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Asymptomatic transmission and the resurgence of Bordetella pertussis

Overview of attention for article published in BMC Medicine, June 2015
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (99th percentile)

Citations

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148 Mendeley
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Title
Asymptomatic transmission and the resurgence of Bordetella pertussis
Published in
BMC Medicine, June 2015
DOI 10.1186/s12916-015-0382-8
Pubmed ID
Authors

Benjamin M. Althouse, Samuel V. Scarpino

Abstract

The recent increase in whooping cough incidence (primary caused by Bordetella pertussis) presents a challenge to both public health practitioners and scientists trying to understand the mechanisms behind its resurgence. Three main hypotheses have been proposed to explain the resurgence: 1) waning of protective immunity from vaccination or natural infection over time, 2) evolution of B. pertussis to escape protective immunity, and 3) low vaccine coverage. Recent studies have suggested a fourth mechanism: asymptomatic transmission from individuals vaccinated with the currently used acellular B. pertussis vaccines. Using wavelet analyses of B. pertussis incidence in the United States (US) and United Kingdom (UK) and a phylodynamic analysis of 36 clinical B. pertussis isolates from the US, we find evidence in support of asymptomatic transmission of B. pertussis. Next, we examine the clinical, public health, and epidemiological consequences of asymptomatic B. pertussis transmission using a mathematical model. We find that: 1) the timing of changes in age-specific attack rates observed in the US and UK are consistent with asymptomatic transmission; 2) the phylodynamic analysis of the US sequences indicates more genetic diversity in the overall bacterial population than would be suggested by the observed number of infections, a pattern expected with asymptomatic transmission; 3) asymptomatic infections can bias assessments of vaccine efficacy based on observations of B. pertussis-free weeks; 4) asymptomatic transmission can account for the observed increase in B. pertussis incidence; and 5) vaccinating individuals in close contact with infants too young to receive the vaccine ("cocooning" unvaccinated children) may be ineffective. Although a clear role for the previously suggested mechanisms still exists, asymptomatic transmission is the most parsimonious explanation for many of the observations surrounding the resurgence of B. pertussis in the US and UK. These results have important implications for B. pertussis vaccination policy and present a complicated scenario for achieving herd immunity and B. pertussis eradication.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 148 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 <1%
France 1 <1%
Australia 1 <1%
Unknown 145 98%

Demographic breakdown

Readers by professional status Count As %
Researcher 31 21%
Student > Master 26 18%
Student > Ph. D. Student 25 17%
Student > Bachelor 15 10%
Student > Postgraduate 10 7%
Other 26 18%
Unknown 15 10%
Readers by discipline Count As %
Medicine and Dentistry 43 29%
Immunology and Microbiology 24 16%
Agricultural and Biological Sciences 24 16%
Biochemistry, Genetics and Molecular Biology 8 5%
Nursing and Health Professions 7 5%
Other 18 12%
Unknown 24 16%

Attention Score in Context

This research output has an Altmetric Attention Score of 238. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 May 2020.
All research outputs
#65,882
of 15,131,013 outputs
Outputs from BMC Medicine
#65
of 2,342 outputs
Outputs of similar age
#1,122
of 233,837 outputs
Outputs of similar age from BMC Medicine
#1
of 1 outputs
Altmetric has tracked 15,131,013 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,342 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 36.8. This one has done particularly well, scoring higher than 97% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 233,837 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them