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Published on: February 22, 2019
[Whooping cough in the first year of life in a region with high vaccination coverage]
H Aristimuño1, O Muga, G Cilla
1Servicio de Pediatría, Hospital Universitario Donostia-Instituto BioDonostia, San Sebastián, Guipúzcoa, España. HENAR.ARISTIMUNOURDAMPILLETA@osakidetza.net
Insights
Infants under 6 months remain at high risk for severe pertussis (whooping cough) despite high vaccination rates. This study highlights the need for enhanced infant pertussis prevention strategies.
Area of Science:
- Pediatric Infectious Diseases
- Vaccinology
- Microbiology
Context:
- Pertussis (whooping cough) continues to occur in vaccinated populations.
- Infants are particularly vulnerable to severe pertussis complications.
- High pediatric vaccination coverage exists in the studied region.
Purpose:
- To assess the impact of pertussis infection on infants in a highly vaccinated region.
- To analyze the characteristics and outcomes of pertussis cases in young children.
Summary:
- A retrospective study analyzed 54 microbiologically confirmed pertussis cases (1999-2008).
- 61.1% of cases were in infants under 3 months; 55% had received no vaccine doses.
- 72% required hospitalization, 31.5% needed pediatric intensive care, and one infant died.
Impact:
- Infants under 6 months are at significant risk for severe pertussis, even with high vaccination coverage.
- Current vaccination schedules may not fully protect the youngest infants.
- New strategies are needed to improve pertussis prevention in vulnerable infant populations.
Introduction:
Despite vaccination, reports of cases and outbreaks of pertussis (whooping cough) continue to appear sporadically, sometimes in young children who are at higher risk of severe disease. The aim of the present study was to evaluate the impact of this infection in infants in a region with high vaccination coverage in the pediatric population.
Patients And Methods:
We performed a retrospective observational chart-review study of pertussis cases occurring over a decade (1999-2008), microbiologically confirmed through a polymerase chain reaction technique that amplifies the IS481 Bordetella pertussis sequence.
Results:
There were 54 confirmed cases, of which 33 (61.1%) occurred in infants aged less than 3 months. Cases were detected in all the study years, with periodic outbreaks (1999, 2004 and 2008). Half of the cases occurred in summer. Due to their young age, 55% of the infants had not received a vaccine dose and only 11% had received the first three doses. Hospitalization was required in 39 cases (72%) and admission to the pediatric intensive care unit in 17 cases (31.5%). One premature infant, with symptoms compatible with malignant pertussis, died at 49 days of life.
Conclusions:
Despite the high pertussis vaccination coverage, infants aged less than 6 months continue to be at risk of severe disease. New preventive strategies are required to further reduce the impact of this infection.
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