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      Pertussis in the central-west region of Brazil: one decade study

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          Abstract

          In many parts of the world, numerous outbreaks of pertussis have been described despite high vaccination coverage. In this article we report the epidemiological characteristics of pertussis in Brazil using a Surveillance Worksheet. Secondary data of pertussis case investigations reported from January 1999 to December 2008 recorded in the Information System for Notifiable Diseases (SINAN) and the Central Laboratory for Public Health (LACEN-MS) were utilized. The total of 561 suspected cases were reported and 238 (42.4%) of these were confirmed, mainly in children under six months (61.8%) and with incomplete immunization (56.3%). Two outbreaks were detected. Mortality rate ranged from 2.56% to 11.11%. The occurrence of outbreaks and the poor performance of cultures for confirming diagnosis are problems which need to be addressed. High vaccination coverage is certainly a good strategy to reduce the number of cases and to reduce the impact of the disease in children younger than six months.

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          Most cited references29

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          Pertussis vaccines: WHO position paper.

          (2010)
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            Accelerating Control of Pertussis in England and Wales

            Pertussis incidence among infants can be reduced by early completion of the primary vaccination schedule.
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              Pertussis: A Review of Disease Epidemiology Worldwide and in Italy

              Pertussis continues to be a relevant public-health issue. The high coverage rates achieved have decreased the spread of the pathogen, but the waning of immunity implies a relevant role of adolescents and adults in the infective dynamics as they may represent a significant source of infection for unvaccinated or incompletely immunized newborns. The passive surveillance system is affected by many limitations. The underestimation of pertussis in adolescents, young adults and adults is mainly related to the atypical clinical characteristics of cases and the lack of lab confirmation. The real epidemiological impact of pertussis is not always perceived, anyway, the unavailability of comprehensive data should not hamper the adoption of active prophylactic interventions aimed at preventing the impact of waning immunity on pertussis. To avoid an increase of the mean age of acquisition of the infection, a booster dose of low-antigen content combined vaccine should be adopted in adolescents and adults. A decreased risk of infection in newborns can be achieved with the cocoon strategy, although the debate on this aspect is still open and enhanced surveillance and further studies are needed to fine-tune the pertussis prevention strategy.
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                Author and article information

                Contributors
                Journal
                Braz J Infect Dis
                Braz J Infect Dis
                The Brazilian Journal of Infectious Diseases
                Elsevier
                1413-8670
                1678-4391
                22 November 2013
                Mar-Apr 2014
                22 November 2013
                : 18
                : 2
                : 177-180
                Affiliations
                [a ]Hospital Universitário, Universidade Federal do Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil
                [b ]Faculdade de Medicina, Universidade Federal do Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil
                [c ]State Department of Health, Campo Grande, MS, Brazil
                Author notes
                [* ] Corresponding author at: Rua Manoel Laburu, 494, Apto 14, Bairro São Lourenço, CEP 79041-310 Campo Grande, MS, Brazil. angelitadruzian@ 123456yahoo.com.br
                Article
                S1413-8670(13)00276-6
                10.1016/j.bjid.2013.08.006
                9427500
                24275370
                9a181e5b-445d-4d8a-82e9-612dc0b7b042
                © 2013 Elsevier Editora Ltda. Este é um artigo Open Access sob a licença de CC BY-NC-ND.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 17 June 2013
                : 15 August 2013
                Categories
                Original Article

                whooping cough,pertussis,epidemiology,bordetella pertussis,outbreak investigation

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