Report of a pertussis outbreak in a low coverage booster vaccination group of otherwise healthy children in Italy

BMC Infectious Diseases

Cinzia Germinario¹  Maria Chironna¹  Rosa Prato²  Domenico Martinelli²  Maria Serena Gallone¹  Silvio Tafuri¹ 

[1] Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy;Department of Medical and Surgical Science, University of Foggia, Foggia, Italy

关键词: Cocoon;    Booster;    Vaccine effectiveness;    Vaccine failure;    Pertussis;   

Others  :  1145388
DOI  :  10.1186/1471-2334-13-541

 received in 2013-02-20, accepted in 2013-11-11,  发布年份 2013

【 摘 要 】

Background

The introduction of universal pertussis immunization and the high coverage achieved in most developed countries have largely changed the epidemiology of the disease. Although vaccination rates are high in the first year of life, the rates of booster doses are unsatisfactory and lead to the onset of outbreaks. This report describes an outbreak of pertussis affecting school students already immunized in a town of Puglia (Italy), detected at the end of April 2009.

Methods

Vaccine effectiveness is measured by calculating the incidence rates (attack rates- AR) of disease among vaccinated (ARV) and unvaccinated (ARU) people and determining the percentage reduction in the incidence rate of disease among vaccinated people compared to unvaccinated people.

Results

The index case was a healthy child, female, 9-years-old who attended a local elementary school and developed pertussis on 27 April 2009. The secondary cases were the aunt and the cousin of the index case who developed a cough on 10 May 2009. In the elementary class of the index case, a cluster occurred. The overall AR was 15.8%, in particular 20% in children who did not receive the booster doses at 5–6 years old (ARU) and 14.3% in children receiving the booster (ARV). The VE of booster dose in this setting was 28.5%. Moreover, only the index case developed a persistent cough; the VE against moderate to severe pertussis was 100%. A cluster was detected in the middle school class that the cousin of the index case attended; AR was 44.4% (12/27); ARU was 50% (10/20) and ARV 28.6% (2/7). VE in this setting was 42.8%.

Conclusions

Our results confirm the need to administer booster doses; failure the booster is the principal determinant for the outbreak onset.

【 授权许可】

   
2013 Tafuri et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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