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Volume 15, Number 8—August 2009


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 3

Increases in illness and death caused by pertussis in 2 periods with low and high frequencies of ptxP3 strains in the Netherlands*

Parameter ptxP3 frequency, % Hospitalizations/100,000 Deaths/100,000 Lethality†
1981–1992 1.6 1.38 0.00057 0.00041
1993–2004 54.5 1.95 0.00582 0.00299
Increase 33.1 1.41 (1.34–1.49) 10.21 (1.31–79.11) 7.23 (0.93–56.07)
p value <0.0001 0.0058 0.03

*ptxP, pertussis toxin promoter. Numbers in parentheses are 95% confidence intervals.
†Lethality = no. of deaths / no. of hospitalizations.

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