Resurgence of pertussis in Slovak Republic and surrounding Central European countries

Bordetella pertussis, the pathogen responsible for a highly contagious respiratory disease, utilizes a broad spectrum of virulence factors that results in subacute or chronic cough.We conducted an analysis of pertussis incidence and reported cases in the European region from 2000 to 2024. We analyzed the potential factors contributing to the rise in pertussis incidence despite high vaccination rates.In 2024, the Slovak Republic and surrounding Central European countries (the Czech Republic, Austria, Hungary, Poland, and Ukraine) have seen a significant increase in pertussis incidence. The results of this study suggest that the resurgence of pertussis was likely due to multiple interacting factors including waning immunity in adults, the genomic changes of B. pertussis, the "immune debt" phenomenon following the lifting of COVID-19 restrictions, the lower vaccination rate against pertussis due to refusal to be vaccinated, a shorter duration of protection offered by acellular vaccines, the transmission of B. pertussis from asymptomatic individuals or patients with mild infection to pertussis-susceptible individuals, as well as improved diagnostics and surveillance.Unimmunised or partially immunised infants are at the highest risk of severe pertussis. The most common sources of infection are family members with asymptomatic or mildly symptomatic disease. All patients with chronic cough should be tested for B. pertussis as part of a comprehensive diagnostic evaluation. To protect newborns, booster vaccination of parents, close family contacts and certain healthcare professionals carrying for the youngest children is recommended. This strategy helps to create a protective environment around infants in the period of pertussis resurgence.