Clinical Evaluation of a New Rapid Immunochromatographic Test for Detection of Bordetella Pertussis Antigen

A more rapid and less complicated test is required in clinical settings to diagnose pertussis. We need to detect Bordetella pertussis, which mainly causes pertussis, as early as possible, because pertussis is more likely to become severe in infants, and people around them can easily become the source of infection due to its strong infectivity. Nevertheless, methods that can detect B. pertussis rapidly and efficiently are lacking. Therefore, we developed a new immunochromatographic antigen kit (ICkit) for the early diagnosis of pertussis. The ICkit detects B. pertussis antigens in a nasopharyngeal swab without equipment and provides the result in about 15 min with a simple procedure. Additionally, a prospective study to evaluate the ICkit was conducted in 11 medical institutions, involving 195 cases with suspected pertussis. The sensitivity and specificity of the ICkit were 86.4% (19/22) and 97.1% (168/173), respectively, compared with the real-time polymerase chain reaction (rPCR). The ICkit detected the antigen in both children and adults. Furthermore, the ICkit detected the antigen until the 25th day from the onset of cough, when rPCR detected the antigen. Thus, the ICkit demonstrated a high correlation with rPCR and would help diagnose pertussis more rapidly and efficiently.

Cellular Immunity in Adolescents and Adults following Acellular Pertussis Vaccine Administration

ABSTRACT Cell-mediated immune (CMI) responses to an acellular pertussis vaccine administered to 49 subjects, a subset of participants in the National Institutes of Health-funded adult acellular pertussis vaccine efficacy trial, were evaluated and compared with antibody responses to vaccine antigens. Levels of proliferation of and cytokine secretion from lymphocytes cultured in the presence of pertussis toxin, filamentous hemagglutinin, or pertactin were measured before vaccination and 1 month and 1 year after vaccination. Statistically significant increases in lymphocyte stimulation indices and cytokine secretion were noted at both 1 month and 1 year after vaccination. Brisk pertussis antigen-specific immunoglobulin G responses were also noted at 1 month after vaccination, but these responses had declined by nearly 50% at 1 year after vaccination. These studies clearly demonstrate that both cellular and humoral immune responses occur after the administration of acellular pertussis vaccines to adolescents and adults but that the CMI responses are of greater magnitude and longer duration. CMI responses may be a better correlate of long-term protection.

Recurrent Abscess Formation Following DTP Immunizations: Association with Hypersensitivity to Tetanus Toxoid

Adverse local reactions to vaccines containing diphtheria and tetanus toxoids and pertussis antigen (DTP) are common, but generally benign. Most often, these reactions are manifested by erythema, induration, and tenderness occurring at the injection site 12 to 24 hours following immunization.1-3 Less frequently, abscess formation may complicate intramuscular injections and these may be staphylococcal, clostridial, or sterile in etiology.4 Tetanus toxoid has been associated with a reaction incidence of 3% to 13%,5,6 and adverse reactions appear to be related to the number of prior immunizations and the height of preexisting antibody responses.3,6 However, recurrent abscess formation associated with hypersensitivity to one or more of the components of the DTP vaccine has not been reported previously.

Evaluation of the Pertussis Components of Diphtheria-Tetanus-Pertussis Vaccine

The adjuvant and antigen components of the pertussis fraction of diphtheria-tetanus-pertussis (DTP) vaccine were evaluated. Four preparations of DTP vaccine composed of either whole cell (Wc) or extracted (E) pertussis antigen combined with either an aluminum phosphate (Ph) or alum (Al) adjuvant were compared. Local reactions were similar in all four vaccines after the first two immunizations but were significantly increased in incidence and severity following the third immunization with vaccine WcPh. This appeared to be due to the Ph adjuvant rather than the antigen component. Febrile reactions were experienced more often (P = .0009) and with higher temperatures (P = .0001) with the WcPh vaccine following the first immunization. This appeared to be due to the Wc component. Comparing the pooled Wc groups with the pooled E groups revealed a greater febrile response in the Wc group after both the first (P = .0008) and the second (P = .03) immunization. Local reactions appear temporally and etiologically to be distinct from febrile reactions. The pooled Wc antigen group produced a higher geometric mean titer than the pooled E antigen group (P = .05). Serologic responses, with respect to geometric mean titer, were not significantly different among the individual vaccines. This study suggests that the combination of whole cell and aluminum phosphate, which is currently in use in the United States, is probably not the optimal formulation for pertussis vaccine.

Respiratory and humoral immune response to aerosol and intramuscular pertussis vaccine

SUMMARYAnimal experiments have shown that respiratory administration of pertussis antigen induces a protective immune response. In this study pertussis antibody in human respiratory secretions was measured and the response to aerosol and intramuscular pertussis immunization investigated. Substantial increases in this antibody occurred after aerosol immunization but no changes were found in serum antibody. The reverse was observed after intramuscular immunization. Severe side effects are frequently seen after intramuscular pertussis vaccine in adults but not with aerosol immunization. The latter method may be of value for paediatric medical and nursing personnel exposed to the risk of pertussis infection.