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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Elsevier
2025-11-01
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| Series: | Journal of Infection and Public Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1876034125002503 |
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| author | Ming-Han Tsai Chih-Jung Chen Lan-Yan Yang Yu-Bin Pan Hsiang-Ju Shih Chyi-Liang Chen Cheng-Hsun Chiu |
| author_facet | Ming-Han Tsai Chih-Jung Chen Lan-Yan Yang Yu-Bin Pan Hsiang-Ju Shih Chyi-Liang Chen Cheng-Hsun Chiu |
| author_sort | Ming-Han Tsai |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-29a84dd3cf8b46ecb0efb095e0e84131 |
| institution | Kabale University |
| issn | 1876-0341 |
| language | English |
| publishDate | 2025-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Infection and Public Health |
| spelling | doaj-art-29a84dd3cf8b46ecb0efb095e0e841312025-08-20T03:44:24ZengElsevierJournal of Infection and Public Health1876-03412025-11-01181110290110.1016/j.jiph.2025.102901Under-estimated burden of pertussis among middle and older-aged adults: A longitudinal seroepidemiological study in Taiwan during 2014–2020Ming-Han Tsai0Chih-Jung Chen1Lan-Yan Yang2Yu-Bin Pan3Hsiang-Ju Shih4Chyi-Liang Chen5Cheng-Hsun Chiu6Department of Pediatrics, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan; Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan; Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, TaiwanDivision of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan; Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, TaiwanClinical Trial Center of Taichung Veterans General Hospital, Taichung, TaiwanClinical Trial Center, Chang Gung Memorial Hospital, Taoyuan, TaiwanDepartment of Pediatrics, Chang Gung Memorial Hospital, Keelung Branch, Keelung, TaiwanChang Gung University College of Medicine, Taoyuan, Taiwan; Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, TaiwanDivision of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan; Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Correspondence to: Department of Pediatrics, Chang Gung Children’s Hospital, 5 Fu-Hsin Street, Kweishan 333, Taoyuan, TaiwanBackground: 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.http://www.sciencedirect.com/science/article/pii/S1876034125002503pertussisseroepidemiologyadultsbiobankunderlying diseases |
| spellingShingle | Ming-Han Tsai Chih-Jung Chen Lan-Yan Yang Yu-Bin Pan Hsiang-Ju Shih Chyi-Liang Chen Cheng-Hsun Chiu Under-estimated burden of pertussis among middle and older-aged adults: A longitudinal seroepidemiological study in Taiwan during 2014–2020 Journal of Infection and Public Health pertussis seroepidemiology adults biobank underlying diseases |
| title | Under-estimated burden of pertussis among middle and older-aged adults: A longitudinal seroepidemiological study in Taiwan during 2014–2020 |
| title_full | Under-estimated burden of pertussis among middle and older-aged adults: A longitudinal seroepidemiological study in Taiwan during 2014–2020 |
| title_fullStr | Under-estimated burden of pertussis among middle and older-aged adults: A longitudinal seroepidemiological study in Taiwan during 2014–2020 |
| title_full_unstemmed | Under-estimated burden of pertussis among middle and older-aged adults: A longitudinal seroepidemiological study in Taiwan during 2014–2020 |
| title_short | Under-estimated burden of pertussis among middle and older-aged adults: A longitudinal seroepidemiological study in Taiwan during 2014–2020 |
| title_sort | under estimated burden of pertussis among middle and older aged adults a longitudinal seroepidemiological study in taiwan during 2014 2020 |
| topic | pertussis seroepidemiology adults biobank underlying diseases |
| url | http://www.sciencedirect.com/science/article/pii/S1876034125002503 |
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