Epidemiology of Pertussis in an Urban Region of Poland: Time for a Booster for Adolescents and Adults

Department of Family Medicine, Warsaw Medical University, Warsaw, Poland.
Advances in Experimental Medicine and Biology (Impact Factor: 1.96). 01/2013; 755:203-12. DOI: 10.1007/978-94-007-4546-9_26
Source: PubMed


Since the last decades, an increase of reported incidence of pertussis has been observed in many countries, including Poland, despite high vaccination coverage among infants and children. Before the vaccinations era, pertussis was a major cause of morbidity and mortality among infants and young children. Currently, pertussis is increasingly reported in adolescents and adults. The objective of this paper was to present the epidemiology of pertussis in Mazovian region in Poland in years 2005-2009. In this report we analyzed retrospectively the epidemiological data collected by the Sanitary Station in Warsaw, Poland. A total of 1,455 cases of pertussis were reported in the Mazovian region of Poland in the years 2005-2009. The incidence of pertussis ranged from 2.4/100,000 (2006) to 7.9/100,000 (2008). The incidence was the highest in two groups: infants (>1 year of age; from 13.3/100,000 in 2005 to 32.7/100,000 in 2007) and teenagers (age of 10-14 years; from 11.8/100,000 in 2006 to 68.5/100,000 in 2008). The highest proportion of cases was also reported in the 10-14 years age-group (from 26.4% in 2009 to 46.0% in 2008). The number of hospitalizations due to pertussis ranged from 137 (2005) to 46 (2006), while the percentage of cases requiring hospitalization ranged from 37% (2005) to 25% (2007 and 2008). Three hundred ninety two (27%) cases of pertussis were reported among patients with negative or not confirmed history of pertussis vaccination. We conclude that there is an urgent need for booster vaccination against pertussis in adolescents and adults in Poland.

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Available from: Ernest Kuchar, Dec 08, 2014
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    ABSTRACT: We discuss the changing epidemiological situation of pertussis observed in recent years, with a focus on the shift of cases from young children to older age groups, teenagers and adults. Whooping cough may affect healthcare workers who belong to a high-risk group and cause hospital infections. We present a case report of pertussis in a nurse and the recommended prophylactic measures in healthcare workers. The current definition and diagnosis of pertussis is also discussed. The clinical course of pertussis can be significantly alleviated and highly non-specific, with no typical coughing and vomiting in people vaccinated against whooping cough a few years earlier. Pertussis should be considered in the differential diagnosis of cough lasting more than fourteen days. Improvement of the epidemiological situation requires, besides immunization of infants, regular and universal booster immunization for adolescents and adults. Vaccinations for health care workers of neonatal and pediatric wards are recommended in the National Program of Immunization for 2013. It seems that booster vaccination of health care workers with a triple vaccine against diphtheria, tetanus and acellular pertussis (dTpa) of the reduced quantity of antigens, particularly of health workers caring for infants, children and the elderly, may be the most effective way to reduce the risk of pertussis transmission in the health care environment.
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