National study of infants hospitalized with pertussis in the acellular vaccine era

Abstract

Despite universal vaccination with DTPa in Australia, pertussis remains an important cause of hospitalization, morbidity and death in infants, most of whom were too young to be vaccinated or had missed vaccinations. The most common source of infection was a parent. Strategies to improve pertussis control in countries with high DTPa coverage could include adult-formulated booster pertussis vaccines for adolescents and recent parents and/or accelerated pertussis vaccine schedules for infants.

Surveillance of hospitalized and outpatient cases of pertussis in Catalonia from 2003 to 2009

“…Of outpatient cases, 52.5% were correctly vaccinated, suggesting that vaccination confers protection against hospitalization, as found by other studies, 15 and it is also supported by the results obtained in the Mantel Heanszel test considering vaccinated and non-vaccinated cases in hospitalized and outpatient cases.…”

“…As found by other studies, incidence rate in hospitalized cases aged < 1 y was higher than incidence rate in other age groups, 15,[18][19][20] reflecting the fact that clinical symptoms are more severe in infants than in young people and adults, who require fewer hospitalizations. The clinical symptoms and the severity of cases may also justify the differences in the reporting delay between hospitalized and outpatient cases.…”

“…However, the incidence of pertussis has increased in recent years, both in Catalonia and other countries. [10][11][12][13] The rate of hospitalized cases < 1 y was 39 per 100,000 persons/y, compared with the 196 per 100,000 persons/y found by Somerville et al 14 or the 56 per 100,000 persons/y found by Elliot et al 15 In our study, 38.7% of hospitalized cases were correctly vaccinated, compared with the 66% found in an Australian study, 15 although another Australian study in New South Wales found that only 3% of hospitalized cases were correctly vaccinated, 16 and a German study found a rate of 4.5%. 17 A higher percentage of unvaccinated cases than vaccinated cases may be expected to be found in hospitalized cases, as vaccination should prevent both infection and the severity of cases.…”

“…An Australian study found that vaccination prevented 37 cases of hospitalization 15 and that there was no difference in the notification of cases between cellular and acellular vaccines.…”

Vacina acelular contra pertússis para adolescentes

“…[31][32][33] As in other countries, in Brazil the positivity of the culture for B. pertussis or the polymerase chain reaction (PCR) has been shown in the family members of children with proven diagnoses. 34 In a study conducted in Germany, the attack rate among unvaccinated children between six and 47 months of age was 69% (110 cases of pertussis among 160 contacts) and 31% in adults (76 cases among 264 contacts).…”