Published Date: 2012-03-22 21:31:31
Subject: PRO/EDR> Pertussis - Australia (04): newly emerging clones, discussion
Archive Number: 20120322.1078115
PERTUSSIS - AUSTRALIA (04): NEWLY EMERGING CLONES, DISCUSSION
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Thu 22 Mar 2012
From: Dr. Frits Mooi [edited]
The Australian study is important and it confirms European studies in which this strain has been linked to pertussis outbreaks. The strain is not "new," however, and was 1st identified in 2004 in the Netherlands (1). On the basis of a mutation in the pertussis toxin promoter region, we designated this strain the P3 strain (or lineage) and showed that it produced higher levels of pertussis toxin compared to the strains it replaced (2).
The emergence of P3 strains was found to be associated with increases in pertussis notifications in Finland and the Netherlands (2). We also found that the P3 strains have a global distribution and very likely evolved recently (3 and unpublished data). The association of P3 strains with pertussis outbreaks in various parts of the world underlines the importance of high vaccine coverage, especially with respect to infants and it also indicates that we need better pertussis vaccines (4, 5).
1. Schouls LM, van der Heide HG, Vauterin L, Vauterin P, Mooi FR: Multiple-locus variable-number tandem repeat analysis of Dutch _Bordetella pertussis_ strains reveals rapid genetic changes with clonal expansion during the late 1990s. J Bacteriol. 2004;186: 5496-5505.
2. Mooi FR, van Loo IHM, van Gent M, et al:. _Bordetella pertussis_ strains with increased toxin production associated with pertussis resurgence. Emerg Infect Dis. 2009;15: 1206-13.
3. van Gent M, Bart MJ, van der Heide HG, et al: SNP-based typing: a useful tool to study _Bordetella pertussis_ populations. PLoS One 2011;6:e20340.
4. Mooi FR, van Oirschot H, Heuvelman K, et al: Polymorphism in the _Bordetella pertussis_ virulence factors P69/pertactin and pertussis toxin in The Netherlands: temporal trends and evidence for vaccine-driven evolution. Infect Immun. 1998;66: 670-75.
5. Mooi, FR: 2010. _Bordetella pertussis_ and vaccination: the persistence of a genetically monomorphic pathogen. Infect Genet Evol 20910;10: 36-49.
Dr. Frits R Mooi
Dutch National Institute for Public Health and the Environment
[ProMED thanks Dr. Mooi for his comments and wishes to recognize the seminal work from his group regarding this field. It is becoming more apparent that alterations in the pertussis vaccine and/or vaccination schedule may be necessary. - Mod.LL]