TY - JOUR AU - Lam, Connie AU - Octavia, Sophie AU - Ricafort, Lawrence AU - Sintchenko, Vitali AU - Gilbert, Gwendolyn AU - Wood, Nicholas AU - McIntyre, Peter AU - Marshall, Helen AU - Guiso, Nicole AU - Keil, Anthony AU - Lawrence, Andrew AU - Robson, Jenny AU - Hogg, Geoff AU - Lan, Ruiting T1 - Rapid Increase in Pertactin-deficient Bordetella pertussis Isolates, Australia T2 - Emerging Infectious Disease journal PY - 2014 VL - 20 IS - 4 SP - 626 SN - 1080-6059 AB - Acellular vaccines against Bordetella pertussis were introduced in Australia in 1997. By 2000, these vaccines had replaced whole-cell vaccines. During 2008–2012, a large outbreak of pertussis occurred. During this period, 30% (96/320) of B. pertussis isolates did not express the vaccine antigen pertactin (prn). Multiple mechanisms of prn inactivation were documented, including IS481 and IS1002 disruptions, a variation within a homopolymeric tract, and deletion of the prn gene. The mechanism of lack of expression of prn in 16 (17%) isolates could not be determined at the sequence level. These findings suggest that B. pertussis not expressing prn arose independently multiple times since 2008, rather than by expansion of a single prn-negative clone. All but 1 isolate had ptxA1, prn2, and ptxP3, the alleles representative of currently circulating strains in Australia. This pattern is consistent with continuing evolution of B. pertussis in response to vaccine selection pressure. KW - Bordetella pertussis KW - bacteria KW - pertactin KW - evolution KW - vaccine KW - Australia KW - whooping cough KW - outbreaks KW - immunization KW - vaccination DO - 10.3201/eid2004.131478 UR - https://wwwnc.cdc.gov/eid/article/20/4/13-1478_article ER - End of Reference