Resurgence of Pertussis in Europe

BACKGROUND: A resurgence of pertussis has been observed in Canada, the United States and Australia since the 1980s, but inconsistent data are currently available for Europe. The objective of this paper is to describe the epidemiology of pertussis in Western European countries to discuss future vaccination strategies. METHODS: The European Community funded a network for the epidemiologic surveillance of measles and pertussis in 1998. Sixteen European countries provided national surveillance data for pertussis for the period 1998-2002 in a standard format. Data were pooled and analyzed to describe incidence rates by age group, seasonality, proportion of hospitalized patients and deaths among notified cases. RESULTS: Children younger than 1 year had the highest incidence during the entire period. Rates in the older than 14 years age group increased by 115% during the study period. Northern countries showed the highest incidence figures in all age groups. Among children younger than 1 year, 70% were admitted into hospital. Children younger than 6 months of age and those not vaccinated were most likely to be hospitalized. Thirty-two deaths were reported, 87% of which were in children younger than 6 months of age. CONCLUSIONS: Pertussis is far from being controlled in Europe. Whereas the incidence in children younger than 1 year was high but remained stable, rates in adults doubled in 5 years.