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Abstract

Background

Routine surveillance systems for pertussis often suffer from under-recognition and under-reporting.

Aim

Our aim was to describe the epidemiology and the clinical features of pertussis in children younger than 1 year in an Italian region, detected through an enhanced hospital surveillance system.

Methods

From 2016 to 2019, we monitored the incidence and the clinical characteristics of hospitalised pertussis cases younger than 1 year in two paediatric hospitals involved in the PERTINENT project.

Results

We detected 141 pertussis cases, corresponding to an estimated incidence of 105.8 per 100.000 in 2016, 91.7 per 100.000 in 2017, 64.5 per 100.000 in 2018 and 40.9 per 100.000 in 2019, based on the hospitals’ catchment area, roughly corresponding to the Lazio region. A total of 101 cases (77.1%) had a household member with cough or other respiratory symptoms. The most frequent combination of symptoms was paroxysmal cough with apnoea in the absence of fever. Almost 40% had been prescribed an antibiotic treatment before hospitalisation, and the median time from symptom onset to contact with the hospital was 8 days. Thirty-one (22.0%) had complications.

Conclusion

An enhanced surveillance system showed a high incidence of pertussis among infants in the Lazio region, where the impact of this disease may still be underestimated. Increasing the coverage of pertussis immunisation among pregnant women and improving the capacity for early detection in primary care may contribute to reducing the impact of pertussis among infants.

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/content/10.2807/1560-7917.ES.2021.26.24.2000562
2021-06-17
2024-11-23
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2021.26.24.2000562
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References

  1. Cherry JD, Wendorf K, Bregman B, Lehman D, Nieves D, Bradley JS, et al. An observational study of severe pertussis in 100 infants ≤120 days of age. Pediatr Infect Dis J. 2018;37(3):202-5. https://doi.org/10.1097/INF.0000000000001710  PMID: 28737623 
  2. World Health Organization. Pertussis vaccines: WHO position paper - September 2015. Wkly Epidemiol Rec. 2015;90(35):433-58. PMID: 26320265 
  3. Halperin BA, Halperin SA. The reemergence of pertussis and infant deaths: is it time to immunize pregnant women? Future Microbiol. 2011;6(4):367-9. https://doi.org/10.2217/fmb.11.15  PMID: 21526936 
  4. Saadatian-Elahi M, Plotkin S, Mills KHG, Halperin SA, McIntyre PB, Picot V, et al. Pertussis: Biology, epidemiology and prevention. Vaccine. 2016;34(48):5819-26.
  5. Heininger U, André P, Chlibek R, Kristufkova Z, Kutsar K, Mangarov A, et al. Comparative epidemiologic characteristics of pertussis in 10 central and eastern European countries, 2000-2013. PLoS One. 2016;11(6):e0155949. https://doi.org/10.1371/journal.pone.0155949  PMID: 27257822 
  6. Tan T, Dalby T, Forsyth K, Halperin SA, Heininger U, Hozbor D, et al. Pertussis across the globe: recent epidemiologic trends from 2000 to 2013. Pediatr Infect Dis J. 2015;34(9):e222-32. https://doi.org/10.1097/INF.0000000000000795  PMID: 26376316 
  7. Jackson DW, Rohani P. Perplexities of pertussis: recent global epidemiological trends and their potential causes. Epidemiol Infect. 2014;142(4):672-84. https://doi.org/10.1017/S0950268812003093 
  8. European Centre for Disease Prevention and Control (ECDC). Pertussis. Annual Epidemiological Report for 2017. Stockholm: ECDC; 2019. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/AER_for_2017-pertussis.pdf
  9. Barkoff A-M, Gröndahl-Yli-Hannuksela K, He Q. Seroprevalence studies of pertussis: what have we learned from different immunized populations. Pathog Dis. 2015;73(7):ftv050. https://doi.org/10.1093/femspd/ftv050  PMID: 26208655 
  10. Chlibek R, Smetana J, Sosovickova R, Fabianova K, Zavadilova J, Dite P, et al. Seroepidemiology of whooping cough in the Czech Republic: estimates of incidence of infection in adults. Public Health. 2017;150:77-83. https://doi.org/10.1016/j.puhe.2017.05.012  PMID: 28646697 
  11. Wood N, McIntyre P. Pertussis: review of epidemiology, diagnosis, management and prevention. Paediatr Respir Rev. 2008;9(3):201-11, quiz 211-2. https://doi.org/10.1016/j.prrv.2008.05.010  PMID: 18694712 
  12. European Commission. Commission implementing decision (EU) 2018/945 of 22 June 2018 on the communicable diseases and related special health issues to be covered by epidemiological surveillance as well as relevant case definitions. Official Journal of the European Union. Luxembourg: Publications Office of the European Union. 6 jul 2018:L 170/1. Available from: https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX%3A32018D0945&from=EN%29
  13. della Salute M. Piano Nazionale per la Prevenzione Vaccinale. [National Vaccine Prevention Plan]. PNPV 2017-2019. Rome: Ministero della Salute; 2017. Italian. Available from: http://www.salute.gov.it/imgs/C_17_pubblicazioni_2571_allegato.pdf
  14. PERTINENT Network. Pertinent Pertussis enhanced surveillance: draft generic protocol v 1.5 Paris: EpiConcept; Jun 2020. Available from: https://sites.google.com/a/epiconcept.fr/pertinent/documentation-and-references/generic-protocol
  15. Kliegman RM, Nelson WE. Nelson textbook of pediatrics. 19th ed. Philadelphia: Elsevier; 2011.
  16. Istituto Nazionale di Statistica (Istat). Demografia in cifre. [Demographics in figures]. Rome: Istat. [Accessed: 6 Apr 2020]. Italian. Available from: http://demo.istat.it
  17. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-4. https://doi.org/10.1001/jama.2013.281053  PMID: 24141714 
  18. Gonfiantini MV, Carloni E, Gesualdo F, Pandolfi E, Agricola E, Rizzuto E, et al. Epidemiology of pertussis in Italy: disease trends over the last century. Euro Surveill. 2014;19(40):20921. https://doi.org/10.2807/1560-7917.ES2014.19.40.20921  PMID: 25323077 
  19. Vaccinazioni dell'età pediatrica anno 2018 (coorte 2016). Ministero della salute; [cited 2020 Apr 6]. Available from: http://www.salute.gov.it/imgs/C_17_tavole_20_allegati_iitemAllegati_0_fileAllegati_itemFile_7_file.pdf
  20. Malattie prevenibili da vaccino - Regione Lazio 2005-2017. Servizio Regionale per l'Epidemiologia, Sorveglianza e controllo delle Malattie Infettive; [cited 2020 Apr 6]. Available from: https://www.inmi.it/wp-content/uploads/2018/12/Malattie-prevenibili-da-vaccino.-Lazio-2005-2017.pdf
  21. Certificato di assistenza al parto (CeDAP) Analisi dell’evento nascita - Anno 2016 Direzione Generale della digitalizzazione, del sistema informativo sanitario e della Statistica Ufficio di Statistica; [cited 2020 Sep 09]. Available from: http://www.salute.gov.it/imgs/C_17_pubblicazioni_2881_allegato.pdf
  22. Byrne L, Campbell H, Andrews N, Ribeiro S, Amirthalingam G. Hospitalisation of preterm infants with pertussis in the context of a maternal vaccination programme in England. Arch Dis Child. 2018;103(3):224-9. https://doi.org/10.1136/archdischild-2016-311802  PMID: 28814424 
  23. Riise ØR, Laake I, Vestrheim D, Flem E, Moster D, Riise Bergsaker MA, et al. Risk of Pertussis in Relation to Degree of Prematurity in Children Less Than 2 Years of Age. Pediatr Infect Dis J. 2017;36(5):e151-6. https://doi.org/10.1097/INF.0000000000001545  PMID: 28403056 
  24. Gonfiantini MV, Villani A, Gesualdo F, Pandolfi E, Agricola E, Bozzola E, et al. Attitude of Italian physicians toward pertussis diagnosis. Hum Vaccin Immunother. 2013;9(7):1485-8. https://doi.org/10.4161/hv.24734  PMID: 23732898 
  25. Dou M, Macias N, Shen F, Bard JD, Domínguez DC, Li X. Rapid and accurate diagnosis of the respiratory disease pertussis on a point-of-care biochip. EClinicalMedicine.2019;8:72-7. https://doi.org/10.1016/j.eclinm.2019.02.008  PMID: 31008450 
  26. Wirsing von Koenig CH. Pertussis: point-of-care testing in the making. EClinicalMedicine.2019;8:4-5. https://doi.org/10.1016/j.eclinm.2019.02.010  PMID: 31193612 
  27. Baxter R, Bartlett J, Fireman B, Lewis E, Klein NP. Effectiveness of vaccination during pregnancy to prevent infant pertussis. Pediatrics. 2017;139(5):e20164091. https://doi.org/10.1542/peds.2016-4091  PMID: 28557752 
  28. Sandmann F, Jit M, Andrews N, et al. Infant hospitalisations and fatalities averted by the maternal pertussis vaccination programme in England, 2012-2017: Post-implementation economic evaluation. Clin Infect Dis. 2020 Feb;ciaa165.
  29. Marchi S, Viviani S, Montomoli E, Trombetta CM. Low prevalence of antibodies against pertussis in pregnant women in Italy. Lancet Infect Dis. 2019;19(7):690. https://doi.org/10.1016/S1473-3099(19)30269-5  PMID: 31250813 
  30. Agricola E, Gesualdo F, Alimenti L, Pandolfi E, Carloni E, D’Ambrosio A, et al. Knowledge attitude and practice toward pertussis vaccination during pregnancy among pregnant and postpartum Italian women. Hum Vaccin Immunother. 2016;12(8):1982-8. https://doi.org/10.1080/21645515.2016.1188242  PMID: 27712242 
  31. D’Alessandro A, Napolitano F, D’Ambrosio A, Angelillo IF. Vaccination knowledge and acceptability among pregnant women in Italy. Hum Vaccin Immunother. 2018;14(7):1573-9. https://doi.org/10.1080/21645515.2018.1483809  PMID: 29863958 
  32. Hoshi SL, Seposo X, Okubo I, Kondo M. Cost-effectiveness analysis of pertussis vaccination during pregnancy in Japan. Vaccine. 2018 16;36(34):5133-40.
  33. American Academy of Pediatrics. Pertussis (Whooping Cough). In: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds. Red Book: 2018 Report of the Committee on Infectious Diseases. American Academy of Pediatrics; 2018; 620-634.
The impact of pertussis in infants: insights from a hospital-based enhanced surveillance system, Lazio region, Italy, 2016 to 2019
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Elisabetta+Pandolfi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pandolfi Elisabetta</a>, <a href="/search?value1=Francesco+Gesualdo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gesualdo Francesco</a>, <a href="/search?value1=Caterina+Rizzo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rizzo Caterina</a>, <a href="/search?value1=Luisa+Russo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Russo Luisa</a>, <a href="/search?value1=Ilaria+Campagna&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Campagna Ilaria</a>, <a href="/search?value1=Emanuela+Carloni&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Carloni Emanuela</a>, <a href="/search?value1=Carlo+Concato&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Concato Carlo</a>, <a href="/search?value1=Giulia+Linardos&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Linardos Giulia</a>, <a href="/search?value1=Alberto+Villani&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Villani Alberto</a>, <a href="/search?value1=Sara+Ciampini&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ciampini Sara</a>, <a href="/search?value1=Antonino+Reale&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Reale Antonino</a>, <a href="/search?value1=Elena+Boccuzzi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Boccuzzi Elena</a>, <a href="/search?value1=Fabio+Midulla&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Midulla Fabio</a>, <a href="/search?value1=Alberto+E+Tozzi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Tozzi Alberto E</a></span>. The impact of pertussis in infants: insights from a hospital-based enhanced surveillance system, Lazio region, Italy, 2016 to 2019. <a href="/content/ecdc">Euro Surveill.</a> 2021;26(24):pii=2000562. <a href="https://doi.org/10.2807/1560-7917.ES.2021.26.24.2000562" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2021.26.24.2000562</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 08 Apr 2020;&nbsp;&nbsp; <span class="generated">Accepted</span>: 25 Sept 2020 </span> </p>
/content/10.2807/1560-7917.ES.2021.26.24.2000562
/content/10.2807/1560-7917.ES.2021.26.24.2000562
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