Investigations into the emergence of pertactin-deficient Bordetella pertussis isolates in six European countries, 1996 to 2012

• Published in: Euro surveillance : bulletin européen sur les maladies transmissibles Vol. 19; no. 33; p. 1
• Main Authors: Zeddeman, A, van Gent, M, Heuvelman, C J, van der Heide, H G, Bart, M J, Advani, A, Hallander, H O, Wirsing von König, C H, Riffelman, Marion, Storsaeter, J, Vestrheim, D F, Dalby, T, Krogfelt, K A, Fry, N K, Barkoff, A M, Mertsola, J, He, Q, Mooi, F
• Format: Journal Article
• Language: English
• Published: Sweden Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS) 21.08.2014
• Subjects: Amino Acid Sequence; Bacterial Outer Membrane Proteins - analysis; Bacterial Outer Membrane Proteins - genetics; Base Sequence; Bordetella pertussis - genetics; Bordetella pertussis - isolation & purification; Child; Child, Preschool; Cluster Analysis; Communicable Diseases, Emerging - genetics; Disease transmission; DNA, Bacterial - genetics; Europe; Female; Genotype; Humans; Infant; Male; Molecular Typing; Mutation; Polymerase Chain Reaction; Polymorphism, Single Nucleotide; Sequence Analysis, DNA; Vaccines; Virulence Factors, Bordetella - analysis; Virulence Factors, Bordetella - genetics; Whooping cough; Whooping Cough - epidemiology; Whooping Cough - microbiology; Whooping Cough - prevention & control; Denmark; Netherlands; Sweden; United Kingdom > UK; Finland
• ISSN: 1560-7917; 1025-496X; 1560-7917
• DOI: 10.2807/1560-7917.ES2014.19.33.20881

Pathogen adaptation has been proposed to contribute to the resurgence of pertussis. A striking recent example is the emergence of isolates deficient in the vaccine component pertactin (Prn). This study explores the emergence of such Prn-deficient isolates in six European countries. During 2007 to 2009, 0/83 isolates from the Netherlands, 0/18 from the United Kingdom, 0/17 Finland, 0/23 Denmark, 4/99 Sweden and 5/20 from Norway of the isolates collected were Prn-deficient. In the Netherlands and Sweden, respectively 4/146 and 1/8 were observed in a later period (2010–12). The Prn-deficient isolates were genetically diverse and different mutations were found to inactivate the prn gene. These are indications that Prn-deficiency is subject to positive selective pressure. We hypothesise that the switch from whole cell to acellular pertussis vaccines has affected the balance between ‘costs and benefits’ of Prn production by Bordetella pertussis to the extent that isolates that do not produce Prn are able to expand. The absence of Prn-deficient isolates in some countries may point to ways to prevent or delay the spread of Prn-deficient strains. In order to substantiate this hypothesis, trends in the European B. pertussis population should be monitored continuously.