Circulation of pertussis and poor protection against diphtheria among middle-aged adults in 18 European countries
Guy A. M. Berbers, Pieter G. M. van Gageldonk, Jan van de Kassteele, Ursula Wiedermann, Isabelle Desombere, Tine Dalby, Julie Toubiana, Sotirios Tsiodras, Ildikó Paluska Ferencz, Kathryn Mullan, Algirdas Griškevičius, Tatjana Kolupajeva, Didrik F. Vestrheim, Paula Palminha, Odette Popovici, Lena Wehlin, Tamara Kastrin, Lucia Maďarová, Helen Campbell, Csaba Ködmön, Sabrina Bacci, Alex‐Mikael Barkoff, Qiushui He, the Serosurveillance Study Team, Jeffrey van Vliet, Marjan Bogaard, Elske van Loghem, Fiona van der Klis, Joanna Jasińska, Denis Piérard, Charlotte Sværke Jørgensen, Sylvain Brisse, Vasiliki Rapti, Zsuzsanna Molnár, Deirdre Burke, Vilnele Lipnickiene, Jelena Galajeva, Audun Aase, Sofia Moura, Mihaela Leuștean, Mia Brytting, Marta Grgič Vitek, Mária Avdičová, Gayatri Amirthalingam, Jussi Mertsola
Abstract
Reported incidence of pertussis in the European Union (EU) and the European Economic Area (EEA) varies and may not reflect the real situation, while vaccine-induced protection against diphtheria and tetanus seems sufficient. We aimed to determine the seroprevalence of DTP antibodies in EU/EEA countries within the age groups of 40-49 and 50-59 years. Eighteen countries collected around 500 samples between 2015 and 2018 (N = 10,302) which were analysed for IgG-DTP specific antibodies. The proportion of sera with pertussis toxin antibody levels ≥100 IU/mL, indicative of recent exposure to pertussis was comparable for 13/18 countries, ranging between 2.7-5.8%. For diphtheria the proportion of sera lacking the protective level (<0.1 IU/mL) varied between 22.8-82.0%. For tetanus the protection was sufficient. Here, we report that the seroprevalence of pertussis in these age groups indicates circulation of B. pertussis across EU/EEA while the lack of vaccine-induced seroprotection against diphtheria is of concern and deserves further attention.