Epidemiology of pertussis among adolescents, adults, and older adults in selected countries of Latin American: a systematic review

Nunes, Altacílio Aparecido; Abreu, Ariane de Jesus Lopes de; Furtado, Bárbara Emoingt; Silva, Anderson Soares da; Coelho, Eduardo Barbosa; Barros, Eliana Nc de

doi:10.1080/21645515.2020.1827613

Cited by 11 publications

(3 citation statements)

References 40 publications

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“…Today, the demographic dispersion of pertussis includes adolescents and adults, in addition to infants. Furthermore, the true burden of pertussis in adolescents and adults is greatly underestimated [ 8 , 35 ].…”

Section: Burden Of Pertussis In Adultsmentioning

confidence: 99%

Improving vaccination rates in older adults and at-risk groups: focus on pertussis

Choi¹,

Sousa

Fletcher

et al. 2022

Aging Clin Exp Res

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Despite the implementation of effective paediatric vaccination programmes, pertussis remains a global health problem. Disease epidemiology has changed over time, shifting towards the adolescent and adult populations. In adults, the true burden of pertussis is greatly underestimated and pertussis vaccine coverage rates are suboptimal, including individuals with chronic conditions. Here, we report the outcomes of a virtual international scientific workshop to assess the evidence on the burden of pertussis in older adults and identify potential solutions to improve uptake of pertussis vaccines. In adults, pertussis is underdiagnosed in part due to atypical or milder clinical presentation and the lack of testing and case confirmation. However, contemporary epidemiological data denoted an increase in the burden of pertussis among adolescents and adults. This might be related to a variety of reasons including the waning of immunity over time, the lack of booster vaccination, and the improved diagnostic methods that led to increased recognition of the disease in adults. Pertussis sequelae can be severe in older adults, particularly those with existing chronic medical conditions, and the vulnerability of these groups is further enhanced by low pertussis vaccine coverage. Possible measures to increase vaccine uptake include strengthening and harmonisation of immunisation guidelines, healthcare professionals taking a more active role in recommending pertussis vaccination, involvement of vaccination centres and pharmacies in the vaccination process, and improving knowledge of pertussis burden and vaccine efficacy among the general population.

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Section: Burden Of Pertussis In Adultsmentioning

confidence: 99%

Improving vaccination rates in older adults and at-risk groups: focus on pertussis

Choi¹,

Sousa

Fletcher

et al. 2022

Aging Clin Exp Res

View full text Add to dashboard Cite

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“…However, underestimation of disease burden is a recognized problem in surveillance systems, particularly for infectious diseases [ 10 ]. A systematic literature review assessing the burden of pertussis in Latin American countries (Argentina, Brazil, Chile, Colombia, Mexico, Panama, and Uruguay) highlighted the limited epidemiological data available in adolescents, adults, and older adults as well as the need for standardized diagnostic tools and improvement of surveillance systems [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Assessing the Underestimation of Adult Pertussis Disease in Five Latin American Countries

Guzman-Holst,

Gomez,

Cintra

et al. 2023

Infect Dis Ther

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Introduction Pertussis, a contagious respiratory disease, is underreported in adults. The study objective was to quantify underestimation of pertussis cases in adults aged ≥ 50 years in five Latin American countries (Argentina, Brazil, Chile, Mexico, Peru). Methods A previously published probabilistic model was adapted to adjust the number of pertussis cases reported to national surveillance systems by successive multiplication steps (proportion of pertussis cases seeking healthcare; proportion with a specimen collected; proportion sent for confirmatory testing; proportion positive for pertussis; proportion reported to passive surveillance). The proportions at each step were added in a random effects model to produce a pooled overall proportion, and a final multiplier was calculated as the simple inverse of this proportion. This multiplier was applied to the number of cases reported to surveillance to estimate the number of pertussis cases. Monte Carlo simulation with 10,000 iterations estimated median as well as upper and lower 90% values. Input data were obtained from surveillance systems and published sources. Results The estimated median underestimation factor for pertussis cases in adults ranged from 104 (90% limits 40, 451) in Chile to 114 (90% limits 39, 419) in Argentina. In all five countries, the largest estimated number of cases was in the group aged 50–59 years. The highest number per 100,000 population was in the group aged ≥ 90 years in most countries. The estimated median underestimation factor for pertussis hospitalizations was 2.3 (90% limits 1.8, 3.3) in Brazil and 2.4 (90% limits 1.8, 3.2) in Chile (data not available for other countries). Conclusion This analysis indicates that the number of pertussis cases in adults aged ≥ 50 years in five Latin American countries is approximately 100 times higher than the number captured in surveillance data. These results could support decision-making in the diagnosis, management, and prevention of pertussis disease in adults.

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“…Such change in the epidemiology of disease comes to a significant increase in pertussis among adolescents, adults, and older adults, who are now convinced to transmit pertussis to their unvaccinated or partly immunized infants and children ( 10 ). Existing pertussis epidemiological data for adolescents, adults, and older adults are limited due to their high incidence of asymptomatic and mild/atypical infection accompanied by the low visiting rate of hospitals, high misdiagnosis rate, and missed diagnosis rate ( 11 ). Therefore, studies of pertussis infection in the family unit have attracted global concerns.…”

Section: Introductionmentioning

confidence: 99%

Epidemiological and clinical characteristics of pertussis in children and their close contacts in households: A cross-sectional survey in Zhejiang Province, China

et al. 2022

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BackgroundDespite the expanded immunization programs, the “re-emergence of pertussis” has become a global concern in recent years. At present, the prevalence of pertussis in China is seriously underestimated, and the role of close contact on the disease spreading in children remains unclear.ObjectivesOur study aimed to investigate pertussis’s epidemiological and clinical characteristics in children and their close contacts in households, as well as the antimicrobial resistance of Bordetella pertussis (B. pertussis) in Zhejiang Province, China.MethodsWe have collected the retrospective and prospective data of children who were suspected of pertussis and their close contacts in households from January 1, 2018, to December 31, 2020, in the Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China. Nasopharyngeal swabs were collected and cultured for B. pertussis. Antibiotics susceptibility test was determined by using E-test methods. Clinical information was collected from the medical records systems.ResultsA total of 350 index patients and their 946 family members (close contacts in households) from 350 families were recruited. B. pertussis strains were isolated from 130 (37.1%) index patients and 116 (12.3%) close contacts. 37 index patients had negative culture results for B. pertussis while their close contacts were positive. A higher positive rate was found in female adults than that in male adults (16.3% vs. 5.1%, P < 0.01). The positive rate in index patients from multi-child families was significantly higher than that from one-child families (51.7% vs. 37.7%, P < 0.05). 53.3% of the pertussis patients were under 6 months of age. 98 (75.4%) isolates had MICs ≥ 256 mg/L to erythromycin, azithromycin, and clindamycin, and 127 (97.7%) had MICs < 0.016 mg/L to piperacillin.ConclusionInfants under 6 months of age are at high risk of pertussis, and close contacts in households are prone to cluster infection. Culture for B. pertussis both in children and their close contacts contributes to improving the diagnosis rate of pertussis in children. Isolates of B. pertussis in China are highly resistant to macrolides.

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Epidemiology of pertussis among adolescents, adults, and older adults in selected countries of Latin American: a systematic review

Cited by 11 publications

References 40 publications

Improving vaccination rates in older adults and at-risk groups: focus on pertussis

Improving vaccination rates in older adults and at-risk groups: focus on pertussis

Assessing the Underestimation of Adult Pertussis Disease in Five Latin American Countries

Epidemiological and clinical characteristics of pertussis in children and their close contacts in households: A cross-sectional survey in Zhejiang Province, China

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