Pertussis epidemiology in argentina: trends after the introduction of maternal immunization.

FABRICIUS G; MARTIN AISPURO, P; BERGERO, PAULA ELENA; BOTTERO D; GABRIELLI, M; HOZBOR, D

EPIDEMIOLOGY AND INFECTION.

CAMBRIDGE UNIV PRESS

Lugar: Cambridge; Año: 2018

0950-2688

<!-- /* Font Definitions */@font-face{font-family:Times;panose-1:2 0 5 0 0 0 0 0 0 0;mso-font-charset:0;mso-generic-font-family:auto;mso-font-pitch:variable;mso-font-signature:3 0 0 0 1 0;}@font-face{font-family:"New York";panose-1:0 0 0 0 0 0 0 0 0 0;mso-font-alt:"Times New Roman";mso-font-charset:77;mso-generic-font-family:roman;mso-font-format:other;mso-font-pitch:variable;mso-font-signature:3 0 0 0 1 0;}@font-face{font-family:"Cambria Math";panose-1:2 4 5 3 5 4 6 3 2 4;mso-font-charset:0;mso-generic-font-family:auto;mso-font-pitch:variable;mso-font-signature:-536870145 1107305727 0 0 415 0;} /* Style Definitions */p.MsoNormal, li.MsoNormal, div.MsoNormal{mso-style-unhide:no;mso-style-qformat:yes;mso-style-parent:"";margin:0cm;margin-bottom:.0001pt;mso-pagination:widow-orphan;font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"New York","serif";mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:"Times New Roman";mso-no-proof:yes;}.MsoChpDefault{mso-style-type:export-only;mso-default-props:yes;font-size:10.0pt;mso-ansi-font-size:10.0pt;mso-bidi-font-size:10.0pt;font-family:"New York","serif";mso-ascii-font-family:"New York";mso-hansi-font-family:"New York";}@page WordSection1{size:612.0pt 792.0pt;margin:72.0pt 90.0pt 72.0pt 90.0pt;mso-header-margin:36.0pt;mso-footer-margin:36.0pt;mso-paper-source:0;}div.WordSection1{page:WordSection1;}-->Abstract            Dataon the impact of the recently recommended maternal pertussis vaccination arepromising, but still insufficient to universalize this approach. We thuscompared the epidemiological data prior to the implementation of thisvaccination strategy in Argentina (2012) with the figures reported after 2012.During that 2010-2016 period, two outbreaks occurred, one in 2011 and anotherin 2016. In the former, the incidence was 6.9/100,000 inhabitants and thecase-fatality rate 2.6%. Thereafter, a decline in incidence was detected until2014. During 2015 and 2016 an increase in the incidence transpired, but this incrementrise was fortunately not accompanied by one in the case fatality ratio. Indeed, in 2016 the casefatality ratio was the lowest(0.6%). Moreover, during the 2016 outbreak the incidence (3.9/100,000inhabitants) and the case severity detected in the most vulnerable population(infants 0-2 months) were both lower than those in 2011. Consistent with thispattern, in 2016, in the most populated province of Argentina (Buenos Aires),the case percentage with laboratory-positive results indicating a high numberof symptoms (59.1% of the total cases) diminished compared to that detected inthe 2011 outbreak without maternal immunization (71.9%). Using the mathematicalmodel of pertussis transmission we previously designed, we assessed the effectof vaccination during pregnancy on infant incidence. From comparisons betweenthe epidemiological data made through calculations, emerged the possibilitythat vaccinating women during pregnancy would benefit the infants beyond age 2months, specifically in the 2-12?month cohort.