Abstract
BackgroundRecent studies worldwide have reported increasing numbers of adults diagnosed with Bordetella pertussis despite receiving childhood vaccinations. This study describes a pertussis outbreak at a university medical faculty campus and examines the effectiveness of diphtheria, tetanus, and pertussis (DTaP) vaccination completed during infancy in Japan.MethodsAfter the outbreak, self-administered questionnaires and serum samples were collected from students on campus to determine the incidence of pertussis and underlying diseases. Pertussis was diagnosed on the basis of clinical criteria and serum anti-pertussis toxin antibody levels. Using data collected from 248 first and second grade students who had submitted copies of their vaccination records, we evaluated the effectiveness of DTaP vaccination in infancy against adult pertussis.ResultsQuestionnaire responses were obtained from 636 students (of 671 registered students; 95% response rate). Of 245 students who reported a continuous cough during the outbreak period, 84 (attack rate: 13.2%) were considered “probable” pertussis cases that met clinical criteria. The outbreak occurred mainly in first and second grade students in the Faculty of Medicine. Of 248 students who provided vaccination records, 225 had received 4 DTaP doses (coverage: 90.7%); the relative risk of the complete vaccination series compared to those with fewer than 4 doses or no doses for probable cases was 0.48 (95% confidence interval: 0.24-0.97).ConclusionsWaning protection was suspected due to over time. Booster vaccination for teenagers and development of highly efficacious pertussis vaccines are needed.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-015-0777-3) contains supplementary material, which is available to authorized users.
Highlights
Recent studies worldwide have reported increasing numbers of adults diagnosed with Bordetella pertussis despite receiving childhood vaccinations
Suggested causes for this increase include increased clinical awareness of pertussis, improved diagnostics using polymerase chain reaction (PCR), identification of mutations in the strain of Bordetella pertussis associated with epidemics, and
Description of outbreak The population characteristics and cough statuses of 636 subjects who participated in the survey just after the outbreak were examined according to clinical diagnosis (Table 1)
Summary
Recent studies worldwide have reported increasing numbers of adults diagnosed with Bordetella pertussis despite receiving childhood vaccinations. Global vaccination coverage for diphtheria, tetanus, and pertussis (DTaP) remains high, recent reports of increasing pertussis cases among adolescents and adults are of concern because this population can be a source of infant infection [1]. Suggested causes for this increase include increased clinical awareness of pertussis, improved diagnostics using polymerase chain reaction (PCR), identification of mutations in the strain of Bordetella pertussis associated with epidemics, and. The number of adult pertussis cases has been increasing in Japan, with outbreaks in high schools and universities as well as workplaces successively reported in 2002 [9,10,11,12,13]. No studies have examined the effectiveness of the vaccine against pertussis after early adolescence
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