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Pertussis surveillance and control: exploring variations and delays in testing, laboratory diagnostics and public

Jeanne Heil1,2, Henriëtte L G Ter Waarbeek1,2, Christian J P A Hoebe1,2

  • 1Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, Geleen, the Netherlands.

Euro Surveillance : Bulletin Europeen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin
|July 28, 2017
PubMed

Insights

Pertussis surveillance in the Netherlands shows significant under-notification and delays, impacting infant protection. Improving diagnostic accuracy and notification systems is crucial for effective pertussis control.

Area of Science:

  • Public Health
  • Epidemiology
  • Infectious Disease Surveillance

Background:

  • Pertussis (whooping cough) poses a severe risk to unvaccinated infants, causing mortality in the Netherlands.
  • Pertussis surveillance data informs control measures to mitigate infant illness and death.
  • Accurate surveillance is essential, but healthcare and public health factors can impede its effectiveness.

Purpose of the Study:

  • To assess the accuracy of pertussis surveillance in the Netherlands.
  • To identify factors hindering effective pertussis control measures.
  • To provide recommendations for improving pertussis surveillance and public health interventions.

Main Methods:

  • Analysis of laboratory databases and public health notifications from a Dutch region (2010-2013).
  • Inclusion of 12,090 pertussis tests in the study.
  • Evaluation of diagnostic accuracy, notification rates, and reporting delays.

Main Results:

  • Identified potential misdiagnoses in pertussis testing.
  • Revealed substantial under-notification, with 18% of laboratory-confirmed cases not reported.
  • Documented a significant delay (median 34 days) between symptom onset and public health notification.

Conclusions:

  • Pertussis surveillance data in the Netherlands may be inaccurate due to misdiagnosis, under-notification, and delays.
  • These surveillance limitations are likely generalizable to other European countries.
  • Recommendations include improved adherence to testing guidelines, standardized interpretation, automated notifications, and earlier interventions, alongside preventive measures like maternal immunization.

Keywords:
Pertussisgeneral practitionersinfectious disease controllaboratorysurveillancevaccine-preventable disease

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