Outbreak of Pertussis, Kabul, Afghanistan

Bordetella pertussis: Vaccine Coverage and Immune Status among Children Under Five Years Old in Sana’a City, Yemen

“…The study findings showed that the vaccination coverage rate was only 79.1%. This result is similar to findings in other developing countries, where DPT vaccine coverage rates among infants and children ranged from 50 -80% [25,26]. Also, the study findings showed that the vaccination coverage rate of DPT (79.1%) was slightly higher than the coverage rates of other types of bacterial and viral vaccines that are in the universal vaccination program of Yemen, such as BCG (76.8%), measles (62%), and polio (71.3%).…”

Respiratory infections in the military

“…Furthermore, a severe case of pertussis infection arose in theatre in late 2006 and two further cases in British service personnel were confirmed serologically at a French military facility in Kabul in early 2007 132. Indeed, a significant increase in ARD, monitored through French Army and NATO surveillance systems, was noted among the multinational force in Kabul with an incidence of pertussis infection of 20% by clinical definition and 22% following serological testing 134. A further study to investigate the prevalence of pertussis infection in a group of symptomatic British soldiers returning from Afghanistan showed that among the 21 personnel who met the case definition, two confirmed cases and one probable case of B pertussis infection were identified, yielding a probable infection rate of 14% 132.…”

“…Similarly, seropositivity was higher among those joining the military within 2 years prior to deployment compared with individuals who joined more than 5 years earlier. Interestingly, the authors noted an increased risk of B pertussis seroconversion among individuals who deployed in 2007, which was also the period during which several outbreaks of B pertussis among the Afghan civilian population occurred 134 138 139. Epidemics of B pertussis among military populations, both under training and while on deployed operations, raises numerous questions including how best to minimise transmission under field conditions in an environment of limited resources and high person density; the role of prophylactic antibiotics and what is the optimal regime (eg, a 3 day course of azithromycin which is effective, well tolerated and offers a high degree of compliance); and, finally, whether personnel should receive a booster vaccination against pertussis, especially prior to deployment overseas to developing countries in which B pertussis remains endemic 108 140 141…”