Prospective pertussis surveillance in Switzerland, 1991–2006

• Published in: Vaccine 2011-03, Vol.29 (11), p.2058-2065
• Main Authors: Wymann, Monica N, Richard, Jean-Luc, Vidondo, Beatriz, Heininger, Ulrich
• Format: Article
• Language: English
• Subjects: Adolescent; adolescents; adults; Age; Age Distribution; Allergy and Immunology; Applied microbiology; asthma; Biological and medical sciences; Bordetella pertussis; bronchitis; Child; Child, Preschool; cough; Disease Notification; Family physicians; Fundamental and applied biological sciences. Psychology; general practitioners; Humans; Immunization; Incidence; Infant; Microbiology; monitoring; otitis media; patients; pediatricians; Pediatrics; Pertussis; Pertussis Vaccine - administration & dosage; pneumonia; polymerase chain reaction; Public health; Sentinel Surveillance; Sentinel surveillance system; Switzerland; Switzerland - epidemiology; Vaccination status; Vaccines; Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies (general aspects); vomiting; Whooping cough; Whooping Cough - epidemiology; Whooping Cough - prevention & control; Young Adult
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/j.vaccine.2011.01.017

Pertussis has been monitored in Switzerland since 1991 by the nationwide Swiss Sentinel Surveillance Network (SSSN), consisting of approximately 200 general practitioners, internists and pediatricians representing about 3% of the total primary care physicians of these specialities. SSSN members report patients with cough ≥14 days plus either an epidemiological link or characteristic symptoms (paroxysms, whoop, post-tussive vomiting) on a weekly basis to the Federal Office of Public Health. Confirmatory PCR from nasopharyngeal specimens is offered for free. A total of 4992 cases have been reported until 2006. Yearly incidence has dropped from 70 cases per 100,000 inhabitants in 1992 to 40 in 2006, with a single epidemic in 1994–1995 with 280–370 cases/100,000. On average 80% of reported cases were tested by PCR, 24% of these were confirmed as Bordetella pertussis infections. For 2.6% of patients complications were reported, most commonly pneumonia, asthma bronchiale, otitis media, bronchitis and rib fractures. On average, 1.5% of patients were hospitalized. Disease in vaccinated patients was mitigated with less frequent complications (unvaccinated: 5.1%; 3 doses: 3.0%; ≥4 doses: 1.7%), hospitalizations (unvaccinated: 3.6%; ≥1 dose: 1.1%) and various clinical symptoms compared to unvaccinated patients. Comparing the periods 1991–1996, 1997–2001 and 2002–2006, a shift of pertussis from age group 1–9 years to 10–19 and ≥40 years was observed among patients cared for by general practitioners and internists. The benefits of further booster doses in adolescents and/or adults need to be considered.