Epidemiology of pertussis in French hospitals in 1993 and 1994: thirty years after a routine use of vaccination

BACKGROUND.Despite widespread vaccination during 30 years, the hypothesis of a resurgence of pertussis in France has been raised by outbreaks and sporadic case reports. No surveillance data were available after 1985. METHODS.A survey was undertaken in 1993 and 1994 in a pediatric hospital network ab...

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Veröffentlicht in:The Pediatric infectious disease journal 1998-05, Vol.17 (5), p.412-418
Hauptverfasser: BARON, SABINE, NJAMKEPO, ELISABETH, GRIMPREL, EMMANUEL, BEGUE, PIERRE, DESENCLOS, JEAN-CLAUDE, DRUCKER, JACQUES, GUISO, NICOLE
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container_end_page 418
container_issue 5
container_start_page 412
container_title The Pediatric infectious disease journal
container_volume 17
creator BARON, SABINE
NJAMKEPO, ELISABETH
GRIMPREL, EMMANUEL
BEGUE, PIERRE
DESENCLOS, JEAN-CLAUDE
DRUCKER, JACQUES
GUISO, NICOLE
description BACKGROUND.Despite widespread vaccination during 30 years, the hypothesis of a resurgence of pertussis in France has been raised by outbreaks and sporadic case reports. No surveillance data were available after 1985. METHODS.A survey was undertaken in 1993 and 1994 in a pediatric hospital network able to confirm cases; the network (22 hospitals) represents 19.6% of pediatric admissions in France. Case definition included clinical (≥21 days of paroxysmal cough), laboratory-confirmed (culture or serology by immunoblot) or epidemiologically confirmed pertussis (documented contact with a laboratory-confirmed case). The pattern of transmission was studied in the household. Vaccine status was obtained from health records. RESULTS.during a 15-month period 560 cases (316 index cases, 244 household contact cases) were reported; 49% of index cases and 20% of contact cases were confirmed by culture and/or serology. Sixty-five percent of index cases were younger than 1 year of age (the incidence in this age group could be estimated to be 95/100 000) and 66% were hospitalized for a mean duration of 2 weeks. Infection was acquired from parents (34%) and siblings (46%). Seventy-three percent of index cases were unvaccinated. CONCLUSIONS.Although pertussis vaccination coverage is very high in France, the organism is still circulating, affecting, within the pediatric population, mostly non- or incompletely vaccinated infants. These results strongly support the importance of adhering to the immunization schedule and suggest introducing booster dose(s) to prolong vaccine immunity and reduce the exposure to Bordetella pertussis of infants too young to be immunized.
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No surveillance data were available after 1985. METHODS.A survey was undertaken in 1993 and 1994 in a pediatric hospital network able to confirm cases; the network (22 hospitals) represents 19.6% of pediatric admissions in France. Case definition included clinical (≥21 days of paroxysmal cough), laboratory-confirmed (culture or serology by immunoblot) or epidemiologically confirmed pertussis (documented contact with a laboratory-confirmed case). The pattern of transmission was studied in the household. Vaccine status was obtained from health records. RESULTS.during a 15-month period 560 cases (316 index cases, 244 household contact cases) were reported; 49% of index cases and 20% of contact cases were confirmed by culture and/or serology. Sixty-five percent of index cases were younger than 1 year of age (the incidence in this age group could be estimated to be 95/100 000) and 66% were hospitalized for a mean duration of 2 weeks. Infection was acquired from parents (34%) and siblings (46%). Seventy-three percent of index cases were unvaccinated. CONCLUSIONS.Although pertussis vaccination coverage is very high in France, the organism is still circulating, affecting, within the pediatric population, mostly non- or incompletely vaccinated infants. These results strongly support the importance of adhering to the immunization schedule and suggest introducing booster dose(s) to prolong vaccine immunity and reduce the exposure to Bordetella pertussis of infants too young to be immunized.</description><identifier>ISSN: 0891-3668</identifier><identifier>EISSN: 1532-0987</identifier><identifier>DOI: 10.1097/00006454-199805000-00013</identifier><identifier>PMID: 9613656</identifier><identifier>CODEN: PIDJEV</identifier><language>eng</language><publisher>Baltimore, MD: Williams &amp; Wilkins</publisher><subject>Adolescent ; Age Distribution ; Bacterial diseases ; Bacterial diseases of the respiratory system ; Bacterial Vaccines - administration &amp; dosage ; Biological and medical sciences ; Child ; Child, Preschool ; Female ; France - epidemiology ; Hospitals, Pediatric - statistics &amp; numerical data ; Human bacterial diseases ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infectious diseases ; Male ; Medical sciences ; Pertussis Vaccine - administration &amp; dosage ; Statistics, Nonparametric ; Whooping Cough - complications ; Whooping Cough - diagnosis ; Whooping Cough - epidemiology ; Whooping Cough - immunology ; Whooping Cough - microbiology ; Whooping Cough - prevention &amp; control</subject><ispartof>The Pediatric infectious disease journal, 1998-05, Vol.17 (5), p.412-418</ispartof><rights>Williams &amp; Wilkins 1998. 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No surveillance data were available after 1985. METHODS.A survey was undertaken in 1993 and 1994 in a pediatric hospital network able to confirm cases; the network (22 hospitals) represents 19.6% of pediatric admissions in France. Case definition included clinical (≥21 days of paroxysmal cough), laboratory-confirmed (culture or serology by immunoblot) or epidemiologically confirmed pertussis (documented contact with a laboratory-confirmed case). The pattern of transmission was studied in the household. Vaccine status was obtained from health records. RESULTS.during a 15-month period 560 cases (316 index cases, 244 household contact cases) were reported; 49% of index cases and 20% of contact cases were confirmed by culture and/or serology. Sixty-five percent of index cases were younger than 1 year of age (the incidence in this age group could be estimated to be 95/100 000) and 66% were hospitalized for a mean duration of 2 weeks. Infection was acquired from parents (34%) and siblings (46%). Seventy-three percent of index cases were unvaccinated. CONCLUSIONS.Although pertussis vaccination coverage is very high in France, the organism is still circulating, affecting, within the pediatric population, mostly non- or incompletely vaccinated infants. 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dosage</subject><subject>Statistics, Nonparametric</subject><subject>Whooping Cough - complications</subject><subject>Whooping Cough - diagnosis</subject><subject>Whooping Cough - epidemiology</subject><subject>Whooping Cough - immunology</subject><subject>Whooping Cough - microbiology</subject><subject>Whooping Cough - prevention &amp; control</subject><issn>0891-3668</issn><issn>1532-0987</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkk1v3CAQhlGVKt2m_QmVOES5ueXb0FsUbdpIkXppz4jF45rWa1zAifbfh81u9xYFCTEfz8wIXhDClHymxLRfSF1KSNFQYzSR1WvqpvwNWlHJWUOMbs_QimhDG66Ufofe5_ynIlxQco7OjaJcSbVCcT2HDrYhjvH3Dscez5DKknPIOEz4NsHkBzzEPIfixudYncixm7q9Ib7iMoRUdngHLmXs-gIJO5ziUsIEeMmw7_ngvA-TKyFOH9DbvjaCj8fzAv26Xf-8-d7c__h2d3N933hRL9BsWEeIB0Kl70BoBXyjvRGgBZF7n_e8l4Yx1260E95I1poa6RjTimnO-AW6OvSdU_y3QC52G7KHcXQTxCXb1hjKW0NeBakSmlEhK6gPoE8x5wS9nVPYurSzlNi9KPa_KPYkin0WpZZ-Os5YNlvoToVHFWr-8ph32buxT27yIZ8wxgRl3FRMHLDHONZ3zn_H5RGSHcCNZbAvfQn-BFZqoeQ</recordid><startdate>199805</startdate><enddate>199805</enddate><creator>BARON, SABINE</creator><creator>NJAMKEPO, ELISABETH</creator><creator>GRIMPREL, EMMANUEL</creator><creator>BEGUE, PIERRE</creator><creator>DESENCLOS, JEAN-CLAUDE</creator><creator>DRUCKER, JACQUES</creator><creator>GUISO, NICOLE</creator><general>Williams &amp; 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dosage</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>France - epidemiology</topic><topic>Hospitals, Pediatric - statistics &amp; numerical data</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Pertussis Vaccine - administration &amp; dosage</topic><topic>Statistics, Nonparametric</topic><topic>Whooping Cough - complications</topic><topic>Whooping Cough - diagnosis</topic><topic>Whooping Cough - epidemiology</topic><topic>Whooping Cough - immunology</topic><topic>Whooping Cough - microbiology</topic><topic>Whooping Cough - prevention &amp; control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BARON, SABINE</creatorcontrib><creatorcontrib>NJAMKEPO, ELISABETH</creatorcontrib><creatorcontrib>GRIMPREL, EMMANUEL</creatorcontrib><creatorcontrib>BEGUE, PIERRE</creatorcontrib><creatorcontrib>DESENCLOS, JEAN-CLAUDE</creatorcontrib><creatorcontrib>DRUCKER, JACQUES</creatorcontrib><creatorcontrib>GUISO, NICOLE</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><jtitle>The Pediatric infectious disease journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BARON, SABINE</au><au>NJAMKEPO, ELISABETH</au><au>GRIMPREL, EMMANUEL</au><au>BEGUE, PIERRE</au><au>DESENCLOS, JEAN-CLAUDE</au><au>DRUCKER, JACQUES</au><au>GUISO, NICOLE</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Epidemiology of pertussis in French hospitals in 1993 and 1994: thirty years after a routine use of vaccination</atitle><jtitle>The Pediatric infectious disease journal</jtitle><addtitle>Pediatr Infect Dis J</addtitle><date>1998-05</date><risdate>1998</risdate><volume>17</volume><issue>5</issue><spage>412</spage><epage>418</epage><pages>412-418</pages><issn>0891-3668</issn><eissn>1532-0987</eissn><coden>PIDJEV</coden><abstract>BACKGROUND.Despite widespread vaccination during 30 years, the hypothesis of a resurgence of pertussis in France has been raised by outbreaks and sporadic case reports. No surveillance data were available after 1985. METHODS.A survey was undertaken in 1993 and 1994 in a pediatric hospital network able to confirm cases; the network (22 hospitals) represents 19.6% of pediatric admissions in France. Case definition included clinical (≥21 days of paroxysmal cough), laboratory-confirmed (culture or serology by immunoblot) or epidemiologically confirmed pertussis (documented contact with a laboratory-confirmed case). The pattern of transmission was studied in the household. Vaccine status was obtained from health records. RESULTS.during a 15-month period 560 cases (316 index cases, 244 household contact cases) were reported; 49% of index cases and 20% of contact cases were confirmed by culture and/or serology. Sixty-five percent of index cases were younger than 1 year of age (the incidence in this age group could be estimated to be 95/100 000) and 66% were hospitalized for a mean duration of 2 weeks. Infection was acquired from parents (34%) and siblings (46%). Seventy-three percent of index cases were unvaccinated. CONCLUSIONS.Although pertussis vaccination coverage is very high in France, the organism is still circulating, affecting, within the pediatric population, mostly non- or incompletely vaccinated infants. These results strongly support the importance of adhering to the immunization schedule and suggest introducing booster dose(s) to prolong vaccine immunity and reduce the exposure to Bordetella pertussis of infants too young to be immunized.</abstract><cop>Baltimore, MD</cop><cop>Philadelphia, PA</cop><cop>Hagerstown, MD</cop><pub>Williams &amp; Wilkins</pub><pmid>9613656</pmid><doi>10.1097/00006454-199805000-00013</doi><tpages>7</tpages></addata></record>
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subjects Adolescent
Age Distribution
Bacterial diseases
Bacterial diseases of the respiratory system
Bacterial Vaccines - administration & dosage
Biological and medical sciences
Child
Child, Preschool
Female
France - epidemiology
Hospitals, Pediatric - statistics & numerical data
Human bacterial diseases
Humans
Incidence
Infant
Infant, Newborn
Infectious diseases
Male
Medical sciences
Pertussis Vaccine - administration & dosage
Statistics, Nonparametric
Whooping Cough - complications
Whooping Cough - diagnosis
Whooping Cough - epidemiology
Whooping Cough - immunology
Whooping Cough - microbiology
Whooping Cough - prevention & control
title Epidemiology of pertussis in French hospitals in 1993 and 1994: thirty years after a routine use of vaccination
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