Prospective pertussis surveillance in Switzerland, 1991-2006.
Pertussis has been monitored in Switzerland since 1991 by the nationwide Swiss Sentinel Surveillance Network (SSSN), consisting of approximately 200 general practitioners, internists and pediatricians representing about 3% of the total primary care physicians of these specialities. SSSN members report patients with cough ≥ 14 days plus either an epidemiological link or characteristic symptoms (paroxysms, whoop, post-tussive vomiting) on a weekly basis to the Federal Office of Public Health. Confirmatory PCR from nasopharyngeal specimens is offered for free. A total of 4992 cases have been reported until 2006. Yearly incidence has dropped from 70 cases per 100,000 inhabitants in 1992 to 40 in 2006, with a single epidemic in 1994-1995 with 280-370 cases/100,000. On average 80% of reported cases were tested by PCR, 24% of these were confirmed as Bordetella pertussis infections. For 2.6% of patients complications were reported, most commonly pneumonia, asthma bronchiale, otitis media, bronchitis and rib fractures. On average, 1.5% of patients were hospitalized. Disease in vaccinated patients was mitigated with less frequent complications (unvaccinated: 5.1%; 3 doses: 3.0%; ≥ 4 doses: 1.7%), hospitalizations (unvaccinated: 3.6%; ≥ 1 dose: 1.1%) and various clinical symptoms compared to unvaccinated patients. Comparing the periods 1991-1996, 1997-2001 and 2002-2006, a shift of pertussis from age group 1-9 years to 10-19 and ≥ 40 years was observed among patients cared for by general practitioners and internists. The benefits of further booster doses in adolescents and/or adults need to be considered.
Federal Office of Public Health, Berne, Switzerland.
Monica N
MN
Wymann
Jean-Luc
JL
Richard
Beatriz
B
Vidondo
Ulrich
U
Heininger
D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D018563:Disease Notification; D006801:Humans; D015994:Incidence; D007223:Infant; D010567:Pertussis Vaccine / Q000008:administration & dosage; D018571:Sentinel Surveillance; D013557:Switzerland / Q000453:epidemiology; D014917:Whooping Cough / Q000453:epidemiology* / Q000517:prevention & control; D055815:Young Adult
D010567:Pertussis Vaccine