title: Clinical characteristics and pertussis costs in cases reported to epidemiological services and cases detected in household contacts in Catalonia (Spain).
abstract: OBJECTIVE
  To assess the clinical characteristics and direct health costs associated with pertussis cases reported to and confirmed by epidemiological services and cases detected among household contacts in Catalonia (Spain) in 2012-2013.
  
  
  METHODS
  All pertussis cases confirmed by the epidemiological services (n = 641) and all cases detected among the household contacts (n = 422) were included in the study. The chi-square test and odds ratios were used to compare percentages and the t-test was used to compare mean pertussis costs, with p < 0.05 being considered statistically significant.
  
  
  RESULTS
  Cases reported to epidemiological services had a higher percentage of hospitalizations (OR = 32.2, p < 0.001) and severe disease (OR = 27.7, p < 0.001) than cases detected among the household contacts. The total health costs associated with pertussis cases were €871,648, €799,704 (92 %) for cases reported to epidemiological services and €71,944 (8 %) for cases detected among the household contacts. Total treatment, detection, and quimiprophylaxis costs were € 809,702, € 44,312, and € 17,635, representing 92.5 %, 5.5 %, and 2 % of total pertussis costs respectively. The mean costs were significantly higher (p < 0.001) in cases reported to epidemiological services than in cases detected among the household contacts, for all cases (€1248 vs €170), and for severe (€4546 vs €1073), moderate (€204 vs €165), and mild (€153 vs €133) disease.
  
  
  CONCLUSIONS
  The burden of pertussis in Catalonia was high in terms of health costs, especially in infants aged less than 1 year. Active epidemiological surveillance activities could prevent pertussis transmisison and reduce pertussis costs.
authors.affiliation: Department of Health of Catalonia, Public Health Agency of Catalonia, Roc Boronat 83-95, 08005, Barcelona, Spain. pedro.plans@gencat.cat.|CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain. pedro.plans@gencat.cat.
authors.forename: P
authors.initials: P
authors.lastname: Plans
authors.affiliation: Sant Joan de Deu Hospital, Instituto de Salud Carlos III, Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Muñoz-Almagro
authors.affiliation: Department of Health of Catalonia, Public Health Agency of Catalonia, Roc Boronat 83-95, 08005, Barcelona, Spain.|CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Godoy
authors.affiliation: Department of Health of Catalonia, Public Health Agency of Catalonia, Roc Boronat 83-95, 08005, Barcelona, Spain.|CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Jané
authors.affiliation: Department of Health of Catalonia, Public Health Agency of Catalonia, Roc Boronat 83-95, 08005, Barcelona, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Carmona
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines / Q000008:administration & dosage / Q000276:immunology; D062665:Epidemiological Monitoring; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014917:Whooping Cough / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines