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Published on: February 20, 2021
Pertussis surveillance results from a French general practitioner network, France, 2017 to 2020
Marion Debin1, Titouan Launay1, Louise Rossignol1,2
1Sorbonne Université, INSERM, Institut Pierre-Louis d'Épidémiologie et de santé publique, Paris, France.
Insights
Pertussis incidence in France was lower in 2020, likely due to COVID-19 measures. Surveillance data indicate a shift towards older age groups and waning immunity post-vaccination.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Background:
- Pertussis surveillance in France traditionally focused on infants and children.
- Limited data existed for adolescents and adults prior to 2017.
- The Sentinelles network was established to address these surveillance gaps.
Purpose of the Study:
- To assess pertussis incidence in France using a general practitioner-based sentinel surveillance system.
- To monitor the age distribution of pertussis cases.
- To evaluate the impact of national vaccination policies on pertussis epidemiology.
Main Methods:
- The Sentinelles network collected weekly data on pertussis cases reported by general practitioners from 2017 to 2020.
- Data included confirmed cases and their demographic characteristics.
- National incidence rates were estimated per 100,000 inhabitants.
Main Results:
- A total of 132 pertussis cases were reported between 2017 and 2020.
- Estimated national incidence rates varied annually, with a significant decrease in 2020.
- The majority of cases (66%) were individuals aged 15 years and older, with a median age of 31.5 years. Women were more affected than men.
- Among vaccinated cases, most had received the recommended doses.
Conclusions:
- Pertussis incidence in France showed a notable decline in 2020, aligning with trends observed for other respiratory illnesses during the COVID-19 pandemic.
- The findings suggest a shift in pertussis morbidity towards older age demographics.
- Evidence points towards a rapid waning of immunity following vaccination, underscoring the need for continued surveillance and potential booster strategies.
Abstract:
IntroductionIn France, three complementary surveillance networks involving hospitals and paediatrician practices currently allow pertussis surveillance among infants (<1 year old) and children (1-12 years old). Data on incidences among adolescents (13-17 years old) and adults (≥ 18 years) are scarce. In 2017, a sentinel surveillance system called Sentinelles network, was implemented among general practitioners (GPs).AimThe purpose of Sentinelles network is to assess pertussis incidence, monitor the cases' age distribution and evaluate the impact of the country's vaccination policy. We present the results from the first 4 years of this surveillance.MethodsGPs of the French Sentinelles network reported weekly numbers of epidemiologically or laboratory-confirmed cases and their characteristics.ResultsA total of 132 cases were reported over 2017-2020. Estimated national incidence rates per 100,000 inhabitants were 17 (95% confidence interval (CI): 12-22) in 2017, 10 (95% CI: 6-14) in 2018, 15 (95% CI: 10-20) in 2019 and three (95% CI: 1-5) in 2020. The incidence rate was significantly lower in 2020 than in 2017-2019. Women were significantly more affected than men (83/132; 63% of women, p = 0.004); 66% (87/132) of cases were aged 15 years or over (median age: 31.5 years; range: 2 months-87 years). Among 37 vaccinated cases with data, 33 had received the recommended number of doses for their age.ConclusionsThese results concur with incidences reported in other European countries, and with studies showing that the incidences of several respiratory diseases decreased in 2020 during the COVID-19 pandemic. The results also suggest a shift of morbidity towards older age groups, and a rapid waning of immunity after vaccination, justifying to continue this surveillance.
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