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[Pertussis surveillance in French military forces in 2007]
A Mayet1, F Berger, R Haus-Cheymol
1Service de santé des armées, département d'épidémiologie et de santé publique Nord, école du Val-de-Grâce, Paris, France. aurelie_marie@hotmail.fr
Insights
Pertussis surveillance in the French military identified a high incidence rate, particularly among individuals under 20. This suggests a potential shift in the pertussis (whooping cough) reservoir to young adults.
Area of Science:
- Epidemiology
- Infectious Disease Surveillance
Context:
- Pertussis (whooping cough) surveillance was re-established in the French military in 2007 after a hiatus in general population monitoring.
- Outbreaks among servicepersons prompted the inclusion of pertussis in military health surveillance.
Purpose:
- To report the findings of the first year of pertussis surveillance within the French military.
- To assess the incidence and characteristics of pertussis cases in this population.
Summary:
- In 2007, 56 pertussis cases were confirmed in the French military, with an incidence density rate of 16.3 per 100,000 servicepersons-years.
- Individuals under 20 years old exhibited a 4.6-fold higher risk of developing pertussis.
- Confirmed cases included biologically, clinically, suspected, and epidemiologically confirmed diagnoses.
Impact:
- The findings suggest a potential shift in the pertussis reservoir to young adults, aligning with trends in industrialized nations post-vaccination.
- The military epidemiological network may serve as a valuable marker for adult pertussis surveillance in France.
- Continued surveillance is necessary to validate the observed epidemiological shifts.
Objectives:
Pertussis surveillance in the French general population was stopped in 1986. Pertussis was added to the list of illnesses surveyed by the military epidemiological surveillance network because of outbreaks having occurred among French servicepersons and in military high schools. This study had for aim to report the results of the first year of surveillance.
Design:
Pertussis declaration criteria were those recommended in 2006 by the French council for public hygiene. The data concerning active military servicepersons was collected by physicians of all military medical units. An anonymous declaration form was used for data collection.
Results:
In 2007, 66 cases of pertussis were reported in the military forces, 10 of which were excluded after a negative biological test. The classification of the 56 included cases was: 46% biologically confirmed cases, 20% clinically confirmed cases, 14% suspected cases, and 6% epidemiologically confirmed cases. The incidence density rate was 16.3 cases for 100,000 servicepersons-years. Age under 20 was associated with a 4.6 fold higher risk to develop pertussis.
Conclusions:
The high incidence rate observed in individuals under 20 years of age could reflect a shift of pertussis reservoir to young adults, as observed in industrialized countries after generalization of vaccination programs. However, several years of surveillance will be needed to confirm this hypothesis. Meanwhile, the military epidemiological network could constitute an important surveillance marker of pertussis among adults in France.
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