Tweet
Pertussis -Multistate (EU) - Monitoring European outbreaks (ECDC/CDTR, September 10 2013, extract)
[Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Extract.]
COMMUNICABLE DISEASE THREATS REPORT
Week 36, 1-7 September 2013
(...)
Pertussis -Multistate (EU) - Monitoring European outbreaks
Opening date: 11 July 2013 Latest update: 5 September 2013
Epidemiological summary
Over the last 20 years, the epidemiology of the disease has changed remarkably. There has been a shift observed from mainly paediatric cases (normally children <10 years of age) towards adolescents, adults and children too young to have been vaccinated or to have completed the primary series. Since 2011, increases in the number of pertussis cases have been repeatedly reported in different regions of the world, even in those with sustained high vaccination coverage. In the countries of the European Union/European Economic Area (EU/EEA), the situation is evolving similarly with many countries observing an increment in cases, mostly in very young infants, adolescents and adults. Pertussis P3 serotypes emerged globally after 1988, and now predominate in many EU/EEA countries. They produce more pertussis toxin (Ptx) which appears to suppress immunity and reduce the duration of immunity among vaccinated or naturally infected individuals. There is evidence that duration of immunity induced by the current DTaP vaccine may be shorter than that induced by the previous DTwP vaccine. Case-based pertussis data is reported to TESSy annually.
In the UK:
Outbreaks were reported in schools and hospitals in the first few months of 2011, with an initial marked increase in cases among teenagers and adults >35 years of age from the third quarter of the year. These increases continued in 2012 and spread to all age groups including vulnerable infants <3 months of age. In October 2012, >1,500 laboratory-confirmed pertussis cases occurred in England and Wales. Temporary vaccination of pregnant women against pertussis was introduced in October 2012 in order to protect infants < 3months through maternal antibodies.
In the UK there were 1 633 laboratory-confirmed cases of pertussis reported to Public Health England in the first quarter of 2013, from January to March. This was a 53% decrease in the number of cases reported in the previous quarter (3 481 in October to December 2012). The number of cases reported in the first quarter of 2013 was more than double than the same quarter in the previous year (702 cases between January and March 2012). There were 84 laboratory-confirmed cases reported in Wales which was more than four times higher than the 19 cases reported in the first quarter of 2012 and almost half of the 158 cases reported in the fourth quarter of 2012.
According to Health Protection Scotland, a high incidence of pertussis has continued during the first 24 weeks of 2013: 772 notifications in the first 24 weeks of 2013 compared with 655 during the same period in 2012. In the first 24 weeks of 2013 there have been 842 laboratory-confirmed cases compared with 536 during the same period in 2012. The large increase in both notifications and laboratory reports of B. pertussis in 2012 started in the spring, with lower numbers in the first 12 weeks of 2012, explaining why the total number for the first 24 weeks of 2013 is higher than the same period last year.
Ireland:
137 cases in 2013; in the same time period last year there were 317 cases.
Spain:
1 356 confirmed cases were recorded until June 2013. In the same time period in 2012 there were 1 160 cases.
Finland:
26 cases have been notified in 2013. In the same time period for 2012 there were 392 cases.
Austria:
367 including 99 cases from last month been notified in 2013, the overall number of cases reported in 2012 was 571.
Sweden:
Sweden used DTwP vaccine in the routine vaccination schedule from the 1950s until 1979, when it was suspended. Vaccination recommenced with DTaP vaccine in 1996 with high uptake. Booster doses have been given at 6-8 years and 14-16 years of age since 2007. Sweden reported 95 cases so far in 2013, the overall number of cases for 2012 was 289.
The Netherlands:
A peak in pertussis cases was observed in 1999 and additional peaks occurred approximately every three years since then ? in 2002, 2005, 2008 and 2012.
Croatia:
39 cases reported through TESSy.
Hungary:
Five cases reported.
(?)
ECDC assessment
The surge in pertussis cases reported from Spain is not unexpected considering the re-emergence of pertussis in several EU countries in recent years. Infants are at highest risk of complications and death from pertussis, and immediate interventions should focus on protecting this group. Pertussis is generally under-reported in adults but this population group is the source of infection to young children.
Actions
ECDC closely monitors pertussis transmission in Europe on a monthly basis by analysing the cases reported to the European Surveillance System and through its epidemic intelligence activities.
(?)
-
-------
COMMUNICABLE DISEASE THREATS REPORT
Week 36, 1-7 September 2013
(...)
Pertussis -Multistate (EU) - Monitoring European outbreaks
Opening date: 11 July 2013 Latest update: 5 September 2013
Epidemiological summary
Over the last 20 years, the epidemiology of the disease has changed remarkably. There has been a shift observed from mainly paediatric cases (normally children <10 years of age) towards adolescents, adults and children too young to have been vaccinated or to have completed the primary series. Since 2011, increases in the number of pertussis cases have been repeatedly reported in different regions of the world, even in those with sustained high vaccination coverage. In the countries of the European Union/European Economic Area (EU/EEA), the situation is evolving similarly with many countries observing an increment in cases, mostly in very young infants, adolescents and adults. Pertussis P3 serotypes emerged globally after 1988, and now predominate in many EU/EEA countries. They produce more pertussis toxin (Ptx) which appears to suppress immunity and reduce the duration of immunity among vaccinated or naturally infected individuals. There is evidence that duration of immunity induced by the current DTaP vaccine may be shorter than that induced by the previous DTwP vaccine. Case-based pertussis data is reported to TESSy annually.
In the UK:
Outbreaks were reported in schools and hospitals in the first few months of 2011, with an initial marked increase in cases among teenagers and adults >35 years of age from the third quarter of the year. These increases continued in 2012 and spread to all age groups including vulnerable infants <3 months of age. In October 2012, >1,500 laboratory-confirmed pertussis cases occurred in England and Wales. Temporary vaccination of pregnant women against pertussis was introduced in October 2012 in order to protect infants < 3months through maternal antibodies.
In the UK there were 1 633 laboratory-confirmed cases of pertussis reported to Public Health England in the first quarter of 2013, from January to March. This was a 53% decrease in the number of cases reported in the previous quarter (3 481 in October to December 2012). The number of cases reported in the first quarter of 2013 was more than double than the same quarter in the previous year (702 cases between January and March 2012). There were 84 laboratory-confirmed cases reported in Wales which was more than four times higher than the 19 cases reported in the first quarter of 2012 and almost half of the 158 cases reported in the fourth quarter of 2012.
According to Health Protection Scotland, a high incidence of pertussis has continued during the first 24 weeks of 2013: 772 notifications in the first 24 weeks of 2013 compared with 655 during the same period in 2012. In the first 24 weeks of 2013 there have been 842 laboratory-confirmed cases compared with 536 during the same period in 2012. The large increase in both notifications and laboratory reports of B. pertussis in 2012 started in the spring, with lower numbers in the first 12 weeks of 2012, explaining why the total number for the first 24 weeks of 2013 is higher than the same period last year.
Ireland:
137 cases in 2013; in the same time period last year there were 317 cases.
Spain:
1 356 confirmed cases were recorded until June 2013. In the same time period in 2012 there were 1 160 cases.
Finland:
26 cases have been notified in 2013. In the same time period for 2012 there were 392 cases.
Austria:
367 including 99 cases from last month been notified in 2013, the overall number of cases reported in 2012 was 571.
Sweden:
Sweden used DTwP vaccine in the routine vaccination schedule from the 1950s until 1979, when it was suspended. Vaccination recommenced with DTaP vaccine in 1996 with high uptake. Booster doses have been given at 6-8 years and 14-16 years of age since 2007. Sweden reported 95 cases so far in 2013, the overall number of cases for 2012 was 289.
The Netherlands:
A peak in pertussis cases was observed in 1999 and additional peaks occurred approximately every three years since then ? in 2002, 2005, 2008 and 2012.
Croatia:
39 cases reported through TESSy.
Hungary:
Five cases reported.
(?)
ECDC assessment
The surge in pertussis cases reported from Spain is not unexpected considering the re-emergence of pertussis in several EU countries in recent years. Infants are at highest risk of complications and death from pertussis, and immediate interventions should focus on protecting this group. Pertussis is generally under-reported in adults but this population group is the source of infection to young children.
Actions
ECDC closely monitors pertussis transmission in Europe on a monthly basis by analysing the cases reported to the European Surveillance System and through its epidemic intelligence activities.
(?)
-
-------