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June 2022

Global spatial dynamics and vaccine-induced fitness changes of Bordetella pertussis


Noémie Lefrancq 1 2Valérie Bouchez 3 4Nadia Fernandes 3Alex-Mikael Barkoff 5Thijs Bosch 6Tine Dalby 7Thomas Åkerlund 8Jessica Darenberg 8Katerina Fabianova 9Didrik F Vestrheim 10Norman K Fry 11 12Juan José González-López 13 14Karolina Gullsby 15Adele Habington 16Qiushui He 5 17David Litt 11Helena Martini 18Denis Piérard 18Paola Stefanelli 19Marc Stegger 7Jana Zavadilova 20Nathalie Armatys 3 4Annie Landier 3 4Sophie Guillot 3 4Samuel L Hong 21Philippe Lemey 21Julian Parkhill 22Julie Toubiana 3 4 23Simon Cauchemez 1Henrik Salje 1 2Sylvain Brisse 3 4

Sci Transl Med. 2022 Apr 27;14(642):eabn3253. doi: 10.1126/scitranslmed.abn3253. Epub 2022 Apr 27


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.