Authors
Noémie Lefrancq 1 2, Valérie Bouchez 3 4, Nadia Fernandes 3, Alex-Mikael Barkoff 5, Thijs Bosch 6, Tine Dalby 7, Thomas Åkerlund 8, Jessica Darenberg 8, Katerina Fabianova 9, Didrik F Vestrheim 10, Norman K Fry 11 12, Juan José González-López 13 14, Karolina Gullsby 15, Adele Habington 16, Qiushui He 5 17, David Litt 11, Helena Martini 18, Denis Piérard 18, Paola Stefanelli 19, Marc Stegger 7, Jana Zavadilova 20, Nathalie Armatys 3 4, Annie Landier 3 4, Sophie Guillot 3 4, Samuel L Hong 21, Philippe Lemey 21, Julian Parkhill 22, Julie Toubiana 3 4 23, Simon Cauchemez 1, Henrik Salje 1 2, Sylvain Brisse 3 4
Sci Transl Med. 2022 Apr 27;14(642):eabn3253. doi: 10.1126/scitranslmed.abn3253. Epub 2022 Apr 27
Abstract
As with other pathogens, competitive interactions between Bordetella pertussis strains drive infection risk. Vaccines are thought to perturb strain diversity through shifts in immune pressures; however, this has rarely been measured because of inadequate data and analytical tools. We used 3344 sequences from 23 countries to show that, on average, there are 28.1 transmission chains circulating within a subnational region, with the number of chains strongly associated with host population size. It took 5 to 10 years for B. pertussis to be homogeneously distributed throughout Europe, with the same time frame required for the United States. Increased fitness of pertactin-deficient strains after implementation of acellular vaccines, but reduced fitness otherwise, can explain long-term genotype dynamics. These findings highlight the role of vaccine policy in shifting local diversity of a pathogen that is responsible for 160,000 deaths annually.