From the Paediatric Infectious Diseases and Vaccinology Unit, University of Basel Children's Hospital, Basel, Switzerland.
Faculty of Medicine, University of Basel, Basel, Switzerland.
Pediatr Infect Dis J. 2021 Jan;40(1):22-25. doi: 10.1097/INF.0000000000002904.
Surveillance of incidence and severity of pertussis is key to control success and shortcomings of vaccination programs followed by adaptations of recommendations if necessary. In Switzerland, nationwide reporting of hospitalizations due to pertussis in children has a long tradition and resumed in 2013 to evaluate the effects of pertussis immunization in pregnancy introduced in 2013.
Since 2013, all patients <16 years of age hospitalized with suspected or proven pertussis have been reported to the Swiss Pediatric Surveillance Unit. Patient data comprising clinical and epidemiologic characteristics and laboratory confirmation were assessed in a standardized fashion, and case definitions were applied to all cases reported until the end of 2019.
Two hundred thirteen of 294 cases were valid cases of pertussis. Of these, 168 (79%) occurred in <6-month-old infants. Mean duration of hospitalization was 8 days (median 5, range 2-47) overall and highest in neonates (14.2 days); 85% of all patients had ≥1 complication, most commonly cyanosis and dyspnea, especially in infants. Overall, case fatality rate was 1.4% (8.7% in neonates). Only 4 (2%) of 168 mothers of infants <6 months had been vaccinated during pregnancy; 14 (12%) of 112 patients with precise records of immunization had completed their primary series and were up-to-date for age.
Despite a decline of cases associated with the introduction of immunization against pertussis in pregnancy, control of the disease remains challenging, mainly due to failure to vaccinate rather than vaccine failure.
监测百日咳的发病率和严重程度是控制成功的关键，如果有必要，可以根据疫苗接种计划的缺陷进行调整。在瑞士，全国性报告儿童因百日咳住院的情况由来已久，2013 年重新开始报告，以评估 2013 年引入的妊娠期间百日咳免疫接种的效果。
自 2013 年以来，所有因疑似或确诊百日咳住院的<16 岁儿童患者均向瑞士儿科监测单位报告。以标准化方式评估患者数据，包括临床和流行病学特征以及实验室确认，并对截至 2019 年底报告的所有病例应用病例定义。
294 例中，213 例为有效的百日咳病例。其中，168 例（79%）发生在<6 个月大的婴儿中。总体而言，住院时间平均为 8 天（中位数 5 天，范围 2-47 天），新生儿最高（14.2 天）；所有患者中 85%有≥1 种并发症，最常见的是发绀和呼吸困难，尤其是在婴儿中。总体而言，病死率为 1.4%（新生儿为 8.7%）。168 名<6 个月大婴儿的母亲中，只有 4 名（2%）在妊娠期间接种过疫苗；112 名有确切免疫记录的患者中，14 名（12%）完成了基础系列接种且符合年龄要求。
尽管由于妊娠期间接种百日咳疫苗的引入，病例有所减少，但疾病的控制仍然具有挑战性，主要是由于疫苗接种失败而不是疫苗失效。
