Burden of Children Hospitalized With Pertussis in Canada in the Acellular Pertussis Vaccine Era, 1999-2015.
Adolescent
Age Factors
Canada
/ epidemiology
Child
Child, Preschool
Comorbidity
Cost of Illness
Diphtheria-Tetanus-acellular Pertussis Vaccines
Female
Hospitalization
/ statistics & numerical data
Hospitals, Pediatric
Humans
Incidence
Infant
Infant, Newborn
Intensive Care Units, Pediatric
Length of Stay
Logistic Models
Male
Pertussis Vaccine
Risk Factors
Sex Factors
Whooping Cough
/ complications
Bordetella pertussis
infant pertussis
vaccination in pregnancy
whooping cough
Journal
Journal of the Pediatric Infectious Diseases Society
ISSN: 2048-7207
Titre abrégé: J Pediatric Infect Dis Soc
Pays: England
ID NLM: 101586049
Informations de publication
Date de publication:
30 Apr 2020
30 Apr 2020
Historique:
received:
29
08
2018
pubmed:
12
12
2018
medline:
15
12
2020
entrez:
12
12
2018
Statut:
ppublish
Résumé
Recent increases in pertussis morbidity and mortality rates among young infants have led to a recommendation in some countries for vaccination against pertussis during pregnancy. Having data on the burden of pediatric pertussis in a large population over time is important for establishing the true burden of disease in the acellular pertussis (aP) vaccine era. Here, we describe age-specific epidemiology and morbidity and mortality rates in children hospitalized with pertussis over 17 years across Canada in the aP vaccine era. Patients aged ≤16 years who were admitted to 1 of 12 pediatric tertiary-care hospitals across Canada between 1999 and 2015 with confirmed (laboratory-confirmed or epidemiologically linked) or probable (clinically diagnosed) pertussis were included. Overall, 1402 patients with pertussis were included. Infants aged <2 months had the highest mean annual incidences of pertussis hospitalization and intensive care unit (ICU) admission (116.40 [95% confidence interval (CI), 85.32-147.49] and 33.48 [95% CI, 26.35-40.62] per 100 000 population, respectively). The overall proportion of children who required ICU admission was 25.46%, and the proportion was highest in infants aged <2 months (37.90%). Over the span of this study, 21 deaths occurred. Age of <16 weeks, prematurity, encephalopathy, and a confirmed pertussis diagnosis were independent risk factors for ICU admission. Age of <4 weeks, prematurity, and female sex were independent risk factors for death. In the aP vaccine era, endemic pertussis still contributes considerably to childhood morbidity and death, particularly in infants aged <2 months. Vaccination against pertussis during pregnancy has the potential to reduce this disease burden.
Sections du résumé
BACKGROUND
BACKGROUND
Recent increases in pertussis morbidity and mortality rates among young infants have led to a recommendation in some countries for vaccination against pertussis during pregnancy. Having data on the burden of pediatric pertussis in a large population over time is important for establishing the true burden of disease in the acellular pertussis (aP) vaccine era. Here, we describe age-specific epidemiology and morbidity and mortality rates in children hospitalized with pertussis over 17 years across Canada in the aP vaccine era.
METHODS
METHODS
Patients aged ≤16 years who were admitted to 1 of 12 pediatric tertiary-care hospitals across Canada between 1999 and 2015 with confirmed (laboratory-confirmed or epidemiologically linked) or probable (clinically diagnosed) pertussis were included.
RESULTS
RESULTS
Overall, 1402 patients with pertussis were included. Infants aged <2 months had the highest mean annual incidences of pertussis hospitalization and intensive care unit (ICU) admission (116.40 [95% confidence interval (CI), 85.32-147.49] and 33.48 [95% CI, 26.35-40.62] per 100 000 population, respectively). The overall proportion of children who required ICU admission was 25.46%, and the proportion was highest in infants aged <2 months (37.90%). Over the span of this study, 21 deaths occurred. Age of <16 weeks, prematurity, encephalopathy, and a confirmed pertussis diagnosis were independent risk factors for ICU admission. Age of <4 weeks, prematurity, and female sex were independent risk factors for death.
CONCLUSIONS
CONCLUSIONS
In the aP vaccine era, endemic pertussis still contributes considerably to childhood morbidity and death, particularly in infants aged <2 months. Vaccination against pertussis during pregnancy has the potential to reduce this disease burden.
Identifiants
pubmed: 30535079
pii: 5236699
doi: 10.1093/jpids/piy128
pmc: PMC7192396
doi:
Substances chimiques
Diphtheria-Tetanus-acellular Pertussis Vaccines
0
Pertussis Vaccine
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
118-127Investigateurs
N Bridger
(N)
R Morris
(R)
K Top
(K)
S Halperin
(S)
P Déry
(P)
R Thibeault
(R)
D Moore
(D)
M A Lefebvre
(MA)
M Lebel
(M)
N Le Saux
(N)
D Tran
(D)
L Ford-Jones
(L)
S Morris
(S)
J Embree
(J)
B Law
(B)
B Tan
(B)
A McConnell
(A)
T Jadavji
(T)
R Chawla
(R)
O Vanderkooi
(O)
J Kellner
(J)
W Vaudry
(W)
D Scheifele
(D)
J Bettinger
(J)
M Sadarangani
(M)
L Sauvé
(L)
Commentaires et corrections
Type : ErratumIn
Informations de copyright
© The Author(s) 2018. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society.
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