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Published on: February 22, 2019
[Pertussis in practice in 2007]
1Consultation, urgences pédiatriques, pathologie infectieuse et tropicale, hôpital d'enfants Armand-Trousseau, 26, avenue du Docteur-Arnold-Netter, 75571 Paris cedex 12, France. emmanuel.grimprel@trs.aphp.fr
Insights
Universal infant pertussis vaccination has shifted disease prevalence to adolescents and adults. Boosting vaccination in older age groups and improving physician diagnosis are crucial for controlling Bordetella pertussis transmission and protecting infants.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Context:
- Universal infant pertussis vaccination has altered disease epidemiology.
- Pertussis (whooping cough) is now frequently observed, though often undiagnosed, in adolescents and adults.
- This contributes to ongoing Bordetella pertussis transmission in France, risking infant exposure.
Purpose:
- To analyze the current epidemiology of pertussis in France.
- To propose strategies for controlling pertussis transmission.
- To highlight the importance of recognizing and treating pertussis in older populations.
Summary:
- Pertussis epidemiology has shifted due to widespread infant vaccination, with increased incidence in adolescents and adults.
- Physician education is needed for early diagnosis of persistent cough in adults and for implementing control measures like antibiotics and revaccination.
- While treatment has limited impact on symptoms, it is effective in reducing transmission, with macrolides being the recommended therapy.
Impact:
- Reinforcing vaccination with late boosters in adolescents and adults is essential.
- Enhanced physician awareness and prompt treatment can curb Bordetella pertussis spread.
- Protecting vulnerable young infants from severe pertussis requires a multi-faceted control strategy.
Abstract:
Universal vaccination of infants against pertussis has transformed the epidemiology of the disease. Pertussis has however become frequent, although not often diagnosed, in adolescents and adults and thus contributes to permanent transmission of Bordetella pertussis in France and contamination of young infants at risk of severe disease. Control of transmission of pertussis in France necessitates reinforcement of vaccination with late boosters in adolescents and adults and, in addition, education of physicians to recognize and treat early cases of pertussis, especially in adolescents and adults with a persistent or chronic cough, and to take appropriate prophylactic measures (antibiotics and recall vaccination) of those in contact with confirmed cases. Effective treatment does little to reduce symptoms but it does reduce transmission. Macrolides are the recommended treatment for pertussis.
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