Source of Infection in Household Transmission of Culture-Confirmed Pertussis in Brazil

Pn, Baptista; Magalhaes,; Rodrigues, Laura C.; Ma, Rocha; Am, Pimentel

doi:10.1097/01.inf.0000186293.85867.e8

Cited by 22 publications

(16 citation statements)

References 3 publications

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“…This is an important area for future study. In the case of pertussis, it appears that spread of the organism to the vulnerable infant is most often from parents and siblings 16 and most severe disease is now in infants who are too young to have been immunised. An immunisation schedule that ensured high levels of antibody in parents and siblings may be an improvement to the current infant regime.…”

Section: Spacing and Making Space In Immunisation Schedulesmentioning

confidence: 99%

Childhood immunisation: what is the future?

Pollard

2007

Archives of Disease in Childhood

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Section: Spacing and Making Space In Immunisation Schedulesmentioning

confidence: 99%

Childhood immunisation: what is the future?

Pollard

2007

Archives of Disease in Childhood

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“…6 However, the incidence among adolescents and adults remains high (eg, 0.1-200 cases per 100,000), and cases of pertussis in these groups are important sources of infection for unvaccinated and partly vaccinated infants. [7][8][9][10][11] Approximately 150,000 cases of pertussis are reported annually by the World Health Organization. 12 To reduce transmission of the bacteria in the general population, some countries (eg, France, Australia) have already …”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness analysis of various pertussis vaccination strategies primarily aimed at protecting infants in the Netherlands

Westra

Vries

Tamminga

et al. 2010

Clinical Therapeutics

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Background: Pertussis is a highly contagious respiratory disease. Despite a high rate of vaccine coverage through the Dutch national immunization program, the incidence of pertussis remains high in the Netherlands and the risk of infection continues. Because pertussis is most severe in unimmunized infants and infants who have only received some of the recommended doses, new pertussis immunization strategies should be considered to protect this vulnerable population.Objective: This study was designed to estimate the cost-effectiveness of 3 new immunization strategies for possible addition to the current Dutch national immunization program: immunization of the infant at birth, immunization of the parents immediately after birth of the child (cocooning), and maternal immunization during the third trimester of pregnancy.Methods: A literature search was performed in the PubMed database for articles published in English, German, and Dutch using the following terms: pertussis, whooping cough, vaccination strategies, maternal immunization, cocooning, at birth, vaccine efficacy, mor-r r tality, underreporting, prevalence, incidence, and cost-effectiveness. A decision-tree model was developed for this analysis, and data on pertussis morbidity and costs were collected consistently for different age groups (infants <1 year of age and adults 25 to 34 years of age). The size of the infant cohort was set at 200,000 to approximate previous Dutch birth cohorts. The size of the adult cohort was set at 401,380 parents for the cocooning strategy and 201,380 mothers for the maternal immunization strategy. Health benefits (qualityadjusted life-years [QALYs]) and costs were estimated in both cohorts for each of the 3 immunization strategies. Incremental cost-effectiveness ratios were calculated from both a payer's and a societal perspective. The robustness of the results was determined through sensitivity analysis.Results: In the base-case analysis, cocooning and maternal immunization were found to be effective in reducing the incidence of pertussis among infants (123 and 174 infant cases were expected to be prevented, respectively). Furthermore, cocooning and maternal immunization were estimated to be cost-effective from a payer's perspective (€4600 [US $6400]/QALY and €3500 [$4900]/QALY, respectively) and even cost-saving from a societal perspective (savings of up to €7200 [$10,100] and €5000 [$7000], respectively). Sensitivity analyses revealed that favorable cost-effectiveness was generally robust. In the sensitivity analysis, the costeffectiveness of cocooning and maternal immunization was mostly sensitive for changes in assumptions on underreporting (200-fold increase in reported number of symptomatic cases) of pertussis disease and infection. With no underreporting, the ICER was estimated at €211,900 ($296,700)/QALY for cocooning and €81,600 ($114,200)/QALY for maternal immunization from a payer's perspective. However, even at much lower levels of underreporting (20-to 30-fold increase in incidence), cost-effectiveness ...

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“…Este grupo etario ha sido implicado en la transmisión de Bordetella pertussis a los lactantes [7][8][9] . Este fenómeno ha sido estudiado parcialmente en algunos países latinoamericanos como brasil, argentina, pero no chile 10 . Una nueva vacuna para adolescentes y adultos ha demostrado adecuada inmunogenicidad y eficacia para la prevención de coqueluche con un buen perfil de seguridad [11][12][13][14][15] .…”

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