Population Dynamics of Pathogens
Leonhard Held, Niel Hens, Philip O’Neill, Jacco Wallinga in Handbook of Infectious Disease Data Analysis, 2019
Inspired by Rand and Wilson’s [36] mathematical analysis, Rohani et al. [38] studied whooping cough dynamics during the transient following introduction of mass-vaccination in UK in 1958. Whooping cough is caused by an airborne bacteria in the genus Bordetella that leads to pneumonia. Pre-vaccination, whooping cough was a leading cause of death of children under 5 years and exhibited a variety of dynamics from low-amplitude annual to 3–4 year cycles [39]. Rohani et al. [38] concluded that the post-vaccination multi-annual cycles were most likely due to an unstable “almost attractor”. Lavine et al. [40] used a similar approach of combining wavelet time series analysis with mathematical models to study a curious run of violent 3-year cycles in pre-vaccination whooping cough dynamics in Copenhagen; again concluding that the most likely explanation was the coexistence of a low-amplitude annual attractor and high-amplitude cyclic “almost attractors”.
Beware of the Crocodiles
Norman Begg in The Remarkable Story of Vaccines, 2023
One question that vexes vaccine researchers more than most is how to define the disease they are looking for. It sounds rather obvious – either you get the disease, or you don’t – but it’s a lot more complicated than that. Are you looking for all cases of the disease, including very mild ones, or do you just want to find the more serious ones? Do you need to have the diagnosis of all cases confirmed by laboratory tests? What about people who get the infection but have no symptoms? The effect of a vaccine will be different depending on how you define a case. Let’s consider the design of a trial against whooping cough vaccine as an example. If you just look for cases in which they had a cough, with a typical “whoop”, the effect of a vaccine would appear to be lower than if you only included people who also had those symptoms plus confirmation of the diagnosis by laboratory tests. Some of your cases of cough and whoop might not in fact be whooping cough, so the vaccine could not be expected to protect them. Only the cases with laboratory confirmation are true whooping cough. It pays to be strict in how you decide who is and who is not a case, as this gives you the best chance of finding out the true effect of the vaccine. Phase 3 trials nearly always require laboratory confirmation to be sure that a suspected case really is a case.
Infections of the larynx
Declan Costello, Guri Sandhu in Practical Laryngology, 2015
We live in an antibiotic era.57 However, we may also be approaching the end of this era as bacteria continually evolve means of resistance to the range of antibiotics currently available. Prior to the widespread introduction of penicillin in the 1940s, bacterial laryngeal infections were feared. An article published in 1977 summed up the feeling of clinicians at the time when it stated that “…acute epiglottitis is the most treacherous inflammatory process that can affect the respiratory tract. It can be a cause of sudden death in children”.58Haemophilus was also the most common cause of meningitis in childhood, and a common cause of cellulitis and osteomyelitis, conditions that have been eradicated thanks to vaccination. Whooping cough was also a significant cause of infant morbidity and mortality, with the majority of hospitalisations in children under 6 months of age. These are serious pathogens causing serious diseases.
Immune interference (blunting) in the context of maternal immunization with Tdap-containing vaccines: is it a class effect?
Published in Expert Review of Vaccines, 2020
Walid Kandeil, Miloje Savic, Maria Angeles Ceregido, Adrienne Guignard, Anastasia Kuznetsova, Piyali Mukherjee
Pertussis, also known as whooping cough, is a highly contagious respiratory disease caused by Bordetella pertussis. Although it can affect all ages, the number of complications and deaths from infection are highest in young infants under 2–3 months of age [1]. Maternal immunization with reduced antigen content tetanus-diphtheria-acellular pertussis (Tdap) vaccines has demonstrated to be a safe, effective, and successful strategy in preventing infant pertussis disease, since it can offer protection through transplacental transfer of maternal antibodies before the infants receive their primary vaccination [2–5]. At least 40 countries are currently recommending maternal immunization as part of their routine immunization schedules [6,7], including the United States (US) and the United Kingdom (UK) [8,9].
Pertussis-like syndrome often not associated with Bordetella pertussis: 5-year study in a large children’s hospital
Published in Infectious Diseases, 2020
Qin Xiong, Shiying Hao, Lei Shen, Jian Liu, Tingting Chen, Guoqin Zhang, Yu-juan Huang
Pertussis, also called whooping cough, is an acute respiratory infectious disease caused by Bordetellapertussis (B. pertussis). Typical symptoms of pertussis are paroxysmal cough, inspiratory whoop, and post-cough vomiting. The course of the disease could last for 2 or 3 months [1,2]. Pertussis is more severe in infants less than 3 months. Paroxysmal cough can cause short breath or apnoea, which will increase the risk of life-threatening complications such as pneumonia, encephalopathy, and pulmonary hypertension [3]. A term pertussis-like syndrome (PLS) has been widely used as a clinical diagnosis for children presenting with symptoms and signs compatible with pertussis, but with indeterminate aetiology or without history of exposure to any confirmed pertussis case [4]. Pathogens of PLS include B. pertussis, other bordetella species, mycoplasma pneumonia, and chlamydia pneumonia, as well as other types of virus and bacteria [5–7].
Trends and costs of pertussis hospitalizations in Portugal, 2000 to 2015: from 0 to 95 years old
Published in Infectious Diseases, 2018
Sara Melo Oliveira, Manuel Gonçalves-Pinho, Alberto Freitas, Hercília Guimarães, Inês Azevedo
We could not directly assess admission to ICU, but mechanical ventilation, either invasive or non-invasive, was coded in 3.6% of hospitalizations, of which more than half were in infants. This is similar to the 4.5% ICU admissions in New Zealand [27] and lower than the 27% reported in a prospective nationwide surveillance study in Switzerland [26], and the 18% in German infants [23]. Complications were mainly respiratory, but also cardiac and neurologic, as reported in Swiss [26] and Japanese children [28]. Complications were coded for 65.4% and 87.0% of the hospitalizations of adults and elderly, respectively. Moreover, a higher percentage of mechanical ventilation was coded in the age group 18–64 years. The substantially higher incidence of complications in these age groups may be related to the fact that whooping cough is still considered a disease of childhood, leading to misdiagnosis, and consequently late diagnosis and treatment [33].
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