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Epidemiology of pertussis in industrialised countries |
Cahiers d'études et de recherches francophones / Santé . Volume 4, Number 3, 195-200, Mai-Juin 1994, Aspects épidémiologiques
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 Résumé
Article gratuit
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Author(s) : Sabine Baron, Pierre Bègue, Emmanuel Grimprel |
Summary : Pertussis remains present in the industrialized world, although the widespread use of whole-cell pertussis vaccine has led to a dramatic decline of the disease. Great differences in immunization policies and coverage explain the uneven epidemiological pattern accross the developped world. Different situations can be described. In some countries such as Japan, UK and Italy, concerns about the occurrence of severe adverse events following pertussis vaccination in the 70’s lea to a reduced acceptance and thus, to a significant decrease in immunization coverage. In Sweden, the protective efficacy of pertussis vaccine was questioned and vaccination was discontinued in 1979. In all these countries, severe epidemics of pertussis were observed in the following years, and immunization was then reinforced in some (UK). In Japan, considerable efforts were made to develop new and safer pertussis acellular vaccines which have replaced the whole-cell vaccine since 1981.
In other countries such as the USA and France, despite a continous immunization programme maintaining a sustained and high coverage, a resurgence of the disease was observed in association with a modification of the age-distribution. Vaccinated adults became susceptible to the infection because of progressive waning, vaccine-induced immunity. These patients contaminated very young and thus, unvaccinated infants. These observations underline the need for early immunization in infants as well as the importance of late booster doses to be given to older children or adults. The WHO targets for control of pertussis in Europe (expected incidence inferior to 1/100 000) are the following: 1) widespread use of available pertussis vaccine (3 doses before 6 months, fourth dose given at 15-24 months of age) with coverage of not less than 90%: 2) surveillance of pertussis morbidity in all countries and ideally, notification of the disease. |
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