Ahead of Print - Pertactin-Negative and Filamentous Hemagglutinin-Negative Bordetella pertussis, Australia, 2013–2017 - Volume 25, Number 6—June 2019 - Emerging Infectious Diseases journal - CDC

Ahead of Print - Pertactin-Negative and Filamentous Hemagglutinin-Negative Bordetella pertussis, Australia, 2013–2017 - Volume 25, Number 6—June 2019 - Emerging Infectious Diseases journal - CDC

Volume 25, Number 6—June 2019

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Pertactin-Negative and Filamentous Hemagglutinin-Negative Bordetella pertussis, Australia, 2013–2017

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The Study

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Conclusions

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More articles on Vaccine, Immunization

Zheng Xu, Sophie Octavia, Laurence Don Wai Luu, Michael Payne, Verlaine Timms, Chin Yen Tay, Anthony D. Keil, Vitali Sintchenko, Nicole Guiso, and Ruiting Lan 

Author affiliations: University of New South Wales, Sydney, New South Wales, Australia (Z. Xu, S. Octavia, L.D.W. Luu, M. Payne, R. Lan); New South Wales Health Pathology and Westmead Hospital, Sydney (V. Timms, V. Sintchenko); The University of Sydney, Sydney (V. Timms, V. Sintchenko); University of Western Australia, Perth, Western Australia, Australia (C.Y. Tay); Perth Children’s Hospital, Perth (A.D. Keil); Institut Pasteur, Paris, France (N. Guiso)

Suggested citation for this article

Abstract

During the 2008–2012 pertussis epidemic in Australia, pertactin (Prn)–negative Bordetella pertussisemerged. We analyzed 78 isolates from the 2013–2017 epidemic and documented continued expansion of Prn-negative ptxP3 B. pertussis strains. We also detected a filamentous hemagglutinin-negative and Prn-negative B. pertussis isolate.

Despite high vaccination coverage, pertussis remains a major public health concern. In many industrialized countries, including Australia, whole-cell vaccine was replaced by the less reactogenic acellular vaccine (ACV). In Australia, the 3-component ACV (containing pertactin [Prn], pertussis toxin [Ptx] and filamentous hemagglutinin [Fha]) has been more widely used than the 5-component ACV (which also contains fimbrial antigen: Fim2 and Fim3).

Since 1991, when notifications began, pertussis has reemerged in Australia, and epidemics occurr every 3–5 years. The largest epidemic occurred in 2008–2012; 39,000 cases were recorded at its peak in 2011 (1,2). Most Bordetella pertussis isolates from that epidemic belonged to 1 genetic group, referred to as single-nucleotide polymorphism (SNP) cluster I (1–3). SNP cluster I had prn2 allele of the prn gene and ptxP3 allele of the Ptx promoter (3).

Figure 1. Pertussis trends and temporal changes of allele frequencies of vaccine antigens genes, Australia. A) Pertussis notifications in Australia, 1991–2017. Surce: national notifiable diseases surveillance system (http://www9.health.gov.au/cda/source/cda-index.cfmExternal Link). Incidence is number of...

In a study of the 2008–2012 epidemic, Lam et al. (1) reported a rapid increase in the number of isolates not expressing the ACV antigen Prn (Prn-negative), from 5.13% in 2008 to 77.78% in 2012. Sequencing of 22 isolates revealed 5 epidemic lineages (ELs) (EL1–EL5) and independent origin of Prn-negative strains in different ELs (4). A smaller epidemic occurred during 2013–2017, peaking at 22,000 cases in 2015 (Figure 1, panel A). We investigated the genotypic and phenotypic characteristics of 78 B. pertussis isolates from 2013–2017 to determine the epidemic trends of pertussis in Australia.