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Abstract

Introduction

PERTINENT is a pilot active surveillance system of infants hospitalised with pertussis in six European Union/European Economic Area countries (37 hospitals, seven sites).

Aim

This observational study aimed to estimate annual pertussis incidence per site from 2016 to 2018 and respective trends between 2017 and 2018. Pertussis cases were described, including their severity.

Methods

We developed a generic protocol and laboratory guidelines to harmonise practices across sites. Cases were hospitalised infants testing positive for by PCR or culture. Sites collected demographic, clinical, laboratory data, vaccination status, and risk/protective factors. We estimated sites’ annual incidences by dividing case numbers by the catchment populations.

Results

From December 2015 to December 2018, we identified 469 cases (247 males; 53%). The median age, birthweight and gestational age were 2.5 months (range: 0–11.6; interquartile range (IQR): 2.5), 3,280 g (range: 700–4,925; IQR: 720) and 39 weeks (range: 25–42; IQR: 2), respectively. Thirty cases (6%) had atypical presentation either with cough or cyanosis only or with absence of pertussis-like symptoms. Of 330 cases with information, 83 (25%) were admitted to intensive care units including five deceased infants too young to be vaccinated. Incidence rate ratios between 2018 and 2017 were 1.43 in Czech Republic (p = 0.468), 0.25 in Catalonia (p = 0.002), 0.71 in France (p = 0.034), 0.14 in Ireland (p = 0.002), 0.63 in Italy (p = 0.053), 0.21 in Navarra (p = 0.148) and zero in Norway.

Conclusions

Incidence appeared to decrease between 2017 and 2018 in all but one site. Enhanced surveillance of hospitalised pertussis in Europe is essential to monitor pertussis epidemiology and disease burden.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2021-01-28
2024-12-21
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References

  1. Yeung KHT, Duclos P, Nelson EAS, Hutubessy RCW. An update of the global burden of pertussis in children younger than 5 years: a modelling study. Lancet Infect Dis. 2017;17(9):974-80.  https://doi.org/10.1016/S1473-3099(17)30390-0  PMID: 28623146 
  2. European Centre for Disease Prevention and Control (ECDC).Pertussis - Annual Epidemiological Report for 2017. Stockholm: ECDC; 2019. Available from: https://www.ecdc.europa.eu/en/publications-data/pertussis-annual-epidemiological-report-2017
  3. Mattoo S, Cherry JD. Molecular pathogenesis, epidemiology, and clinical manifestations of respiratory infections due to Bordetella pertussis and other Bordetella subspecies. Clin Microbiol Rev. 2005;18(2):326-82.  https://doi.org/10.1128/CMR.18.2.326-382.2005  PMID: 15831828 
  4. Vittucci AC, Spuri Vennarucci V, Grandin A, Russo C, Lancella L, Tozzi AE, et al. Pertussis in infants: an underestimated disease. BMC Infect Dis. 2016;16(1):414.  https://doi.org/10.1186/s12879-016-1710-0  PMID: 27528377 
  5. European Centre for Disease Prevention and Control (ECDC). Pertussis - Annual Epidemiological Report 2016. Stockholm: ECDC; 2016. Available from: https://www.ecdc.europa.eu/en/publications-data/pertussis-annual-epidemiological-report-2016-2014-data
  6. World Health Organization (WHO). WHO-UNICEF estimates of DTP3 coverage. Geneva: WHO. [Accessed 21 Nov 2019]. Available from: https://apps.who.int/immunization_monitoring/globalsummary/timeseries/tswucoveragedtp3.html
  7. 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 
  8. 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 
  9. European Centre for Disease Prevention and Control (ECDC). Surveillance systems overview for 2016. Stockholm: ECDC; 2018. Available from: https://www.ecdc.europa.eu/en/publications-data/surveillance-systems-overview-2016
  10. European Commission. Commission Implementing Decision of 8 August 2012. Official Journal of the European Union. Luxembourg: Publications Office of the European Union. 27.9.2012: L 262/1. Available from: https://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2012:262:0001:0057:EN:PDF
  11. European Centre for Disease Prevention and Control (ECDC). Expert consultation on pertussis – Barcelona, 20 November 2012. Stockholm: ECDC; 2014. Available from: https://www.ecdc.europa.eu/sites/default/files/media/en/publications/Publications/pertussis-meeting-2012.pdf
  12. Abu-Raya B, Bettinger JA, Vanderkooi OG, Vaudry W, Halperin SA, Sadarangani M,, et al. Burden of Children Hospitalized With Pertussis in Canada in the Acellular Pertussis Vaccine Era, 1999-2015. J Pediatric Infect Dis Soc. 2020;9(2):118-27.  https://doi.org/10.1093/jpids/piy128  PMID: 30535079 
  13. Tubiana S, Belchior E, Guillot S, Guiso N, Lévy-Bruhl D, Renacoq Participants. Monitoring the Impact of Vaccination on Pertussis in Infants Using an Active Hospital-based Pediatric Surveillance Network: Results from 17 Years’ Experience, 1996-2012, France. Pediatr Infect Dis J. 2015;34(8):814-20.  https://doi.org/10.1097/INF.0000000000000739  PMID: 25955837 
  14. McRae JE, Quinn HE, Saravanos GL, McMinn A, Britton PN, Wood N, et al. Paediatric Active Enhanced Disease Surveillance (PAEDS) annual report 2016: Prospective hospital-based surveillance for serious paediatric conditions. Commun Dis Intell (2018). 2019;43.  https://doi.org/10.33321/cdi.2019.43.5  PMID: 30727704 
  15. Skoff TH, Baumbach J, Cieslak PR. Tracking Pertussis and Evaluating Control Measures through Enhanced Pertussis Surveillance, Emerging Infections Program, United States. Emerg Infect Dis. 2015;21(9):1568-73.  https://doi.org/10.3201/eid2109.150023  PMID: 26291475 
  16. PERTINENT Network. Pertussis enhanced surveillance: Generic Protocol v 1.5. Paris: Epiconcept; 2018. Available from: https://docs.google.com/a/epiconcept.fr/viewer?a=v&pid=sites&srcid=ZXBpY29uY2VwdC5mcnxwZXJ0aW5lbnR8Z3g6MmYxM2FiMTQ3OGM3MTFjYw
  17. Valero-Rello A, Henares D, Acosta L, Jane M, Jordan I, Godoy P, et al. Validation and Implementation of a Diagnostic Algorithm for DNA Detection of Bordetella pertussis, B. parapertussis, and B. holmesii in a Pediatric Referral Hospital in Barcelona, Spain. J Clin Microbiol. 2019;57(1):e01231-18.  https://doi.org/10.1128/JCM.01231-18  PMID: 30404946 
  18. 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 
  19. De Greeff SC, Dekkers ALM, Teunis P, Rahamat-Langendoen JC, Mooi FR, De Melker HE. Seasonal patterns in time series of pertussis. Epidemiol Infect. 2009;137(10):1388-95.  https://doi.org/10.1017/S0950268809002489  PMID: 19327200 
  20. Wang Y, Xu C, Wang Z, Zhang S, Zhu Y, Yuan J. Time series modeling of pertussis incidence in China from 2004 to 2018 with a novel wavelet based SARIMA-NAR hybrid model. PLoS One. 2018;13(12):e0208404.  https://doi.org/10.1371/journal.pone.0208404  PMID: 30586416 
  21. 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 (Text with EEA relevance). Official Journal of the European Union. Luxembourg: Publications Office of the European Union. 6.7.2018:L 170/1. Available from: https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32018D0945&from=EN#page=32
  22. van der Maas NAT, Hoes J, Sanders EAM, de Melker HE. Severe underestimation of pertussis related hospitalizations and deaths in the Netherlands: A capture-recapture analysis. Vaccine. 2017;35(33):4162-6.  https://doi.org/10.1016/j.vaccine.2017.06.037  PMID: 28651837 
  23. Crowcroft NS, Booy R, Harrison T, Spicer L, Britto J, Mok Q, et al. Severe and unrecognised: pertussis in UK infants. Arch Dis Child. 2003;88(9):802-6.  https://doi.org/10.1136/adc.88.9.802  PMID: 12937105 
  24. Godoy P, García-Cenoz M, Toledo D, Carmona G, Caylà JA, Alsedà M, et al. , Transmission of Pertussis in Households Working Group. Factors influencing the spread of pertussis in households: a prospective study, Catalonia and Navarre, Spain, 2012 to 2013. Euro Surveill. 2016;21(45):30393.  https://doi.org/10.2807/1560-7917.ES.2016.21.45.30393  PMID: 27918260 
  25. Skoff TH, Kenyon C, Cocoros N, Liko J, Miller L, Kudish K, et al. Sources of Infant Pertussis Infection in the United States. Pediatrics. 2015;136(4):635-41.  https://doi.org/10.1542/peds.2015-1120  PMID: 26347437 
  26. World Health Organization (WHO). Laboratory Manual for the diagnosis of whooping cough caused by bordetella pertussis/bordetella parapertussis: update 2014. Geneva: WHO; 2014. Available from: https://apps.who.int/iris/handle/10665/127891
  27. Pittet LF, Emonet S, Schrenzel J, Siegrist C-A, Posfay-Barbe KM. Bordetella holmesii: an under-recognised Bordetella species. Lancet Infect Dis. 2014;14(6):510-9.  https://doi.org/10.1016/S1473-3099(14)70021-0  PMID: 24721229 
  28. Liko J, Robison SG, Cieslak PR. Do Pertussis Vaccines Protect Against Bordetella parapertussis? Clin Infect Dis. 2017;64(12):1795-7.  https://doi.org/10.1093/cid/cix221  PMID: 28369240 
Incidence and severity of pertussis hospitalisations in infants aged less than 1 year in 37 hospitals of six EU/EEA countries, results of PERTINENT sentinel pilot surveillance system, December 2015 to December 2018
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Lore+Merdrignac&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Merdrignac Lore</a>, <a href="/search?value1=Fatima+A%C3%AFt+El+Belghiti&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Aït El Belghiti Fatima</a>, <a href="/search?value1=Elisabetta+Pandolfi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pandolfi Elisabetta</a>, <a href="/search?value1=Mireia+Jan%C3%A9&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jané Mireia</a>, <a href="/search?value1=Jane+Murphy&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Murphy Jane</a>, <a href="/search?value1=Kate%C5%99ina++Fabi%C3%A1nov%C3%A1&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fabiánová Kateřina </a>, <a href="/search?value1=Manuel+Garc%C3%ADa+Cenoz&option1=author&noRedirect=true" class="nonDisambigAuthorLink">García Cenoz Manuel</a>, <a href="/search?value1=Elmira+Flem&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Flem Elmira</a>, <a href="/search?value1=Sophie+Guillot&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Guillot Sophie</a>, <a href="/search?value1=Alberto+E+Tozzi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Tozzi Alberto E</a>, <a href="/search?value1=Gloria+Carmona&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Carmona Gloria</a>, <a href="/search?value1=Adele+Habington&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Habington Adele</a>, <a href="/search?value1=Jana+Zavadilov%C3%A1&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Zavadilová Jana</a>, <a href="/search?value1=Ana+Navasu%C3%A9s&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Navasués Ana</a>, <a href="/search?value1=H%C3%A5kon+B%C3%B8%C3%A5s&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bøås Håkon</a>, <a href="/search?value1=Daniel+L%C3%A9vy-Br%C3%BChl&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lévy-Brühl Daniel</a>, <a href="/search?value1=Beatrice+Ferretti&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ferretti Beatrice</a>, <a href="/search?value1=Miguel+Lanaspa&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lanaspa Miguel</a>, <a href="/search?value1=Niam+O%E2%80%99Sullivan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">O’Sullivan Niam</a>, <a href="/search?value1=Pavla+K%C5%99%C3%AD%C5%BEov%C3%A1&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Křížová Pavla</a>, <a href="/search?value1=Leticia+Fernandino&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fernandino Leticia</a>, <a href="/search?value1=Terese+Bekkevold&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bekkevold Terese</a>, <a href="/search?value1=Thomas+Hanslik&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hanslik Thomas</a>, <a href="/search?value1=Carmen+Mu%C3%B1oz-Almagro&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Muñoz-Almagro Carmen</a>, <a href="/search?value1=Sabrina+Bacci&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bacci Sabrina</a>, <a href="/search?value1=Gianfranco+Spiteri&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Spiteri Gianfranco</a>, <a href="/search?value1=Marta+Valenciano&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Valenciano Marta</a>, <a href="/search?value1=Alain+Moren&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Moren Alain</a>, <a href="/search?value1=PERTINENT+Group&option1=author&noRedirect=true" class="nonDisambigAuthorLink">PERTINENT Group</a></span>. Incidence and severity of pertussis hospitalisations in infants aged less than 1 year in 37 hospitals of six EU/EEA countries, results of PERTINENT sentinel pilot surveillance system, December 2015 to December 2018. <a href="/content/ecdc">Euro Surveill.</a> 2021;26(4):pii=1900762. <a href="https://doi.org/10.2807/1560-7917.ES.2021.26.4.1900762" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2021.26.4.1900762</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 19 Dec 2019;&nbsp;&nbsp; <span class="generated">Accepted</span>: 17 Aug 2020 </span> </p>
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