Comparison of pertussis surveillance systems in Europe

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Microbiology

Background:

• Pertussis (whooping cough) remains a significant public health concern globally.
• Effective surveillance systems are essential for monitoring pertussis epidemiology and guiding control strategies.
• Variations in surveillance methodologies across countries can hinder accurate disease assessment and international comparisons.

Purpose of the Study:

• To compare pertussis surveillance systems across 16 European countries between 1998 and 2002.
• To identify variations in case definitions, laboratory diagnostic methods, and hospitalization/fatality rates, particularly in infants.
• To provide recommendations for improving pertussis surveillance in Europe.

Main Methods:

• Comparative analysis of national pertussis surveillance systems.
• Data collection on system coverage (general population vs. specific groups).
• Review of case definitions used (e.g., WHO case definition) and laboratory confirmation methods (e.g., PCR).

Main Results:

• Surveillance systems covered the general population in 12 out of 16 countries.
• Ten countries utilized the WHO case definition for pertussis surveillance.
• Laboratory tests were applied in 11 countries, with 8 using PCR for confirmation. Significant variation in hospitalization (33.1-100%) and case fatality (0-21.3 per 1000) rates was observed in children under one year.

Conclusions:

• Significant heterogeneity exists in European pertussis surveillance systems.
• Standardization of the WHO case definition and laboratory diagnostic methods, including PCR, is recommended.
• Integration of data on deaths from alternative sources is crucial for comprehensive pertussis surveillance.