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...

Full description

Saved in:
Bibliographic Details
Main Authors: Ming-Han Tsai, Chih-Jung Chen, Lan-Yan Yang, Yu-Bin Pan, Hsiang-Ju Shih, Chyi-Liang Chen, Cheng-Hsun Chiu
Format: Article
Language:English
Published: Elsevier 2025-11-01
Series:Journal of Infection and Public Health
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1876034125002503
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849387776403832832
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
work_keys_str_mv AT minghantsai underestimatedburdenofpertussisamongmiddleandolderagedadultsalongitudinalseroepidemiologicalstudyintaiwanduring20142020
AT chihjungchen underestimatedburdenofpertussisamongmiddleandolderagedadultsalongitudinalseroepidemiologicalstudyintaiwanduring20142020
AT lanyanyang underestimatedburdenofpertussisamongmiddleandolderagedadultsalongitudinalseroepidemiologicalstudyintaiwanduring20142020
AT yubinpan underestimatedburdenofpertussisamongmiddleandolderagedadultsalongitudinalseroepidemiologicalstudyintaiwanduring20142020
AT hsiangjushih underestimatedburdenofpertussisamongmiddleandolderagedadultsalongitudinalseroepidemiologicalstudyintaiwanduring20142020
AT chyiliangchen underestimatedburdenofpertussisamongmiddleandolderagedadultsalongitudinalseroepidemiologicalstudyintaiwanduring20142020
AT chenghsunchiu underestimatedburdenofpertussisamongmiddleandolderagedadultsalongitudinalseroepidemiologicalstudyintaiwanduring20142020