Superbug fears for whooping cough

UNSW Sydney researchers are calling for a new whooping cough vaccine in the face of a rise of evolving strains that can evade vaccine-generated immunity. The bacteria of the highly contagious respiratory disease are becoming better at colonising hosts, whether they have been vaccinated or not.

Australia’s whooping cough epidemic from 2008 to 2012 saw more than 140,000 cases, with a peak of almost 40,000 in 2011. The current vaccine, widely used since 2000, targets three antigens in the bacteria, but UNSW research demonstrates that a new vaccine is needed to protect vulnerable members of the community from the emergence of superbug strains.

In a series of UNSW studies, with the latest published in Vaccine, researchers found that the evolving strains made additional changes to better survive in their host, regardless of that person’s vaccination status. They also identified new antigens as potential vaccine targets.

First author and microbiologist Dr Laurence Luu, who led the team of researchers with Professor Ruiting Lan, said whooping cough’s ability to adapt to vaccines and survival in humans might be the answer to its surprise resurgence despite Australia’s high vaccination rates.

“We found the whooping cough strains were evolving to improve their survival, regardless of whether a person was vaccinated or not, by producing more nutrient-binding and transport proteins, and fewer immunogenic proteins which are not targeted by the vaccine,” Dr Luu said.

“This allows whooping cough bacteria to more efficiently scavenge nutrients from the host during infection, as well as to evade the body’s natural immune system because the bacteria are making fewer proteins that our body recognises.

“Put simply, the bacteria that cause whooping cough are becoming better at hiding and better at feeding — they’re morphing into a superbug.”

Dr Luu said it was possible for a vaccinated person to contract whooping cough bacteria without symptoms materialising.

“So, the bacteria might still colonise you and survive without causing the disease — you probably wouldn’t know you’ve been infected with the whooping cough bacteria because you don’t get the symptoms,” he said.

“Another issue with the vaccine is that immunity wanes quickly — so, we do need a new vaccine that can better protect against the evolving strains, stop the transmission of the disease and provide longer lasting immunity.”

Professor Lan said that although he would like to see a new vaccine developed and introduced in the next five to 10 years, the research team’s important discovery did not render Australia’s whooping cough vaccine redundant.

“It is critical that people are vaccinated to prevent the spread of whooping cough — the current vaccine is still effective for protecting against the disease — but new vaccines need to be developed in the long term,” Professor Lan said.

“We need more research to better understand the biology of the whooping cough bacteria, how they cause disease and what proteins are essential for the bacteria to cause infection, so that we can target these proteins in a new and improved vaccine.

“This will all help to futureproof new vaccines against the evolving whooping cough strains.”

Dr Luu agreed it was crucial that Australia maintained its high vaccination coverage for whooping cough.

“Although the number of whooping cough cases has increased during the past decade, it’s still nowhere near as high as what it was before the introduction of whooping cough vaccines,” Dr Luu said.

“Therefore, we emphasise that Australia must maintain its high vaccination coverage to protect vulnerable newborns who are not protected by maternal immunity and cannot complete the three-dose primary vaccine course until they are six months old.

“So, vaccination is especially important for children, people who are in contact with children and pregnant women who need the vaccine to produce antibodies to protect their newborns from developing whooping cough in the first few weeks of life.”

In addition to babies under six months having a high risk of catching the disease, the elderly, people living with someone who has whooping cough and people who have not had a booster in the past 10 years are also at risk.

Image credit: ©stock.adobe.com/au/Kateryna_Kon