Pertussis is the most poorly controlled bacterial vaccine-preventable disease. Since the early 1980s there has been an increase in reported cases of pertussis. Multiple factors have likely contributed to the increase, including waning immunity, increased recognition, and changes in diagnostic testing and reporting. Of the four combination vaccines used to prevent diphtheria, tetanus, and pertussis, one dose of Tdap should be used to vaccinate preteens as well as teens and adults who have not yet received this booster dose. It is the position of NASN that immunizations, including the Tdap vaccine, are key to primary prevention of diseasefrom infancy through adulthood. The school nurse is in a critical position to create awareness and influence action-related national and state recommendations for the Tdap vaccine.
"In addition, since the early 1980s there has been an increase in reported cases of pertussis , even in countries with a high vaccination coverage rate . Waning immunity conferred by vaccines, increased recognition, changes in diagnostic testing and reporting, and adaptation of the agent to immunity induced by vaccines are some of the factors that may have contributed to this increase . Taken together, it is clear that additional vaccine approaches are needed. "
[Show abstract][Hide abstract] ABSTRACT: This study examined the immunogenic properties of the fusion protein fimbria 2 of Bordetella pertussis (Fim2)—cholera toxin B subunit (CTB) in the intranasal murine model of infection. To this end B. pertussis Fim2 coding sequence was cloned downstream of the cholera toxin B subunit coding sequence. The expression and assembly of the fusion protein into pentameric structures (CTB- Fim2) were evaluated by SDS-PAGE and monosialotetrahexosylgaglioside (GM1-ganglioside) enzyme-linked immunosorbent assay (ELISA). To evaluate the protective capacity of CTB-Fim2, an intraperitoneal or intranasal mouse immunization schedule was performed with 50 𝜇g of CTB-Fim2. Recombinant (rFim2) or purified (BpFim2) Fim2, CTB, and phosphate-buffered saline (PBS) were used as controls. The results showed that mice immunized with BpFim2 or CTB-Fim2 intraperitoneally or intranasally presented a significant reduction in bacterial lung counts compared to control groups (𝑃 < 0.01 or 𝑃 < 0.001, resp.). Moreover, intranasal immunization with CTB-Fim2 induced significant levels of Fim2-specific IgG in serum and bronchoalveolar lavage (BAL) and Fim2-specific IgA in BAL. Analysis of IgG isotypes and cytokines mRNA levels showed that CTB-Fim2 results in a mixed Th1/Th2 (T-helper) response. The data presented here provide support for CTB-Fim2 as a promising recombinant antigen against Bordetella pertussis infection.
BioMed Research International 05/2014; 2014(Article ID 421486). DOI:10.1155/2014/421486 · 2.71 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Vaccination programs reduce the morbidity and mortality of diphtheria, pertussis, and tetanus. Erythema nodosum is a reactive erythema that can be associated with infections, drugs, and many conditions. The new onset of erythema nodosum after receiving vaccination is uncommon.
Combined reduced-antigen content tetanus, diphtheria, and acellular pertussis (Tdap) vaccine-associated erythema nodosum is described and the reports of vaccine-related erythema nodosum are summarized.
The clinical features of a 39-year-old woman who developed erythema nodosum after receiving Tdap vaccine are reported. Using the PubMed database, an extensive literature search was performed on erythema nodosum, vaccine, and vaccination.
Tdap, the most commonly used booster vaccine against tetanus, diphtheria, and pertussis, is well tolerated in all age groups. Local injection-site reactions are the most common adverse events, whereas headache, fatigue, gastrointestinal symptoms, and fever are the most frequent systemic events. Erythema nodosum has not previously been reported in patients who have received Tdap vaccine. The patient developed erythema nodosum within 48 h after receiving Tdap vaccine; her symptoms cleared and nearly all skin lesions resolved within 2 weeks after initiating oral treatment with ibuprofen, fexofenadine, and prednisone. Vaccine-associated erythema nodosum has previously been reported following vaccination for cholera, hepatitis B, human papillomavirus, malaria, rabies, small pox, tuberculosis, and typhoid.
Vaccine-associated erythema nodosum is uncommon. Erythema nodosum occurring after Tdap vaccination is a rare, yet potential, adverse effect.
[Show abstract][Hide abstract] ABSTRACT: Pertussis, also known as whooping cough, has recently re-emerged as a major public health threat despite high levels of vaccination against the aetiological agent Bordetella pertussis. In this Review, we describe the pathogenesis of this disease, with a focus on recent mechanistic insights into B. pertussis virulence-factor function. We also discuss the changing epidemiology of pertussis and the challenges facing vaccine development. Despite decades of research, many aspects of B. pertussis physiology and pathogenesis remain poorly understood. We highlight knowledge gaps that must be addressed to develop improved vaccines and therapeutic strategies.
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