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Volume 15, Number 8—August 2009

Research

Bordetella pertussis Strains with Increased Toxin Production Associated with Pertussis Resurgence

Frits R. MooiComments to Author , Inge H.M. van Loo, Marjolein van Gent, Qiushui He, Marieke J. Bart, Kees J. Heuvelman, Sabine C. de Greeff, Dimitri Diavatopoulos, Peter Teunis, Nico Nagelkerke, and Jussi Mertsola
Author affiliations: National Institute for Public Health and the Environment, Bilthoven, the Netherlands (F.R. Mooi, M. van Gent, M.J. Bart, K.J. Heuvelman, S.C. de Greeff, D. Diavatopoulos, P. Teunis); Maastricht University Hospital, Maastricht, the Netherlands (I.H.M. van Loo); National Public Health Institute, Turku, Finland (Q. He); United Arab Emirates University, Al Ain, United Arab Emirates (N. Nagelkerke); University of Turku, Turku (J. Mertsola)

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Table 2

Worldwide frequencies of ptxP1 and ptxP3 during 1935–1990 and 1991–2004*

Region† 1935–1990
1991–2004
ptxP1 ptxP3 Other‡ N ptxP1 ptxP3 Other‡ N
The Netherlands 89 3 8 265 47 53 0 614
Africa 100 0 0 11 100 0 0 7
Asia 100 0 0 12 83 13 3 30
Europe§ 73 0 27 22 46 53 0 577
North America 50 13 38 8 20 80 0 10
South America



0

10
80
10
10
Total 88 3 9 318 47 52 1 1,248

*ptxP, pertussis toxin promoter. Allele frequencies are given in percentages.
†The following countries represented the continents: Africa: Senegal; Asia: Japan and Australia; Europe: Denmark, Finland, France, Germany, Italy, Sweden; North America: USA; South America: Argentina.
‡Nine ptxP alleles were found in low frequencies: ptxP2, ptxP4, ptxP5, ptxP6, ptxP7, ptxP8, ptxP9, ptxP10, and ptxP11.
§Dutch strains were excluded.

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