Whooping cough dynamics in Chile (1932–2010): disease temporal fluctuations across a north-south gradient

Abstract

BackgroundThe spatial-temporal dynamics of Bordetella pertussis remains as a highly interesting case in infectious disease epidemiology. Despite large-scale vaccination programs in place for over 50 years around the world, frequent outbreaks are still reported in many countries.MethodsHere, we use annual time series of pertussis incidence from the thirteen different regions of Chile (1952–2010) to study the spatial-temporal dynamics of Pertussis. The period 1975–1995 was characterized by a strong 4 year cycle, while the last two decades of the study period (1990–2010) were characterized by disease resurgence without significant periodic patterns.ResultsDuring the first decades, differences in periodic patterns across regions can be explained by the differences in susceptible recruitment. The observed shift in periodicity from the period 1952–1974 to the period 1975–1995 across regions was relatively well predicted by the susceptible recruitment and population size. However, data on vaccination rates was not taken into account in this study.ConclusionsOur findings highlight how demography and population size have interacted with the immunization program in shaping periodicity along a unique latitudinal gradient. Widespread B. pertussis vaccination appears to lead to longer periodic dynamics, which is line with a reduction in B. pertussis transmission, but our findings indicate that regions characterized by both low birth rate and population size decreased in periodicity following immunization efforts.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-015-1292-2) contains supplementary material, which is available to authorized users.

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

“…Nine of them [25][26][27][28][29][30][31][32][33] included data from the national surveillance system SINAN (Sistema de Informação de Agravos de Notificação [System for Notifiable Diseases]); two used convenience samples of household contacts 34 or healthcare workers; 35 each used data from one 36 or ten 37 hospital clinics; and one 12 study was a population-based study. We retrieved 11 crosssectional studies, 25,26,28,29,[31][32][33][34][35]37,38 one case-control study, 13 one case series, 36 and one literature review 14 (Table 1). The pertussis-confirmed cases in the in-scope population reported by all included studies, ranged from 5.2% to 14.0% (Table 1).…”

“…Nine studies 25,29,[32][33][34][35][36][37][38] reported regional-level data. Of these, one was the case-series study and the others were crosssectional studies.…”

Whooping Cough Followed by Lower Motor Neuron Facial Palsy: A Case Report

“…Whooping cough is a vaccine preventable disease initially well controlled with whole cell vaccine, but due to serious complications with this vaccine, it has now been replaced with acellular vaccine. Purtussis is a public health problem worldwide and despite effective vaccinations strategies it's still endemic in many parts of the world with frequent outbreaks occurring in many countries 1 . Some have blamed the new vaccines to be less effective than the older ones and other says that new sophisticated techniques for diagnosis are responsible for rise in the disease incidence 2 .…”

Episodio Hipotonía-Hiporreactividad posterior a la inmunización con vacuna combinada con pertussis de células enteras. Reporte de un caso

“…El EHH es un efecto adverso severo que se caracteriza por la triada clínica de inicio súbito de flacidez muscular, reducida respuesta a estímulos y un cambio en la coloración de la piel (palidez o cianosis) 6 . Aunque la inmunización masiva de la población con vacunas DTwP disminuyó significativamente la ocurrencia de tos ferina 7,8 , la preocupación por los efectos adversos conllevó a que en la década de 1970 y 1980 se desarrollaran vacunas anti-pertussis acelulares (aP) compuestas por uno o más antígenos purificados (toxina pertussis, hemaglutinina filamentosa, pertactina y fimbrias). Las vacunas DTaP mostraron ser menos reactogénicas en comparación con las que contenían componentes wP y están actualmente incluidas en los programas de vacunación de muchos países desarrollados 9,10 .…”

“…Aunque las razones por las que la enfermedad está re-emergiendo son complejas y pueden variar entre países, la corta duración de la protección y el probable menor impacto de las vacunas aP sobre la infección y transmisión parecen jugar un rol importante 14 , lo que actualmente es tema de estudio y debate 15,16 . En este panorama epidemiológico, la tos ferina continúa siendo un problema en salud pública y una de las enfermedades prevenibles por vacunación más comunes en países occidentales desarrollados y en vía de desarrollo 8,17 . En Chile, la inmunización contra pertussis inició en 1955 con una vacuna combinada de wP y difteria (DP).…”