Under-estimated burden of pertussis among middle and older-aged adults: A longitudinal seroepidemiological study in Taiwan during 2014–2020

IF 4 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-07-16 DOI:10.1016/j.jiph.2025.102901

Ming-Han Tsai , Chih-Jung Chen , Lan-Yan Yang , Yu-Bin Pan , Hsiang-Ju Shih , Chyi-Liang Chen , Cheng-Hsun Chiu

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Abstract

Background

The resurgence of pertussis has been observed in Taiwan in the last 2 decades. Most cases are infants and young children, and few were reported in adults. The study aimed to investigate the seroprevalence of pertussis among adults aged ≧ 45 years and identify associated risk factors.

Methods

Sera from adults ≧ 45 years of age, stored at the biobank of a tertiary medical center from 2014 to 2020, were analyzed. Anti-pertussis toxin (PT) IgG levels ≧ 40 IU/mL measured using enzyme-linked immunosorbent assay was defined as seropositivity. The association between seropositivity, clinical characters and different age groups was investigated.

Results

A total of 2199 samples were analyzed. The seropositivity was 4.5 % (99/2199), with increasing rates by age ranging from 2.9 % (21/732) in 45–54-year-old to 16.2 % (17/105) in ≧ 75-year-old age groups. Of the analysis between seropositivity and clinical characters, seropositive individuals were more likely to be male (69.7 % vs. 56.1 %; OR 2.12, 95 % CI 1.25–3.59, P = 0.005), older (mean age 63.7 vs. 58.6 years old; OR 1.04, 95 % CI 1.01–1.06, P = 0.004), and have end-stage renal disease (ESRD) (21.6 % vs. 7.1 %; OR 2.94, 95 % CI 1.61–5.36, P < 0.001). Additionally, if the anti-PT IgG levels were measured as geometric mean titers, malignancy was found to be more common in cases with seropositivity compared with those without (P = 0.0085).

Conclusions

Pertussis, which was underestimated in older adults, has been circulating in Taiwan. To avoid the resurgence of pertussis in Taiwan, targeted tetanus, diphtheria, and acellular pertussis (Tdap) vaccination is recommended for adults, especially for those with older age, ESRD or malignancy.

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低估的中老年人百日咳负担：台湾2014-2020年纵向血清流行病学研究

背景在过去二十年，台湾发现百日咳死灰复燃。大多数病例是婴儿和幼儿，很少有成人报告。该研究旨在调查年龄≧ 45岁成人百日咳的血清患病率，并确定相关的危险因素。方法对某三级医疗中心生物库2014 ~ 2020年贮存的45岁成人≧ 血清进行分析。酶联免疫吸附法测定抗百日咳毒素（PT） IgG水平≧ 40 IU/mL为血清阳性。探讨血清阳性、临床特征与不同年龄组的关系。结果共分析样品2199份。血清阳性率为4.5 %(99/2199)，随年龄的增长，45 - 54岁年龄组的阳性率为2.9 %(21/732)，≧ 75岁年龄组的阳性率为16.2 %（17/105）。在血清阳性与临床特征分析中，血清阳性个体以男性居多(69.7% % vs. 56.1% %；OR 2.12, 95 % CI 1.25-3.59, P = 0.005)，年龄较大(平均年龄63.7 vs. 58.6；OR 1.04, 95 % CI 1.01-1.06, P = 0.004)，并有终末期肾病（ESRD）(21.6% % vs. 7.1 %；OR 2.94, 95 % CI 1.61-5.36, P <； 0.001)。此外，如果以几何平均滴度测量抗pt IgG水平，则发现血清阳性的病例中恶性肿瘤的发生率高于无血清阳性的病例（P = 0.0085）。结论台湾地区存在着被低估的老年人精子症。为避免百日咳在台湾死灰复燃，建议成人有针对性地接种破伤风、白喉和无细胞百日咳（Tdap）疫苗，特别是对于年龄较大、ESRD或恶性肿瘤的人。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.