005-11-16
期刊: VACCINE
影响因子: 5.5
作者:
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发表时间: 2006-12-01
影响因子: 4.2
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