Evaluation of reported cases of pertussis: epidemiological study in a large city in Spain

Abstract

We retrospectively analysed the incidence rate of reported cases of pertussis in Barcelona during 2009-2012 according to age, sex, type of medical centre and vaccination status. We included 748 confirmed or suspected cases, 613 (82.0 %) of which were confirmed by laboratory testing and the remaining 135 (18.0 %) by epidemiological evidence. The highest reported incidence of pertussis was amongst ,1 year olds [96.1 per 100 000 person-years, 95 % confidence interval (CI): 84.3-109.1]. The majority of confirmed and suspected cases were reported in 2011 and 2012, and the total incidence (confirmed or suspected) was 6.3 (95 % CI: 5.6-6.9) and 4.2 (95 % CI: 3.6-4.7) per 100 000 person-years, respectively. Incidence increased significantly (P50.001) in 2011-2012 compared with 2009. Most confirmed cases occurred in children ,1 year old (87.9 %). Cases were confirmed by real-time (RT)-PCR (87.5 %; 95 % CI: 81.3-87.6) and bacterial culture (13.7 %; 95 % CI: 11.0-17.1). We recommend performing RT-PCR in suspected cases with no epidemiological link to a confirmed case.

Real-Time Polymerase Chain Reaction–Based Detection of Bordetella pertussis in Mexican Infants and Their Contacts: A 3-Year Multicenter Study

“…Other studies also reported that between 30%-50% of the patients had not received any vaccine, whereas others had incomplete schedules. 15,17,23,26,31 Only 14% of our infants with B pertussis detected had a positive culture, which is in accordance with the rates of 12%-19% documented by other authors, 20,23,32 although some other reported positive culture rates <10%, 31 whereas others reported high rates, between 60% and 71%. 16,17 This study was based on the multitarget RT-PCR strategy.…”

“…The rates of paroxysmal cough, posttussive emesis, and inspiratory "whoop" were similar to those reported by other authors. [16][17][18][19][20][21] Cough persisting <14 days was documented in 71.4% of patients, and cough persisting <7 days was found in 40.5%. This finding is relevant because in the clinical evaluation of infants, cough persisting for >2 weeks should not be a criterion for a diagnosis of pertussis.…”

Airborne bioaerosols and their impact on human health

“…A meta-analysis study reported that the average annual risk of developing TB for healthcare workers (across all settings) was three times higher (95% CI 2.43-3.51) than that of the general population (Baussano et al, 2011). Bordetella pertussis, known as the agent of whooping cough (pertussis), is transmitted primarily via droplets (Solano et al, 2014). As a result of the infection, colonization and rapid multiplication of the bacteria may occur on the mucous membranes of the respiratory tract.…”

Epidemiology of pertussis in two Ibero-American countries with different vaccination policies: lessons derived from different surveillance systems

“…A 4-dose schedule is typically used (2, 4, 6 and 18 months), and a booster dose is given between the ages of 4 and 6; this treatment reaches >90% of the population in most regions, but is incomplete in regions with political or geographical barriers, resulting in poor uptake of combination vaccines and low coverage [9, 46]. The situation in Spain is different to that in DR, suggesting a progressive accumulation of susceptible individuals due to waning immunity following years of low incidence [6, 47–49]. …”

“…Reports from several regions in Spain and in some Latin-American countries highlight increased incidence, hospitalization and mortality due to pertussis infection, especially among infants who are too young to be immunized [6–9]. …”