Abstract
IntroductionPERTINENT is a pilot active surveillance system of infants hospitalised with pertussis in six European Union/European Economic Area countries (37 hospitals, seven sites).AimThis 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.MethodsWe developed a generic protocol and laboratory guidelines to harmonise practices across sites. Cases were hospitalised infants testing positive for Bordetella pertussis 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.ResultsFrom 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.ConclusionsIncidence 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.
Highlights
PERTINENT is a pilot active surveillance systaem of infants hospitalised with pertussis in six European Union/European Economic Area countries (37 hospitals, seven sites)
A total of 469 infants were positive for B. pertussis (23%) including one co-infection with B. pertussis and parapertussis
The generic protocol presented some challenges and efforts by all partners were needed to improve data quality and laboratory procedures but we believe this allowed to pool sites’ data to better describe hospitalised laboratoryconfirmed pertussis cases, as these were recruited using the same criteria across six EU/EEA countries
Summary
PERTINENT is a pilot active surveillance systaem 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. We estimated sites’ annual incidences by dividing case numbers by the catchment populations. Most severe cases of pertussis (whooping cough) occur below 5 years of age. Worldwide, it causes substantial mortality in infants (85,900 estimated deaths in 2014) [1]. Sixty-three percent of cases aged less than 1 year Study sites Czech Republic France. Year of introduction Ages for different doses. Year of introduction No. Participating hospitals and catchment population estimation
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