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Pertussis in Germany: regional differences in management and vaccination status of hospitalized cases
P Juretzko1, T Fabian-Marx, B Haastert
1Department of Biometrics and Epidemiology of the German Diabetes Research Institute at the Heinrich-Heine-University of Düsseldorf.
Insights
Pertussis hospitalization rates were higher in East Germany compared to West Germany post-reunification. Older children in East Germany showed a higher risk for pertussis, possibly due to differing immunity levels.
Area of Science:
- Pediatrics
- Epidemiology
- Public Health
Background:
- Pertussis (whooping cough) is a highly contagious respiratory infection.
- Vaccination strategies varied between East and West Germany prior to reunification.
- Understanding pertussis epidemiology is crucial for public health interventions.
Purpose of the Study:
- To estimate the incidence of pertussis requiring hospitalization in children under 16.
- To compare pertussis hospitalization rates between East and West Germany.
- To investigate age-specific differences in hospitalized pertussis cases.
Main Methods:
- Active surveillance system used for case ascertainment.
- Data collected from 1997-1998.
- Analysis of hospitalization data and incidence rates per 100,000 person-years.
Main Results:
- A total of 754 pertussis cases resulted in 11,151 hospital inpatient days.
- The incidence of hospitalized pertussis was 2.68/100,000 person-years.
- Significantly higher incidence in East Germany (45% of cases in 6-15 year olds) vs. West Germany (13% in 6-15 year olds).
Conclusions:
- Pertussis hospitalization incidence was higher in East Germany.
- Older children (6-15 years) in East Germany represented a significant proportion of hospitalized cases.
- Differences may stem from varied disease perception, prior immunity from infection, or vaccination history.
Abstract:
The incidence of pertussis requiring hospitalization in children younger than 16 years was estimated by the use of an active surveillance-system. Of special interest were differences between West and East Germany following different vaccination strategies before reunification. In 1997 and 1998, 754 pertussis cases required a total of 11,151 hospital inpatient days. The incidence of hospitalized pertussis was 2.68/100,000 person years and this was significantly higher in East than in West Germany. In East Germany an unusually high percentage of hospitalized cases was found in children aged 6-15 years (45% versus 13% in West Germany). The difference between the regions may be due either to a different perception of the disease or to an increased immunity induced by prior disease or vaccination. In East Germany, pertussis was rare until reunification but it has increased significantly since then. Older children may thus represent a population at risk of pertussis having not had previous exposure to pertussis antigens.