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Bordetella pertussis es un patógeno exclusivo de humanos que causa la tos ferina, enfermedad respiratoria aguda que afecta principalmente a la población pediátrica. Existen dos tipos de vacunas comercializadas contra este patógeno: celulares y acelulares. Las vacunas celulares han sido extensamente utilizadas y siguen teniendo gran relevancia. El presente trabajo tuvo como objetivo la estandarización de un ELISA para la cuantificación de anticuerpos IgG contra células enteras de Bordetella pertussis. Para ello se determinó la concentración de recubrimiento, el rango lineal de la curva, los parámetros de precisión intra e interensayo, la especificidad, el valor de corte y el límite de detección. Se determinó como concentración de recubrimiento 0,5 UO/mL de células enteras. La curva estándar utilizando un suero de referencia internacional presentó un buen ajuste a una función polinómica en un intervalo entre las diluciones 1/100 y 1/24.300 con un coeficiente de correlación R2≥0,98. Los coeficientes de variación en los ensayos de precisión intra e interensayo estuvieron en los intervalos establecidos para cada uno (≤10%, ≤20% respectivamente). Los resultados obtenidos avalan el empleo de este ELISA cuantitativo para la evaluación de la respuesta a células enteras de Bordetella pertussis en ensayos clínicos.

Introduction: Pertussis is a respiratory infection caused by bacteria of the genus Bordetella, mainly pertussis and parapertussis species. Despite the high vaccination coverage in developed countries, it is considered a re-emerging disease that is also underreported and underdiagnosed, especially in patients who do not require hospital referral. Material and methods: Descriptive, prospective and multicentre study of pertussis diagnosis and contact investigation in 17 primary care paediatric clinics through collection of samples for polymerase chain reaction (PCR) testing over a period of 4 years and after the implementation of routine vaccination against pertussis during pregnancy. Results: Pertussis was diagnosed in a total of 50 patients; the estimated incidence in these years was higher compared to previous rates in the paediatric age group. Fourteen percent of the cases occurred in children aged less than 1 year. The mean age was 6.7 years. Cough was present in 100% of cases, followed in frequency by vomiting and rhinorrhoea. Only 1 patient required hospital admission, and none died or developed complications. B. pertussis was the predominant causative agent. Only 40% knew the source of infection. In 26% of the cases, pertussis was confirmed in contacts of the patient by PCR, and in 46% it was suspected based on the clinical presentation but without microbiological confirmation. Conclusions: Access to diagnostic tests (PCR) for pertussis in primary care allows us to optimise its diagnosis and treatment, to break the chain of transmission, to know the real incidence rates and to assess the impact of routine vaccination of pregnant women on this disease. Resumen: Introducción: La tos ferina es una infección respiratoria causada por bacterias del género Bordetella, principalmente por las especies pertussis y parapertussis. A pesar de las altas coberturas vacunales en países desarrollados, está considerada como una enfermedad reemergente existiendo, además, una infranotificación y un infradiagnóstico especialmente en los pacientes que no precisan derivación hospitalaria. Material y métodos: Estudio descriptivo, prospectivo y multicéntrico de diagnóstico de casos de tos ferina, así como el estudio de sus contactos en 17 consultas de pediatría de atención primaria mediante la toma de muestras para realización de técnicas de PCR (reacción en cadena de la polimerasa) a lo largo de cuatro años y tras la implantación de la vacunación sistemática de la tos ferina en el embarazo. Resultados: Se diagnostican un total de 50 pacientes; la tasa de incidencia estimada en estos años fue superior a las publicadas en edad pediátrica. Un 14% de los casos sucedieron en menores de 1 año. La media de edad fue de 6,7 años. La tos estuvo presente en el 100% de los casos, seguida de los vómitos y rinorrea como síntomas más frecuentes. Sólo 1 paciente precisó ingreso y ninguno falleció ni presentó complicaciones. B. pertussis fue el agente causal predominante. Sólo un 40% conocía la fuente de contagio. En un 26% de los casos se comprobó mediante PCR tos ferina en sus contactos y en un 46% se sospechó clínicamente, aunque sin confirmación microbiológica. Conclusiones: El acceso a pruebas diagnósticas (PCR) para tos ferina en Atención Primaria permite optimizar su diagnóstico y tratamiento, cortar la cadena de transmisión, conocer las tasas de incidencia reales y valorar el impacto de la vacunación sistemática de las embarazadas en esta enfermedad.

Objetivo. Desarrollar y evaluar un método de bajo costo basado en celulosa para la purificación rápida y amplificación directa de ADN de Bordetella pertussis de hisopados nasofaríngeos. Materiales y métodos. Se prepararon discos de celulosa y se evaluaron diferentes parámetros (buffers de lisis/lavado, número de discos y elución de ADN). El método se acopló a una amplificación directa por PCR en tiempo real (qPCR) y se es­timó el rendimiento utilizando hisopados nasofaríngeos que fueron positivos (n=100) y negativos (n=50) para ADN B. pertussis por qPCR, comparado con el método basado en columnas de sílice. Se calculó el grado de concordancia, sensibilidad, especificidad, valor predictivo positivo (VPP) y valor predictivo negativo (VPN). Se evaluó la factibilidad del método rápido para ser acoplado a un ensayo colorimétrico de amplificación isotérmica mediada por lazo (LAMP). Resultados. El método rápido con un disco de celulosa y buffer de lisis y lavado conteniendo PVP-40 y Tween 20, respectivamente, mostró una mayor capacidad para purificar ADN amplificable de B. pertussis. El método tuvo una sensibilidad de 89,0% (IC95%, 80,2%-94,9%) y una especificidad de 98,5% (IC95%, 92,1%-100,0%), con un buen grado de concordancia (Kappa=0,867; IC95% 0,788 – 0,946), respecto al método referencial. Los VPP y VPN fueron 98,6% (IC95%, 92,7,2%-100,0%) y 88,2% (IC95%, 78,7%-94,4%), respectivamente. Se evidenció una amplificación exitosa por LAMP, y se obtuvieron resultados comparables con el método por columnas de sílice. Conclusión. El método desarrollado es simple, de bajo costo y libre de equipos para la obtención rápida (60 segundos) de ADN en el punto de atención, y puede ser implementado en diversas técnicas moleculares orientados al diagnóstico oportuno y al estudio epidemiológico de tos ferina

Objetivo: determinar las características epidemiológicas de la tos ferina en la Provincia de Huancavelica, periodo 2017-2018. Metodología: se realizó un estudio no experimental transversal - descriptivo; Muestra: Se recolectaron datos del total de fichas de investigación epidemiológica de casos probables de Tos ferina en niños menores de 5 años de la Dirección Regional de Salud de Huancavelica presentados de enero del 2017 a diciembre del 2018. Resultados: el 85.7% de casos se presentaron en niños menores de 01 año, con predominancia en varones a una razón 1.25 entre varones y mujeres, el 55.1% fueron del área rural; el 50% de niños tuvieron vacunación completa para su edad, la tos paroxística fue el signo más frecuente, aunque también se presentaron inspiración ruidosa y vómitos después de la tos, el 89.8% de casos recibieron tratamiento en hospitalización y en los meses de mayo y junio se evidenció el incremento de casos. Conclusión: la tos ferina continua siendo causa de morbilidad infantil, siendo los más vulnerables niños menores de 01 año, procedentes del área rural, sin estado vacunal o con inmunización parcial, la tos paroxística fue el signo característico y con mayor ocurrencia en periodo de heladas.

Introduction: Serological surveillance (serosurveillance) provides the most direct measure of herd immunity of vaccine-preventable diseases. Little is known about the opportunities and challenges of serosurveillance experiences, particularly pertussis. Objective: To describe the process of serosurveillance for vaccine-preventable diseases with an emphasis on the experience of pertussis in the metropolitan area of Antioquia (Valle de Aburrá) in 2015 and 2016 and analyze the contributions and challenges for its sustainability. Materials and methods: We described the planning and conduction of serosurveillance of pertussis antibodies of mothers and in the umbilical cord at the time of delivery in eight hospitals based on random sampling and their capacity to advance the serosurveillance periodically. We compared the contributions and the challenges of this experience with other probabilistic and non-probabilistic programs. Results: We achieved the participation of hospitals and mothers respecting the delivery care process. We established a serum bank following ethical and technical guidelines. This program based on the random selection of hospitals and mothers has enabled the estimation of antibodies prevalence in mothers and in the umbilical cord, which has been possible given the high coverage of hospital care during childbirth at a lower cost and fewer risks than a population-based survey in conflictive areas. The main challenges for the sustainability of this program are the creation of stable jobs and access to funding and legal and methodological long-term frameworks. Conclusions: Hospital serosurveillance as described is an option to monitor the impact of vaccination on the population. Our experience could be reproduced in other regions under similar conditions if the above-mentioned challenges are solved.

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Introducción: la tos convulsa es una enfermedad infecciosa respiratoria aguda debida a Bordetella pertussis y Bordetella parapertussis. Factores de mal pronóstico son edad menor a 6 meses, hiperleucocitosis, coinfección bacteriana. En Uruguay, desde la incorporación de la vacuna antipertussis en 1963, disminuyeron significativamente las notificaciones con comportamiento endémico con brotes. En el 2011, luego del fallecimiento de dos niños con tos convulsa, se registró un aumento de casos en el Hospital Las Piedras (HLP). Objetivo: describir las características clínico-evolutivas de los niños hospitalizados por tos convulsa en el HLP entre el 1º de agosto de 2011 y el 30 de abril de 2012. Material y método: estudio descriptivo, prospectivo, de los niños hospitalizados por tos convulsa. La confirmación se realizó por reacción en cadena de polimerasa (PCR) en secreciones respiratorias. Se analizan variables epidemiológicas, características clínicas y evolutivas. Resultados: se hospitalizaron 41 niños con tos convulsa confirmada (6,4%); 48,8% fueron menores de 6 meses. Diez fueron derivados a centros de tratamiento intensivo (CTI), ocho de ellos menores de 6 meses; dos fallecieron. Tuvieron contacto con casos confirmados 10% y con casos sospechosos 51%. Presentaron leucocitosis > 20.000 cel/mm3, 39%. En tres casos existió coinfección con adenovirus. Discusión y conclusiones: el brote de tos convulsa comenzó en 2011, siendo el HLP el centro que alertó su inicio y registró la tasa más elevada de hospitalización. Las características clínico-evolutivas de los niños afectados son similares a las descritas en la región. Su abordaje requiere accesibilidad a nuevas herramientas diagnósticas de biología molecular. Para el control y la prevención se requiere reforzar las estrategias de vacunación.

The aim of this article is to study the two phases of the poliomyelitis’ vaccination campaign in the years 1963 and 1964, with the Sabin oral vaccine, in the city of Jerez de la Frontera (Cádiz). We also expound some data about the vaccination campaign in 1965 against polio, diphtheria, whooping cough and tetanus in the same city. We have used, in our study, original documents sources from Municipal Archives of Jerez, other archives and libraries of the province, as well as local, regional and national press, which have provided us some information on the mentioned vaccination campaigns.

Objectives. In Latin America and the Caribbean (LAC), pertussis disease incidence has reportedly increased since 2000 despite high vaccine coverage. A systematic review of pertussis literature and a meta-analysis was conducted to understand the burden of disease in LAC. Methods. A systematic literature review was completed, using relevant search terms. Original articles describing pertussis epidemiology and vaccine coverage in LAC published between 1980 and 2015 were identified. Applying a Bayesian meta-analysis random-effects model, we calculated pooled estimates and corresponding 95% credible intervals (95% CrIs) for pertussis incidence, case fatality ratio (CFR), pertussis prevalence among contacts, and coverage with three doses of diphtheria, tetanus, and pertussis (DTP) vaccine (DTP3). Results. A total of 59 studies meeting our selection criteria were identified, representing 15 countries. Of the 59, 15 of them provided incidence data, with 7 of the 15 reporting a pertussis case definition. The pertussis incidence estimate for the 1980-1999 period was 17.8 cases per 100 000 persons (95% CrI: 5.9-29.7); for the 2000-2015 period, it was 2.5 cases per 100 000 persons (95% CrI: 1.8-3.2). For the 1980-2015 period, the CFR, in 19 studies reviewed, was 3.9% (95% CrI: 2.9%-4.9%); for that same period, in 5 studies reviewed, pertussis prevalence among contacts was 24.9% (95% CrI: 13.7%-36.1%). Pooled DTP3 vaccine coverage estimates, in a total of 20 studies reviewed for the following three time periods, were: 1980-1990, 72.4% (95% CrI: 64.6%-80.2%); 1991-2000, 79.0% (95% CrI: 66.1%-91.9%); and 2001-2015, 90.0% (95% CrI: 87.7%-92.3%). Conclusion. A decrease in pertussis incidence and an achievement of moderately high DTP3 vaccine coverage since the early 2000s was observed. The review highlights the need for increased publication of pertussis data at the country level and for LAC as a whole in order to better understand the true burden of the disease. Application of a standardized case definition and use of active case finding would aid in obtaining more accurate estimates of the disease burden in LAC. [ABSTRACT FROM AUTHOR]

Pertussis-like syndrome and whooping cough-like illness are the terms used to refer to the indistinguishable signs and symptoms of whooping cough in the absence of laboratory tests to confirm the presence of the bacteria that causes it. Although there are no reported cases in Cuba, it is important to keep paying attention to the most representative symptoms of this disease, since there has recently been a resurgence of whooping cough in the world. Therefore, it is relevant to present the case of a patient with a two-week history of upper respiratory symptoms and dry cough. These symptoms intensified, so she attended the emergency service of her health area.

ertussis is an endemic disease in our population. Every 3 to 4 years, pertussis has an epidemic pattern even in countries with good health conditions. Antipertussis vaccine first dose is adminis- tered at the age of 2 months; a second and third dose are given at 4 and 6 months of age. This vaccine has an 8 to 10 year protective effect, for which reason it is suggested that pregnant women in the third trimester should be vaccinated in order to prevent pertussis in newborns. It should also be administered to older people to avoid turning them into asymptomatic carriers. Clinic manifestations are easily identifiable due to respiratory symptoms, especially to the particular characteristics of the cough. The diagnosis is supported by the presence of leukocytosis (predominantly lymphocytes) and by certain thoracic radiologic findings. The diagnosis is confirmed with a positive culture for Bordetella pertussis or with a polymerase chain reaction (PCR). In a non complicated clinic course macrolides are still the best therapeutic choice. Nonetheless clinic observation is highly recom- mended in order to avoid complications. Redefinition of vaccine programs against Bordetella pertussis in Mexican population is recommended and also to notify the presence of the disease to the corresponding health authorities.

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El síndrome coqueluchoide, cuadro parecido a la tos ferina, es uno de los síndromes respiratorios bajos más comunes en la práctica pediátrica sobre todo en los últimos años. La tos ferina sigue siendo la enfermedad inmunoprevenible más antigua de la infancia que aún causa brotes importantes, principalmente en niños, pero también en adolescentes y adultos. El objetivo de esta revisión es proporcionar información a todos los médicos generales y pediatras de atención primaria y secundaria de salud sobre este problema epidemiológico y de su actual reemergencia. El control de esta enfermedad es un problema de salud tanto en países desarrollados como en vías de desarrollo. Uno de los mayores obstáculos que ha contribuido a una tardía intervención epidemiológica y tratamiento de la tos ferina en varios países del mundo, ha sido la baja sospecha clínica de esta enfermedad en los médicos y trabajadores de la salud, y el desconocimiento de la familia, en la mayoría de las veces. En el momento actual existe una reemergencia mundial de la tos ferina, situación que es necesario conocer y aceptar para un oportuno diagnóstico y tratamiento.Pertussis-like syndrome, a clinical picture similar to whooping cough, is one of the most common lower respiratory syndromes in the pediatric practice in recent years. Whooping cough continues to be one of the oldest preventable diseases in infants, which still causes significant outbreaks mainly in children, but also in adolescents and adults. The objective of this review was to provide general physicians and pediatricians at the primary and the secondary health care levels with information about this present re-emerging epidemiological problem. The management of this disease is difficult for both the developed and the developing countries. One of the major obstacles that lead to delayed epidemiological intervention and treatment of whooping cough in several countries has been the poor clinical suspicion of the presence of the disease on the part of health workers and physicians, and the lack of knowledge within the family setting. It is required to know and to accept the re-emergence of whooping cough at present, in order to make a timely diagnosis and to apply a line of treatment.

La tos ferina es una enfermedad del tracto respiratorio superior que ha incrementado últimamente su incidencia. Se ha demostrado que los adultos son la principal fuente de transmisión para los niños susceptibles. En la actualidad, la enfermedad afecta con más frecuencia a los niños menores de 3 meses, entre los cuales, los menores de 1 mes tienen mayor riesgo de complicaciones y letalidad. Se presenta un caso autóctono de una recién nacida de 16 días con episodios de tos quintosa, cianosante y emetizante, cuadro hemático que evidencia leucocitosis y linfocitosis, que se originó en un área donde está implementada, como política de salud pública, la vacunación para tos ferina en niños. La paciente tuvo una evolución tórpida complicada con convulsiones y necesidad de ventilación mecánica. Se identificó en la paciente Bordetella pertussis por inmunofluorescencia, reacción en cadena de la polimerasa y cultivo. Se hace una breve revisión de la literatura, haciendo énfasis en el panorama actual de la vacunación en neonatos.Neonatal pertussis is an upper respiratory tract infection whose incidence has recently increased. Adults have been demonstrated to be the main source for neonatal infection, accounting for the rising rates of disease in this later population group. Currently, the disease affects chiefly infants under three months of age, among which, those younger than one moth have the highest rates of complication and death. Here we present an indigenous case of a 16 days old newborn that arose in an area where pertussis vaccination during the first months of life is the rule and very few cases had been documented throughout the last years. The patient presented whooping cough with cyanosis and emesis episodes, whose complete blood count showed markedly and increasingly high leukocytosis and lymphocytosis. Her clinical course complicated with seizures and required mechanical ventilation. B. pertussis was demonstrated by means of immunofluorescence, polymerase chain reaction and culture. A brief literature review is made with emphasis on current landmarks on pertussis vaccination.

OBJECTIVE: To develop a model to assess different strategies of pertussis booster vaccination in the city of São Paulo. METHODS: A dynamic stationary age-dependent compartmental model with waning immunity was developed. The "Who Acquires Infection from Whom" matrix was used to modeling age-dependent transmission rates. There were tested different strategies including vaccine boosters to the current vaccination schedule and three of them were reported: (i) 35% coverage at age 12, or (ii) 70% coverage at age 12, and (iii) 35% coverage at age 12 and 70% coverage at age 20 at the same time. RESULTS: The strategy (i) achieved a 59% reduction of pertussis occurrence and a 53% reduction in infants while strategy (ii) produced 76% and 63% reduction and strategy (iii) 62% and 54%, respectively. CONCLUSION: Pertussis booster vaccination at age 12 proved to be the best strategy among those tested in this study as it achieves the highest overall reduction and the greatest impact among infants who are more susceptible to pertussis complications.

La tos ferina sigue siendo responsable de una carga de enfermedad importante en el mundo. Aunque la implementación del uso de la vacuna contra esta enfermedad ha disminuido en gran medida el número de casos en la población pediátrica, se ha observado que la inmunidad inducida por la vacuna y por la infeccion natural disminuye con el tiempo lo que hace nuevamente susceptibles a adolescentes y adultos jóvenes que pueden transmitir la enfermedad a lactantes no inmunizados o con esquema de vacunación incompleto. Este documento, resultado de la reunión de un grupo internacional de expertos en la Ciudad de México, ha analizado la información médica reciente para establecer el estado actual de la epidemiología, diagnóstico, vigilancia y, especialmente, el valor de la dosis de refuerzo con dTpa en adolescentes y adultos como estrategia de prevención de tos ferina en México.Pertussis continues to be responsible for a significant disease burden worldwide. Although immunization practices have reduced the occurrence of the disease among children, waning vaccine- and infection-induced immunity still allows the disease to affect adolescents and adults who, in turn, can transmit the disease to non-immunized or partially immunized infants. This document is the result of a meeting in Mexico City of international experts who analyzed recent medical information in order to establish the current status of the epidemiology, diagnosis and surveillance of pertussis and, especially, the value of the dTpa booster dose in adolescents and adults as a pertussis prevention strategy in Mexico.

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El Gran Catharro (1580) es considerado como la primera epidemia de gripe. El análisis conjunto de los datos contenidos en diferentes testimonios, suscita dudas respecto a que se tratara de una epidemia de gripe y apoyan la posibilidad de que se tratara de una de tos ferina.

Fundamento: A partir de la declaración de varios casos en un centro escolar se inicia el estudio de brote con el objetivo de caracterizar éste desde el punto de vista de persona, lugar y tiempo; se calcula la efectividad de la vacuna, y se estudia la concordancia entre los casos y el resultado positivo del estudio serológico. Métodos: Se define caso a la persona que presenta tos persistente de dos semanas de duración. Se realiza estudio de la difusión de la enfermedad a través de la curva epidémica, y de la efectividad de la dosis de refuerzo de la vacuna antipertussis. La concordancia entre los casos y la serología positiva se evalúa por el índice Kappa. Resultados: Entre los alumnos de varios centros escolares y sus convivientes se encuesta a 130 personas, de los que 94 entran en la definición de caso. La media de edad de los casos es 10,5 años, un 42,6% son varones, el 84% escolares, el 71,3% muestra signos de infección reciente (IgM positiva), y el tiempo medio desde la última dosis de vacuna antipertussis es de 8,25 años. La efectividad de la dosis de refuerzo de la vacuna es del 66%. La concordancia entre los casos y el resultado positivo de la serología muestra un Kappa igual a 0,45. No se aisló B. Pertussis en las 25 muestras de frotis faríngeo. Conclusiones: Las aulas y el medio familiar son un factor de difusión de la enfermedad. La inclusión de una dosis de refuerzo a los 18 meses mejora la efectividad de la vacuna antipertussis. El aislamiento de la B. Pertussis es poco frecuente, y la serología, puede ser una alternativa ante la sospecha clínica de la enfermedad.

Fundamentos: Para un buen desarrollo de los programas de vacunación es primordial conocer la cobertura de vacunación. En las Islas Baleares la cobertura notificada era muy inferior a la del resto de España. El objetivo de este trabajo es la estimación de la cobertura de las vacunas incluidas en el calendario recomendado hasta los 18 meses de edad (4 dosis de polio oral, tétanos y difteria; 3 de tosferina; 1 de sarampión, rubeola y parotiditis). Métodos: Estudio descriptivo, transversal, de base poblacional. Se calcularon los estimadores puntuales de distribución de frecuencias y los intervalos de confianza al 95% (IC95%) correspondientes, sobre una muestra de la población residente en Baleares de dos años de edad (nacida en 1995), seleccionada por muestreo aleatorio por conglomerados en una sola etapa a partir de las secciones censales. Se consultan los registros de vacunas de Sanidad y de los centros de salud del Insalud, se pide telefónicamente a las familias los datos del documento de vacunación y a los pediatras privados los de la historia clínica. Resultados: La muestra incluía 606 niños. Pudo obtenerse la información completa de 532. Se consiguió la información completa de 377 casos (62%) a partir de los registros del sector público. La cobertura más baja fue la de la vacuna antidiftérica, 518 niños complentamente vacunados, el 96,8% (IC95% = 94,8 - 98,1) y la más alta la de la vacuna antipertussis, 537 niños, el 98,9% (IC95% = 97,5 - 99,5). Conclusiones: En las Islas Baleares existe una buena cobertura de la vacunación, similar a lo que se viene estimando en España en su totalidad. Se cumple el objetivo incluido en el Plan de Erradicación de la Polio. La información recogida desde el sector público es escasa.

The aim of this article is to study the two phases of the poliomyelitis' vaccination campaign in the years 1963 and 1964, with the Sabin oral vaccine, in the city of Jerez de la Frontera (Cádiz). We also expound some data about the vaccination campaign in 1965 against polio, diphtheria, whooping cough and tetanus in the same city. We have used, in our study, original documents sources from Municipal Archives of Jerez, other archives and libraries of the province, as well as local, regional and national press, which have provided us some information on the mentioned vaccination campaigns. [ABSTRACT FROM AUTHOR]

Background: Bordetella pertussis infection remains a public health problem in several developed and developing we describe the epide-miological syndrome cases subsystem special surveillance of whooping cough from 1992 to 2011 at a population with social security. Methods: We obtained special cases subsystem Pertussis surveillance of 1992-2011. Univariate analysis was made of rates, ratios and proportions. Wilson was determined test for proportions to an alpha of 0.05, t-test for mean difference. Results: We appreciate epidemic cycles every three to five years, the average baseline incidence, excluding epidemic years, 0.1 is considered confirmed cases per 100 000 beneficiaries assigned to family medicine, the highest incidence was recorded in 1997 and 2009. The most affected were children under 1 year of age and in outbreaks, the disease occurred at older ages. Conclusions: During the period observed intermediate epidemic cycles 5 and 3 years of age presentation is consistent in other countries. [ABSTRACT FROM AUTHOR]

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Copyright of Acta Pediátrica Española is the property of Ediciones Mayo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Pertussis is a respiratory infection caused by bacteria of the genus Bordetella, mainly pertussis and parapertussis species. Despite the high vaccination coverage in developed countries, it is considered a re-emerging disease that is also underreported and underdiagnosed, especially in patients who do not require hospital referral., Material and Methods: Descriptive, prospective and multicentre study of pertussis diagnosis and contact investigation in 17 primary care paediatric clinics through collection of samples for polymerase chain reaction (PCR) testing over a period of 4 years and after the implementation of routine vaccination against pertussis during pregnancy., Results: Pertussis was diagnosed in a total of 50 patients; the estimated incidence in these years was higher compared to previous rates in the paediatric age group. Fourteen percent of the cases occurred in children aged less than 1 year. The mean age was 6.7 years. Cough was present in 100% of cases, followed in frequency by vomiting and rhinorrhoea. Only 1 patient required hospital admission, and none died or developed complications. B. pertussis was the predominant causative agent. Only 40% knew the source of infection. In 26% of the cases, pertussis was confirmed in contacts of the patient by PCR, and in 46% it was suspected based on the clinical presentation but without microbiological confirmation., Conclusions: Access to diagnostic tests (PCR) for pertussis in primary care allows us to optimise its diagnosis and treatment, to break the chain of transmission, to know the real incidence rates and to assess the impact of routine vaccination of pregnant women on this disease., (Copyright © 2022 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.)

Introducción: la tos convulsa, enfermedad producida por Bordetella pertussis, fue clásicamente una enfermedad de la niñez. Desde hace años se reportan cambios en la presentación clínica. Aumentan los casos en adolescentes y adultos jóvenes con cuadros no característicos, y en lactantes pequeños, aún no protegidos por vacuna, algunos graves y mortales. Según la Organización Mundial de la Salud ocupa el quinto puesto en las causas de muerte prevenibles por vacuna. Para modificar los esquemas de inmunización es importante conocer la epidemiología de cada país. Objetivo: esta investigación pretende contribuir a establecer si la tos convulsa sigue presente entre los lactantes hospitalizados en el Centro Hospitalario Pereira Rossell (CHPR). Material y método: se realizó un estudio observacional, longitudinal y prospectivo desde el 1º de enero al 31 de diciembre del año 2008. Se incluyeron todos los lactantes menores de 6 meses que ingresaron al CHPR con diagnóstico clínico probable de tos convulsa, acompañado de leucocitosis igual o mayor a 20.000/mm³. Se investigó Bordetella pertussis por técnica de PCR (reacción en cadena de polimerasa). Resultados: ingresaron al estudio según criterios preestablecidos 26 lactantes. En diez pacientes se obtuvo PCR positiva. La media de edad fue de 2 meses; la media de tos, 11 días, 6/10 de los niños no estaban inmunizados. En 8/10 había personas con tos en el domicilio. Conclusiones: se confirma la vigencia de tos convulsa en los lactantes usuarios del sector público. Difundir el problema y discutir nuevas estrategias de vacunación contribuirán al control de esta enfermedad.

Pertussis is an endemic disease in our population. Every 3 to 4 years, pertussis has an epidemic pattern even in countries with good health conditions. Antipertussis vaccine first dose is administered at the age of 2 months; a second and third dose are given at 4 and 6 months of age. This vaccine has an 8 to 10 year protective effect, for which reason it is suggested that pregnant women in the third trimester should be vaccinated in order to prevent pertussis in newborns. It should also be administered to older people to avoid turning them into asymptomatic carriers. Clinic manifestations are easily identifiable due to respiratory symptoms, especially to the particular characteristics of the cough. The diagnosis is supported by the presence of leukocytosis (predominantly lymphocytes) and by certain thoracic radiologic findings. The diagnosis is confirmed with a positive culture for Bordetella pertussis or with a polymerase chain reaction (PCR). In a non complicated clinic course macrolides are still the best therapeutic choice. Nonetheless clinic observation is highly recommended in order to avoid complications. Redefinition of vaccine programs against Bordetella pertussis in Mexican population is recommended and also to notify the presence of the disease to the corresponding health authorities. [ABSTRACT FROM AUTHOR]

Despite vaccination against pertussis, there are still a large number of pertussis deaths worldwide. Waning vaccine-induced immunity and the gradual increase in reported incidence among adolescents and adults have supported the role of these age groups in the transmission. Several countries have implemented a booster vaccination in order to reduce transmission and clinical significance. Pertussis is a current public health problem in Mexico. The clinical suspicion in toddlers, adolescents and adults, delayed or incomplete vaccination series and diagnosis confirmation are the most important challenges for pertussis control. The introduction of new vaccination strategies in adults and adolescents as well as pregnant women should improve disease control. [ABSTRACT FROM AUTHOR]

Copyright of Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To evaluate the health care workers' knowledge about some aspects of pertussis disease and its prevention by vaccination Methods: Surveys were conducted in 136 health professionals and medical students at the Clínica Razetti and Hospital Pediatrico "Agustin Zubillaga" of Barquisimeto. Results:A total of 136 surveys were conducted. 95.6% of the persons who were interviewed work in direct contact with infants and older children, 87% (95% CI: 80.7 to 92.8%) of respondents are aware that pertussis not only affects children, 55.8 % thought that the immunity conferred by pertussis continues throughout life. 73.5% felt that there is no need to apply boosters against pertussis after application of the childhood schedule, 64% were unaware that a vaccine against pertussis is available for adolescents and adults. 81% of those surveyed responded affirmatively that they would vaccinate against pertusis. Conclusion: The study provides data suggesting that health personnel in this study, in its majority, have knowledge of the importance of pertussis in small children; as well as the potential for infection of the adolescent and adult population. However, their knowledge about protection through immunization and its duration, is scarce; furthermore, since they have a good disposition towards prevention of the disease, educative efforts should be directed towards this population to help implement the diverse strategies of vaccination for a better control of the disease. [ABSTRACT FROM AUTHOR]

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: to describe an epidemiological study of one case of pertusis. Clinical case: a five-year old boy was diagnosed with pneumonia and he had incomplete DPT vaccination scheme; pertusis was diagnosed by using the PCR technique and culture. An epidemiological study with family contacts was carried out, in which 20 samples for both tests were obtained. These were taken twice. Results: The average age of the family members was 26.5 years, 50% were women, 62% did not have social security and 30% had three doses of DPT. 35% were positive to PCR and, 20% out of these had positive cultures. Conclusions: in children smaller than five years suffering from pneumonia, is relevant to ascertain about DPT vaccination status and to consider the possibility of carrying out an epidemiological study with the family. [ABSTRACT FROM AUTHOR]

Pertussis is a highly contagious disease caused by Bordetella pertussis, which may be preventable by vaccination. There are two types of vaccines: whole-cell vaccines and acellular vaccines. Since pertussis control worldwide is heterogeneous, re-emergence of whooping cough has been observed in some countries. This re-emergence has been related to several factors: increased susceptibility to infection, better detection of disease, problems in obtaining adequate vaccination coverage, increase in susceptible subjects (mainly under 6 months of age), loss of immunity in adolescents and young adults, and likely genetic and adaptive B. pertussis changes. This paper discusses whole-cell and acellular vaccines' characteristics, advantages, and disadvantages. International recommendations are presented, and the participants' position is offered regarding the influence of the use of acellular vaccines and the potential disadvantages of reintroducing whole-cell vaccines, mainly due to their reactogenicity. Finally, strategies to achieve better control of pertussis in Mexico are discussed.

Una sinopsis de los hechos más notables presentados a la Asociación Médica Americana como fruto del trabajo de investigadores de diversas partes del Hemisferio Occidental, reviste la mayor importancia para la información de los profesionales colombianos. Datos generales, y en lo posible lo más concisos, se dan en este resumen sobre trabajos personalmente seleccionados de Medicina General, Patología, Fisiología, Medicina Tropical e Higiene Pública, los cuales fueron presentados o exhibidos ante los 8.103 médicos que asistieron a la Convención médica más importante de los tiempos actuales.

Enfermedad infectocontagiosa endémica, con brotes epidémicos, caracterizada por su típica evolución y sus accesos de tos en quintas, en uno de sus períodos evolutivos.

Copyright of Matronas Profesion is the property of Ediciones Mayo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Ante el aumento de la incidencia de tos ferina a nivel mundial han surgido nuevas estrategias de vacunación para paliar la situación ya que, pese a las altas coberturas de vacunación en países desarrollados, se sigue observando un aumento del número de casos. Una de estas estrategias es la vacunación de las mujeres embarazadas, actualmente la mayor seguida. Este hecho ha llevado al estudio del riesgo real que tienen las mujeres en edad fértil en España para contraer tos ferina. Tras el análisis de los datos epidemiológicos encontrados y estudios revisados, las mujeres en edad fértil no son un grupo prioritario de riesgo de padecer la enfermedad, como sí lo son los menores de un año. Sí se ha visto que vacunando a la mujer embarazada se logra un paso de anticuerpos que proporciona protección al recién nacido hasta el comienzo de su primovacunación. También se ha visto que la vacunación reduce las formas graves de presentación de la enfermedad así como el tiempo de hospitalización, pero se produce una pérdida de inmunidad que no protege frente a la enfermedad por lo que habría que considerar nuevos proyectos de investigación de una vacuna que confiera mayor inmunidad y mejores medidas de diagnóstico ya que, muchas veces fuera de la infancia, no se diagnostica la enfermedad.

Pertussis incidence has increased in recent years, especially among infants aged <2months. A number of Spanish regions have started a vaccination program with Tdap vaccine to all pregnant women in the third trimester of pregnancy. An observational study has shown that this strategy reduces the number of cases of pertussis by 90% in infants aged <2months. Mathematical models showed that a cocooning strategy (i.e. vaccination of the mother at immediate postpartum, and other adults and adolescents who have close contact with the newborn and caregivers) will reduce the incidence of pertussis by 70% in infants aged <2months. It is intended to conduct a clinical trial in which 340 pregnant women will receive Tdap vaccine, whereas another 340 pregnant woman will be vaccinated soon after delivery. Vaccination with Tdap will be offered to all partners and caregivers of the newborn. After assessing both the ethical and scientific reasons supporting the trial, it is concluded that it is ethically and legally acceptable to invite pregnant women living in communities where Tdap vaccination has been implemented to participate in the trial., (Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.)

Introduction: An increase in whooping cough in most of the developed countries has been detected in the last decade., Objective: To determine whether the administration of dTpa vaccine instead of DTPa fifth dose is contributing to the appearance of these cases., Methods: A descriptive study based on cases of whooping cough reported during an epidemic period in the city of Alicante in the first 5 months of 2014. Only pertussis cases confirmed by PCR were included in the study, and only those vaccinated with 5 doses were included in the analysis of the period of protection., Results: A total of 104 cases of pertussis confirmed by PCR were reported, with 85 cases (82%) having had 5 doses of vaccine. The mean time and standard deviation (SD) of protection was 2.1±1.1 years with dTpa, and 5.1±1.5 years with DTPa (p<.001). In the protection, adjusted for age, it was observed that, after 3 years, only 47.6% of people vaccinated with dTpa were still protected, while people vaccinated with DTPa were 100% protected (P<.001)., Conclusions: This study found that people who were properly vaccinated against pertussis and received their last re-vaccination dose with dTpa had a shorter period of protection than those who were vaccinated with DTPa., (Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.)

Pertussis continues to be a public health problem despite the significant decrease in its incidence due to routine vaccination. Resurgence of the disease in countries that have maintained high vaccination coverage has been observed in recent years. Although vaccination is the most effective preventive control measure, both natural and artificial immunity wane over time, and thus the protection offered by current vaccines is not long-lasting. Furthermore, acellular vaccines are less effective. The implementation of new vaccine strategies is required. Vaccination of pregnant women is the most effective strategy for preventing pertussis in young infants, who are the most vulnerable, and should be recommended together with cocooning, ie vaccination of future household and extra-domiciliary contacts who are the main transmitters of the disease., (Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.)

Introduction: We describe the pertussis epidemic, based only on confirmed whooping cough cases. We have analyzed data on the diagnosis, epidemiology and vaccine history in order to understand the factors that might explain the trends of the disease., Methods: A descriptive study of the confirmed pertussis cases reported during 2011 in the Vallès region (population 1,283,000). Laboratory criteria for confirmed pertussis cases include isolation of Bordetella pertussis from a clinical specimen or detection of B. pertussis by PCR in nasopharyngeal swabs., Results: A total of 421 pertussis confirmed cases were reported, which was the highest incidence reported in the last decade (33 cases/100,000 people/year in 2011). The highest incidence rate was among infants less than 1 year old (448/100,000), followed by children 5-9 years old (154/100,000). Pertussis cases aged 2 months-1 year were 90% vaccinated following the current DTaP schedule for their age group in Catalonia, and cases of 5-9 years were 87% fully vaccinated with 5 doses of DTaP vaccine. There were no deaths, although 8% of cases were hospitalized. Pertussis was more severe in infants, 30% required hospitalization despite having received the vaccine doses corresponding to their age. Children of 5-9 years were most often identified as primary cases in households or school clusters., Conclusion: Despite high levels of vaccination coverage, pertussis circulation cannot be controlled at all. The results question the efficacy of the present immunization programmes., (Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.)

Introduction: Pertussis incidence has increased in recent years in countries with high vaccination coverage. The aim of this study was to determine the health impact of pertussis in Spain in the period 1997-2011 in relation to hospitalizations, mortality, and associated costs., Methods: We retrospectively analyzed hospital discharges included in the Minimum Data Set (MDS) in Spain for the period 1997-2011, with a primary or secondary diagnosis related to pertussis. We calculated incidence rates of hospitalization for pertussis (per 100,000) per year, by age group and by Autonomous Region, along with the mortality and lethality rates., Results: A total of 8,331 hospital discharges with a diagnosis of pertussis were recorded in Spain between 1997 and 2011. The overall incidence of pertussis hospitalizations was 1.3 cases per 100,000 inhabitants. The large majority (92%) of hospitalizations occurred in children under one year of age, with an incidence of 115.2 hospitalizations per 100,000. There were 47 deaths, 37 (79%) in the group of children under 1 year and 6 (13%) in the group older than 65 years. The estimated cost of hospitalization for pertussis was 1,841 euros., Conclusion: The epidemiology of severe cases of pertussis, and its clinical and economic impact, confirms the need to modify the vaccination strategies for Spain to achieve more effective control in the most vulnerable groups., (Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.)

Introduction: An increase in cases of pertussis, mainly in young infants, has been reported in the last few years. The clinical presentation of this disease is very similar to that produced by respiratory syncytial virus (RSV), which makes the diagnosis difficult., Objective: To compare the clinical and epidemiological characteristics between Bordetella pertussis and RSV infections in infants admitted to hospital., Material and Methods: An analytical matched case-control study was conducted during the period 2008-2011. Cases were defined as infants admitted with pertussis confirmed by PCR in nasopharyngeal aspirate. Each case was matched by age, sex and date of admission to two controls defined as patients with RSV infection detected by immunochromatography in nasal aspirate. Demographic, clinical, laboratory data were compared., Results: Seventy eight patients (26 cases of pertussis and 52 controls RSV+) were included. Sociodemographic characteristics were similar in both groups. Cases had more days of symptoms prior to admission, longer hospital stays, and increased frequency of epidemic family environment. Apnoea and cyanosis were more frequent. Cases of pertussis were more likely to have apnoea, cyanosis, and lymphocytosis while RSV infections had more frequent fever, vomiting and respiratory distress., Conclusions: The clinical presentations of pertussis and RSV infection are similar, but there are some characteristics that can help to distinguish between them., (Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.)

Objective: To analyse the vaccination status of children diagnosed with pertussis and to compare the clinical manifestations of fully vaccinated with unvaccinated, or incompletely-vaccinated, children., Methods: The clinical histories and vaccination cards of patients under 16years of age seen in the Emergency Room of the University Hospital Vall d'Hebron, Barcelona (Spain), for pertussis confirmed by a microbiological study were reviewed. The study period lasted from January 1, 2009 to December 31, 2011., Results: Two hundred and twelve cases were studied: 35 in 2009, 28 in 2010 and 149 in 2011. RT-PCR was positive in 210 patients, and 73 had a positive culture. Infants under 6months of age account for 36.8% of all cases. Forty-four patients (21.5%) were not vaccinated. Forty-four (21.5%) children were between 2 and 5months of age and had received 1-2vaccine doses. One hundred and seventeen (57%) children were fully vaccinated; 76.9% (90cases) had received the last dose less than 4years ago. When clinical manifestations of the fully vaccinated patients were compared with those of the non-vaccinated or incompletely-vaccinated children, only cyanosis was found with a higher frequency in the latter group (P<.001). The age-adjusted probability of hospitalisation was significantly associated with non-vaccination (P=.001). The case mortality rate among inpatients was 1.3%., Conclusions: The number of pertussis cases seen in our centre has risen significantly in the last year. More than half (57%) of the patients were fully vaccinated, and 76.9% had received the last dose in the previous 4years. Other vaccination strategies, such as vaccination of adolescents, adults, and pregnant women, as well as a cocoon strategy are required to protect infants under 6months of age. More effective vaccines need to be developed., (Copyright © 2012 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.)

Background and Objectives: Pertussis remains an important cause of morbimortality despite current vaccination strategies. This study was designed to describe the results and characteristics of close contacts of pertussis cases diagnosed in children less than 16 years in a tertiary hospital in Barcelona., Patients and Methods: Cross-sectional study. Data were collected from chart review of contacts of paediatric cases of pertussis in Vall d'Hebron University Hospital from 2005 to 2009. Only patients with microbiological study done were included. The odds ratio (OR) and 95% confidence interval (95% CI) were calculated as association measure., Results: Ninety-one index cases and 404 contacts were studied. The prevalence of positive cases among contacts was 33.2%. Contacts of index cases younger than 6 months had a higher risk of being positive for pertussis than contacts of older children (OR: 3.38; 95% CI: 1.88-6.10). Primary cases were identified as 16.7% of the contacts studied, who were the source of infection for 67.7% of index cases younger than 6 months and for 26.9% of older index cases., Conclusions: Contact tracing of paediatric pertussis cases is a necessary clinical activity. It is more likely to find primary cases in the contact investigation of children less than 6 months. Preventive strategies should be targeted primarily to frequent contacts of this age group., (Copyright © 2012 Elsevier España, S.L. All rights reserved.)

Introduction: Pertussis is a highly contagious vaccine-preventable disease. An increasing incidence has been reported in several countries around the world in the last few years. The aim of this study is to analyze the situation of pertussis in the Valencian Community (Spain), with the purpose of verifying the increased incidence of the illness., Methods: A descriptive analysis of probable and confirmed cases detected during 2011 was conducted. Methods used for Bordetella pertussis detection from clinical samples were: culture isolation, polymerase chain reaction (PCR)-based detection of bacterial DNA, and/or detection of specific IgM antibodies. The disease incidence and other epidemiological variables were estimated. These results were compared to data collected in previous years (2008-2010). The Epidemiological Surveillance Analysis and Microbiological Surveillance Network integrated systems of the regional Department of Health were used as sources of information., Results: In 2011, 249 cases of pertussis were detected (incidence rate of 4.89×10(5) inhabitants). This rate is statistically significantly higher than those reported in 2008 (0.73×10(5) inhabitants), 2009 (0.53×10(5) inhabitants), and 2010 (0.53×10(5) inhabitants). The highest incidence rate was observed in cases younger than one year old (252.97×10(5) inhabitants), with marked differences compared to the rest of age groups. More than two-thirds (69%) of reported cases were confirmed by a laboratory test. Detection of specific serum IgM antibodies was positive in 10% of cases, culture isolation was positive in 17%, and PCR-based detection of bacterial DNA in 35% of cases., Conclusions: The results of this study show a clear increase of pertussis incidence in the Valencian Community during 2011., (Copyright © 2012 Elsevier España, S.L. All rights reserved.)

Introduction: Despite routine pertussis immunization, pertussis burden remains high, especially among infants. The aim of this study was to describe epidemiologic, clinical and outcome features in pediatric patients admitted to a tertiary hospital in Andalusia (Southern Spain) with confirmed Bordetella pertussis infection., Methods: Retrospective descriptive study based on a review of medical records for all pediatric patients admitted to Hospital Universitario Virgen del Rocío (Sevilla) between January 1, 2007 and December 31, 2011., Results: Overall, 39 patients were diagnosed with pertussis during the study period with significant higher incidence rate in 2011 compared to 2007 (p=0.0003). Eleven children were admitted to the pediatric intensive care unit (ICU) in 2010 and 2011 and two of them died. Patients who were admitted to ICU presented with more atypical disease compared to controls in a conventional ward. They were less likely to have pertussoid cough and clinical diagnosis at admission and had a smaller percentage of lymphocytes. Creactive protein values were higher and they had a longer duration of hospital stay., Conclusion: The pertussis incidence rate increased significantly among hospitalized infants during the study period, and was associated with severe morbidity, including unusual complications, and mortality. A higher awareness of the clinical diagnosis of pertussis among infants admitted to ICU is required due to more atypical manifestations, and the risk of sudden deterioration associated to fatal outcome., (Copyright © 2012 Elsevier España, S.L. All rights reserved.)