Prospective pertussis surveillance in Switzerland, 1991–2006
2011
Wymann, Monica N. | Richard, Jean-Luc | Vidondo, Beatriz | Heininger, Ulrich
Pertussis has been monitored in Switzerland since 1991 by the nationwide Swiss Sentinel Surveillance Network (SSSN), consisting of approximately 200 general practitioners, internists and pediatricians representing about 3% of the total primary care physicians of these specialities. SSSN members report patients with cough ≥14 days plus either an epidemiological link or characteristic symptoms (paroxysms, whoop, post-tussive vomiting) on a weekly basis to the Federal Office of Public Health. Confirmatory PCR from nasopharyngeal specimens is offered for free. A total of 4992 cases have been reported until 2006. Yearly incidence has dropped from 70 cases per 100,000 inhabitants in 1992 to 40 in 2006, with a single epidemic in 1994–1995 with 280–370 cases/100,000. On average 80% of reported cases were tested by PCR, 24% of these were confirmed as Bordetella pertussis infections. For 2.6% of patients complications were reported, most commonly pneumonia, asthma bronchiale, otitis media, bronchitis and rib fractures. On average, 1.5% of patients were hospitalized. Disease in vaccinated patients was mitigated with less frequent complications (unvaccinated: 5.1%; 3 doses: 3.0%; ≥4 doses: 1.7%), hospitalizations (unvaccinated: 3.6%; ≥1 dose: 1.1%) and various clinical symptoms compared to unvaccinated patients. Comparing the periods 1991–1996, 1997–2001 and 2002–2006, a shift of pertussis from age group 1–9 years to 10–19 and ≥40 years was observed among patients cared for by general practitioners and internists. The benefits of further booster doses in adolescents and/or adults need to be considered.
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