title: Comparative Epidemiologic Characteristics of Pertussis in 10 Central and Eastern European Countries, 2000-2013.
abstract: We undertook an epidemiological survey of the annual incidence of pertussis reported from 2000 to 2013 in ten Central and Eastern European countries to ascertain whether increased pertussis reports in some countries share common underlying drivers or whether there are specific features in each country. The annual incidence of pertussis in the participating countries was obtained from relevant government institutions and/or national surveillance systems. We reviewed the changes in the pertussis incidence rates in each country to explore differences and/or similarities between countries in relation to pertussis surveillance; case definitions for detection and confirmation of pertussis; incidence and number of cases of pertussis by year, overall and by age group; population by year, overall and by age group; pertussis immunization schedule and coverage, and switch from whole-cell pertussis vaccines (wP) to acellular pertussis vaccines (aP). There was heterogeneity in the reported annual incidence rates and trends observed across countries. Reported pertussis incidence rates varied considerably, ranging from 0.01 to 96 per 100,000 population, with the highest rates generally reported in Estonia and the lowest in Hungary and Serbia. The greatest burden appears for the most part in infants (<1 year) in Bulgaria, Hungary, Latvia, Romania, and Serbia, but not in the other participating countries where the burden may have shifted to older children, though surveillance of adults may be inappropriate. There was no consistent pattern associated with the switch from wP to aP vaccines on reported pertussis incidence rates. The heterogeneity in reported data may be related to a number of factors including surveillance system characteristics or capabilities, different case definitions, type of pertussis confirmation tests used, public awareness of the disease, as well as real differences in the magnitude of the disease, or a combination of these factors. Our study highlights the need to standardize pertussis detection and confirmation in surveillance programs across Europe, complemented with carefully-designed seroprevalence studies using the same protocols and methodologies.
authors.affiliation: University of Basel Children's Hospital (UKBB), Basel, Switzerland.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Heininger
authors.affiliation: Service d'Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: André
authors.affiliation: Department of Epidemiology, University of Defence, Hradec Kralove, Czech Republic.
authors.forename: Roman
authors.initials: R
authors.lastname: Chlibek
authors.affiliation: Faculty of Public Health, Slovak Medical University, Bratislava, Slovakia.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Kristufkova
authors.affiliation: Estonian Health Board, Tallinn, Estonia.
authors.forename: Kuulo
authors.initials: K
authors.lastname: Kutsar
authors.affiliation: Hospital for Infectious Diseases, Sofia, Bulgaria.
authors.forename: Atanas
authors.initials: A
authors.lastname: Mangarov
authors.affiliation: National Institute of Health Promotion, Paediatric Directorate, Budapest, Hungary.
authors.forename: Zsófia
authors.initials: Z
authors.lastname: Mészner
authors.affiliation: Department of Family Medicine, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Aneta
authors.initials: A
authors.lastname: Nitsch-Osuch
authors.affiliation: Institute for Public Health of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Petrović
authors.affiliation: University Hospital, Hradec Kralove, Czech Republic.
authors.forename: Roman
authors.initials: R
authors.lastname: Prymula
authors.affiliation: Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
authors.forename: Vytautas
authors.initials: V
authors.lastname: Usonis
authors.affiliation: Department of Paediatrics, Riga Stradins University, Riga, Latvia.
authors.forename: Dace
authors.initials: D
authors.lastname: Zavadska
mesh_terms: D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007115:Immunization Schedule; D015994:Incidence; D007223:Infant; D008297:Male; D010567:Pertussis Vaccine / Q000008:administration & dosage / Q000627:therapeutic use*; D011159:Population Surveillance; D014611:Vaccination; D014917:Whooping Cough / Q000453:epidemiology* / Q000517:prevention & control
chemical_list: D010567:Pertussis Vaccine