Pertussis (Whooping Cough)
The global incidence of pertussis is estimated at 48.5 million cases a year with 295,000 deaths [Mattoo 2005]. In the US, pertussis has the greatest incidence and mortality of all vaccine-preventable diseases [Roush 2007].
Pertussis continues to be a public health concern, even in countries with high vaccination coverage [ECDC 2013].
Epidemiology [ECDC 2013]
The incidence of pertussis varies widely in Europe due to differences in vaccination policies, levels of awareness, and surveillance procedures.
There has been an increase in pertussis cases in some countries in the EU (Belgium, France, Germany, the Netherlands and Spain), particularly among older children, adolescents and adults [ECDC 2013]. This may be due to:
Recent Pertussis outbreaks
Pertussis outbreaks (Figure 5) occur even in the presence of excellent paediatric vaccination programmes, and peaks are typically seen every 3–4 years. Recently there was an outbreak in England and Wales in 2011 that continued into 2012 [Health Protection Agency UK]:
Reported cases more than doubled from 2010 to 2011 (421 to 1,040 cases, respectively)
Total cases in 2011 were higher than a typical peak year
There were 665 confirmed cases between January and March 2012
Most of the increase was due to infection in teenagers and adults aged 15-40 years, but also included very young children with highest risk of complications
Hospitalisation and Mortality [WHO European Hospital Morbidity Database, WHO Detailed European Mortality Database]
Hospitalisation and mortality for pertussis are rare in Europe.
Vaccination and Control Strategies
In view of concerns about transmission of pertussis from adults and adolescents to young children, several countries have recommended booster doses
for adolescents (e.g. Austria, France and Germany) and adults (e.g. Austria). In addition, the Global Pertussis Initiative has recommended universal adult
immunisation [Tan 2005]. Success of these strategies depends on:
Pertussis (Whooping Cough): Summary of key points