Under-estimated burden of pertussis among middle and older-aged adults: A longitudinal seroepidemiological study in Taiwan during 2014–2020
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. Met...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-11-01
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| Series: | Journal of Infection and Public Health |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1876034125002503 |
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| Summary: | 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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| ISSN: | 1876-0341 |