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Waning of vaccine-induced immunity has been cited as one of the reasons for the observed epidemiologic trend.

For the first 9 months of 2013 compared with the same period in 2012, the greatest proportionate fall in confirmed cases (328 cases in 2012 vs 72 cases in 2013, −78%, 95% CI −72 to −83) and in hospitalisation admissions (440 admissions in 2012 vs 140 admissions in 2013, −68%, −61 to −74) occurred in infants younger than 3 months, although the incidence remained highest in this age group. De statistiek van de moedersterfte wordt opgesteld op basis van de gegevensbank van de doodsoorzaken. EXISTING evidence suggests that the concentrations of IgG immunoglobulin* in maternal and cord sera are essentially the same. However, one of these studies found fetal cell DNA in multiple regions of the maternal brain, and in one case, decades after the woman had given birth to a son 75, suggesting that fetal microchimerism in the human maternal brain may be pervasive and long‐lasting.

Pasgeborenen en jonge, nog niet of onvoldoende gevaccineerde zuigelingen vormen de belangrijkste risicogroep voor het krijgen van een ernstige kinkhoestinfectie. Neonatal complications including ventilation requirement, sepsis, intraventricular hemorrhage, and neonatal death were also similar. Although the antibody response to a dose of Tdap in healthy nonpregnant women of child-bearing age and postpartum women occurs by day 14 and is suggestive of an anamnestic immune response, it may not be sufficiently rapid to protect infants in the first weeks of life.

Antibody responses to pertussis toxin (PT), filamentous hemagglutinin (FHA), fimbriae 2 + 3 (FIMs), diphtheria, tetanus, Hib, MCC and PCV13 serotypes were compared to responses in a historical cohort of 246 infants born to mothers not vaccinated in pregnancy. Maternal vaccination has long been given for the prevention of tetanus in developing countries, and for the prevention of pertussis and influenza in developed countries, such as the United States, England and Belgium. Serum levels of immunoglobin (Ig) G and IgA against pertussis antigens, serum levels of IgG against diphtheria and tetanus, and breast milk levels of IgA against pertussis antigens were measured at various times after vaccination. These paradoxical effects may be due to the fact that maternal and offspring fitness interests are aligned in certain domains and conflicting in others, which may have led to the evolution of fetal microchimeric phenotypes that can manipulate maternal tissues. Routine use of whole-cell pertussis (wP) vaccines was suspended in some countries in the 1970s and 1980s because of concerns about adverse effects.De minister van Volksgezondheid, Welzijn en Sport (VWS) is voornemens dit advies over te nemen, mits het uitvoerbaar en betaalbaar blijkt te zijn. Presence of fetal cells in the thyroid might also contribute to thyroid cancer risk or susceptibility to other thyroid diseases if these cells are proliferating or producing factors that may induce abnormal thyroid physiology. There were 180 Bordetella infections; 116 (64%) were caused by B pertussis and 64 (36%) by B parapertussis. whereas mothers may be more infectious to their infants than are other household members (estimated relative infectiousness of mothers = 3. Fetal IgA showed a slow linear rise with fetal levels at term remaining approximately 1,000 times lower than the concentration in the maternal circulation.

Two of these injury models report clustering of fetal cells in relation to maternal blood vessels at sites of inflammation, suggesting participation in maternal angiogenesis 17, 40.Fetal cells increase in frequency in the maternal body with increasing gestational age 7, 8 and have been identified in maternal blood and tissues for decades following birth 9, 10. De sinds 2014 waargenomen stijging (3,7 maternale overlijdens in de periode 2012-2016) kan dus in verband worden gebracht met deze wijziging van de definitie, die met name rekening houdt met gevallen van zelfmoord.

This resource transfer may be mutually beneficially for both maternal and offspring fitness interests, or fetal manipulation may push maternal tissues beyond the maternal optimum 2 leading to conflict over resource allocation.The maternal‐fetal dyad is a complex and dynamic system and there may be substantial individual differences with regard to this trajectory. The presence of fetal cells has been associated with both positive and negative effects on maternal health. Offspring interests often favor higher levels of resource transmission than what is optimal for maternal fitness, likely leading to selection on fetal microchimeric cell phenotypes to manipulate maternal tissues to increase the level of resource transfer to offspring. It is generally accepted that the presence of fetal cells in the lung is due to high fetal cell traffic, as the blood from the placenta must first pass through the mother's pulmonary circulation 30, 91. Despite >50 years of universal vaccination, pertussis remains the most prevalent vaccine-preventable infectious disease in developed countries.

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