The seroepidemiology of immunoglobulin G antibodies against pertussis toxin and filamentous hemagglutinin in the east of China during the COVID-19 pandemic

ABSTRACT

This study employed sero-epidemiological methods to estimate the incidence of pertussis within a healthy population located in eastern China. The aim was to gain deeper insights into the epidemiological characteristics and burden of pertussis within the country. Blood samples were collected from healthy individuals in Jiangsu Province between June 2019 and December 2022. The levels of IgG antibodies against pertussis toxin (anti-PT) and filamentous hemagglutinin (anti-FHA) in the serum were quantitatively measured using enzyme-linked immunosorbent assay (ELISA). Additionally, pertussis case data reported in Jiangsu Province were collected from the China Information System for Disease Control and Prevention and compared with the results of this study. In 2022, the reported incidence of pertussis stood at 1.0 per 100,000 individuals, marking the highest rate observed in the past two decades. Among 1,909 patients examined, the geometric mean concentration (GMC) of anti-PT IgG antibody was 20.2 (18.5–21.9) IU/ml, while that of anti-FHA IgG antibody was 27.0 (25.4–28.7) IU/ml. The IgG-PT and IgG-FHA seropositivity rate (>20.0 IU/ml) was highest in the 1 ~ 2 y old group and decreased rapidly to the lowest in the 3 ~ 4 y old group and then increased gradually with age. The estimated rate of pertussis infection based on seroprevalence was approximately 25,625‐fold higher than the reported notification rate in the ≥15 year age group. Our findings highlight decreased immunity post-vaccination, stressing the importance of additional booster shots for adolescents and adults to maintain immunity and reduce severe illness. Additionally, they offer vital guidance for policymakers to enhance immunization strategies.

KEYWORDS:

• Pertussis
• seroepidemiology
• immunological response
• vaccination
• anti-PT IgG
• anti-FHA IgG

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Acknowledgments

We would like to thank the participants of the project and the staff of the Centers for Disease Control and Prevention in the six counties for their dedication and contribution to the project.

Disclosure statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Author contributions

All authors participated in the design, implementation, analysis, and/or interpretation of the study. All authors were involved in drafting the manuscript or revising it critically for important intellectual content. All authors provided final approval of the manuscript.

Data availability statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethics approval and consent to participate

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of Jiangsu of the Jiangsu Provincial Center for Disease Control and Prevention (JSJK2019-A004-02). Informed consent was obtained from all subjects involved in the study.

Additional information

Funding

This manuscript was funded by the Jiangsu Health Development Research Center Open Project [grant number JSHD2022043], the Jiangsu Provincial Geriatric Health Research Project [grant number LKM2023005], Suqian Sci&Tech Program [grant number SY202312] and Jiangsu Provincial Health Commission Preventive Medicine and Hematology Prevention Research Project [grant number Ym2023099].