Bordetella pertussis strains with increased toxin production associated with pertussis resurgence

Frits R. Mooi, Inge H.M. Van Loo, Marjolein Van Gent, Qiushui He, Marieke J. Bart, Kees J. Heuvelman, Sabine C. De Greeff, Dimitri Diavatopoulos, Peter Teunis, Nico Nagelkerke, Jussi Mertsola

Research output: Contribution to journalArticlepeer-review

265 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1206-1213
Number of pages8
JournalEmerging Infectious Diseases
Volume15
Issue number8
DOIs
Publication statusPublished - Aug 2009
Externally publishedYes

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

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