title: Epidemiological features of pertussis resurgence based on community populations with high vaccination coverage in China.
abstract: Active symptom surveillance was applied to three selected communities ( 160,147 persons) in Tianjin from 2010 to 2012. We examined 1089 individuals showing pertussis-like symptoms, of which 1022 nasopharyngeal specimens were tested for pertussis by polymerase chain reaction and 802 sera for anti-pertussis toxin antibodies. Of the total cases tested, 113 were confirmed, and their demographic, clinical, and vaccination-related data were collected. The annual incidence was 23.52 cases/100,000 persons among communities, which was 16.22 times that obtained via hospital reports for the same period (P < 0.001). The actual incidence in the 15-69 years age group was most significantly underestimated by hospitals, given that it was 43.08 times that of the reported hospital rate. Among the cases aged <15 years, 84.5% were individuals who had been fully vaccinated. The misdiagnosis rate was as high as 94.69%, and only 5.31% of the confirmed pertussis cases were properly diagnosed as pertussis at their first medical visit. Pertussis incidence in China has been severely underestimated and this was in part due to a high misdiagnosis rate. Adolescents and adults have become new high-risk populations. Future work should focus on reinforcing immunization programmes, especially among adolescents and adults.
authors.affiliation: Tianjin Centers for Disease Control and Prevention,Tianjin,China.
authors.forename: H
authors.initials: H
authors.lastname: Huang
authors.affiliation: Tianjin University of Science and Technology,Tianjin,China.
authors.forename: T
authors.initials: T
authors.lastname: Zhu
authors.affiliation: Tianjin CanSino Biotechnology Inc.,Tianjin,China.
authors.forename: C
authors.initials: C
authors.lastname: Gao
authors.affiliation: Tianjin Centers for Disease Control and Prevention,Tianjin,China.
authors.forename: Z
authors.initials: Z
authors.lastname: Gao
authors.affiliation: Tianjin Centers for Disease Control and Prevention,Tianjin,China.
authors.forename: Y
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Tianjin Centers for Disease Control and Prevention,Tianjin,China.
authors.forename: Y
authors.initials: Y
authors.lastname: Ding
authors.affiliation: Tianjin Centers for Disease Control and Prevention,Tianjin,China.
authors.forename: J
authors.initials: J
authors.lastname: Sun
authors.affiliation: Tianjin Centers for Disease Control and Prevention,Tianjin,China.
authors.forename: L
authors.initials: L
authors.lastname: Guo
authors.affiliation: Tianjin Centers for Disease Control and Prevention,Tianjin,China.
authors.forename: P
authors.initials: P
authors.lastname: Liu
authors.affiliation: Hongqiao Centers for Disease Control and Prevention,Tianjin,China.
authors.forename: D
authors.initials: D
authors.lastname: Chen
authors.affiliation: Hangu Centers for Disease Control and Prevention,Tianjin,China.
authors.forename: L
authors.initials: L
authors.lastname: Wang
authors.affiliation: Beichen Centers for Disease Control and Prevention,Tianjin,China.
authors.forename: S
authors.initials: S
authors.lastname: Wu
authors.affiliation: Tianjin Centers for Disease Control and Prevention,Tianjin,China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D037342:Pertussis Toxin / Q000276:immunology; D016133:Polymerase Chain Reaction; D012621:Seasons; D014611:Vaccination; D014917:Whooping Cough / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D037342:Pertussis Toxin
keywords: Community populations; epidemiological features; high immunization coverage; pertussis resurgence; symptom surveillance