Whooping cough adapts to increase survival

Researchers say that whooping cough is becoming “smarter” as it evolves, and they are asking for a new vaccine, but for now vaccination is vital, and pharmacists have a key role to play.

Australia needs a new pertussis vaccine to protect vulnerable people from the appearance of “superbacterial” strains, say researchers at the University of New South Wales.

The current vaccine, widely used since 2000, targets three antigens in the highly contagious respiratory disease bacteria that can be fatal to babies.

The researchers observed that all babies under six months (especially newborns who are not protected by maternal immunization) are at risk of infection since at this age they have not completed the three-dose primary vaccine cycle.

They say that a “pertussis epidemic” from 20018 to 2012 saw more than 140,000 cases, reaching its peak in 2011 with almost 40,000 cases, noted the increase in evolving strains of the disease that can evade the immunity generated by the vaccine.

In a series of UNSW studies, with the last one published in Vaccine, UNSW researchers took this knowledge further and demonstrated, in a discovery for the first time in the world, that the evolving strains made additional changes to better survive in their host, regardless of that person’s vaccination status. They also identified new antigens as possible vaccine targets.

The first author and microbiologist, Dr. Laurence Luu, who led the team of researchers with Professor Ruiting Lan, said that the ability of whooping cough to adapt to vaccines and survival in humans could be the answer to its surprising resurgence despite high vaccination rates in Australia.

“We discovered that whooping cough strains were evolving to improve their survival, regardless of whether a person was vaccinated or not, by producing more binding and nutrient transport proteins, and less immunogenic proteins that are not the target of the vaccine.” said Dr. Luu.

“This allows pertussis bacteria to more efficiently eliminate host nutrients during infection, as well as evade the body’s natural immune system because bacteria are producing less protein than our body recognizes.

“In a nutshell, the bacteria that cause whooping cough are becoming better for hiding and for feeding, they are transforming into a superbug.”

Dr. Luu said that, therefore, it was possible for a vaccinated person to contract pertussis bacteria without the symptoms materializing.

“Then, the bacteria could still colonize you and survive without causing the disease; you probably wouldn’t know that you have been infected with whooping cough bacteria because you don’t have the symptoms,” he said.

“Another problem with the vaccine is that immunity decreases rapidly, so we need a new vaccine that can better protect against evolving strains, stop disease transmission and provide more lasting immunity.”

While researchers want to see a new vaccine developed and introduced in the next five to 10 years, Professor Lan said it was “critical” that, for now, Australians get vaccinated with the current product.

“Although the number of cases of pertussis has increased over the past decade, it is still not as high as before the introduction of pertussis vaccines,” said Dr. Luu.

“Therefore, we emphasize that Australia must maintain its high vaccination coverage to protect vulnerable newborns who are not protected by maternal immunity and cannot complete the three-dose primary vaccine cycle until they are six months old .

“Therefore, vaccination is especially important for children, people who are in contact with children and pregnant women who need the vaccine to produce antibodies to protect their newborns from developing pertussis in the first weeks of life.” .

Older people, people living with someone who has pertussis, and anyone who hasn’t had a booster in the last 10 years are at greater risk, said Professor Lan.

Anthony Tassone, president of the Victorian branch of the Pharmacy Guild, told AJP It was very worrying to know about the potential resistance to the pertussis vaccine of the causative bacteria.

“Meanwhile, vaccination with the current vaccine remains our best protection against this life-threatening infection,” said Tassone.

“The community pharmacy has an important role to play in helping to achieve ‘herd immunity’ with trained pharmaceutical immunizers authorized to administer the pertussis vaccine in all states and territories of Australia, with some jurisdictions including: Victoria, Western Australia and Tasmania allow administration to patients from 16 years old

“Collective immunity is a team effort: all trained immunizers in the workforce of health professionals have a role to play and we must provide patients with so many opportunities to safely access vaccination services.”

Tassone also expressed disappointment at the fact that several celebrities have recently been campaigning against vaccination.

“It is irritating to hear that some celebrities continue to publicly defend their misinformed” anti-vaxxer “opinions that are simply dangerous,” he said.

“Instead of the term ‘anti-vaxxer’, I think terms like ‘pro-plague’ or ‘pro-death’ would be much more appropriate given the potentially devastating consequences of some of these preventable diseases, such as what was seen with the recent measles outbreak in Samoa. “

Recent examples include influencer Taylor Winterstein, who is married to rugby league player Frank Winterstein, and who has been campaigning against mandatory vaccination in Samoa, saying that vaccination is the cause of the outbreak.

As of January 7, the death toll from the measles outbreak in that country was 83.

The famous chef Pete Evans also received criticism this week after he promoted the work of prominent vaccination activist Robert F. Kennedy Jr, saying the work was “important.”

These comments provoked the wrath of the RACGP, and the national president, Dr. Harry Nespolon, said newsGP that the movement against vaccination is “intensely frustrating” and undermines some of the advances made by vaccines to improve public health.

“Pete Evans should keep talking about” activated almonds “and leave the vaccines alone,” said Dr. Nespolon.

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