Pertussis epidemiological pattern and disease burden in Brazil: an analysis of national public health surveillance data

Abstract

Objective: We described pertussis epidemiological trends in Brazil between 2010 and 2015. We also assessed tetanus, diphtheria and acellular pertussis (Tdap) vaccine coverage among pregnant women from 2014, the year of the introduction of Tdap maternal immunization recommendation in Brazil, to 2016. Methods: Epidemiological data for incidence, prevalence, hospitalization, mortality, and maternal vaccination coverage were calculated based on the Brazilian public surveillance databases. Results: The epidemiological data analysis results showed that the pertussis average incidence rate (IR) was 2.19/100,000 inhabitants for all ages, with a peak in 2014 (4.03/100,000 inhabitants) and highest incidence in <1-year-old children (IR = 175.20/100,000). 97.6% of pertussis deaths (405/415) were in <1-year-old children.

Clinical and epidemiological features of pertussis in Salvador, Brazil, 2011–2016

“…In this period, important aspects were associated with the occurrence of this disease in Brazil, as reflected in Salvador: an increase of pertussis cases was noted in 2012, with high numbers of reported cases, reaching a peak in 2014. After 2014, reductions in the number of reported cases were seen through 2016 [ 11 , 13 ].…”

“…Some of the main public health challenges have been evidence of waning immunity in current vaccines, lack of compliance with the vaccine schedule and conducting targeted immunization campaigns to protect susceptible populations [9,21]. Also, it is important to note that pertussis epidemiology indicates that epidemic cycles normally occur every 2-5 years in Brazil, similar to what is observed in other countries [2,13]. �� Anemia, atelectasis, bronchiolitis, hypoxia, hypoxemia, pneumothorax, cardiorespiratory arrest or septicemia.…”

“…Despite low immunization coverage in mothers (<60%), the inclusion of the dTap vaccine for pregnant women in 2014 may have contributed to a reduction in the number of pertussis cases during 2015-2016 [13,16]. It is known that a single dose of dTap during pregnancy enhances antibody levels in the mother, which should provide passive protection to her newborn in the first months of life [22,23].…”

“…It is known that a single dose of dTap during pregnancy enhances antibody levels in the mother, which should provide passive protection to her newborn in the first months of life [22,23]. Accordingly, several studies have recommended increased vaccination and immunization monitoring in pregnant women; increased awareness campaigns would serve to make this target population more aware of the benefits that vaccination offers to protect their babies [13,22,23].…”

“…From 2007 to 2014, a total of 80,068 suspected and 24,612 confirmed cases of pertussis were reported in Brazil, with a significant increase in incidence observed between 2012–2014 [ 10 – 12 ]. A peak was observed in 2014 (4.03/100,000 inhabitants), with the highest incidence noted children in their first year of life [ 13 , 14 ].…”