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Review
. 2012 Dec;9(12):4626-38.
doi: 10.3390/ijerph9124626.

Pertussis: a review of disease epidemiology worldwide and in Italy

Giovanni Gabutti  1 , Maria Cristina Rota
Affiliations
Review

Pertussis: a review of disease epidemiology worldwide and in Italy

Giovanni Gabutti et al. Int J Environ Res Public Health. 2012 Dec.

Abstract

Pertussis continues to be a relevant public-health issue. The high coverage rates achieved have decreased the spread of the pathogen, but the waning of immunity implies a relevant role of adolescents and adults in the infective dynamics as they may represent a significant source of infection for unvaccinated or incompletely immunized newborns. The passive surveillance system is affected by many limitations. The underestimation of pertussis in adolescents, young adults and adults is mainly related to the atypical clinical characteristics of cases and the lack of lab confirmation. The real epidemiological impact of pertussis is not always perceived, anyway, the unavailability of comprehensive data should not hamper the adoption of active prophylactic interventions aimed at preventing the impact of waning immunity on pertussis. To avoid an increase of the mean age of acquisition of the infection, a booster dose of low-antigen content combined vaccine should be adopted in adolescents and adults. A decreased risk of infection in newborns can be achieved with the cocoon strategy, although the debate on this aspect is still open and enhanced surveillance and further studies are needed to fine-tune the pertussis prevention strategy.

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Figures

Figure 1
Figure 1
Pertussis: pre and post-immunization epidemiology related to the immunological pressure exerted by vaccination.
Figure 2
Figure 2
Incidence/100,000 cases of pertussis in Europe, stratified by age, 2009 (modified from EUVAC.NET annual report 2009)
Figure 3
Figure 3
Pertussis: trend of notifications in Italy, 1996–2009 (source Ministry of Health).
Figure 4
Figure 4
Pertussis: number of yearly hospitalizations in Italy, 1999–2009 (source Ministry of Health).
See this image and copyright information in PMC

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