Table 2.
Overview of epidemiology studies of pertussis in Western Europe
| Country, design, period Age, N |
Laboratory method of diagnosis | Key findings | |
|---|---|---|---|
|
Austria [35] Hospital-based, case surveillance November 1995 to December 1998 < 16 years 184 suspected cases |
PCR, culture, ELISA/seroconversion (paired sera) |
71 Incidence/100,000: < 5 years: 2,385 6–10 years: 1841 11–16 years: 302 |
|
|
Belgium [36] Population-based, national surveillance 2008–2012 All ages 342 notified cases |
PCR, culture, or fourfold rise in sera antibody titre |
208 in 2008 356 in 2012 (71% increase) 181 cases were in children aged > 5 years |
|
|
Belgium [38] Population-based, active surveillance 2012 20–29.9 years 670 leftover serum samples |
PT IgG > 50 IU/ml |
n (%) E. Flanders: 8 (6.7) W. Flanders: 13 (10.2) Liege: 4 (3.2) Hainaut: 8 (13.1) Brussel: 6 (4.8) Bruxelles: 7 (6.0) |
|
|
Belgium [37] Population-based, active surveillance 2012 20–39 years 1500 left over serum samples |
PT IgG > 100 IU/ml |
n E. Flanders: 16 W. Flanders: 11 Liege: 6 Hainaut: 14 UZ Brussels: 5 CHU Bruxelles: 9 |
|
|
France [41] Healthcare based, case surveillance June 2013 to August 2014 > 50 years 129 suspected cases (cough 7–21 days) |
PCR |
Incidence/100,000 103.6 (crude) 187.1 (extrapolated) |
|
|
France [43] Healthcare based, case surveillance June 2013 to August 2014 > 50 years 129 suspected cases (cough 7–21 days) |
PCR |
Incidence/100,000 50 years: 187.1 Large cities: 131.1 Medium cities: 256.1 Rural: 187.1 |
|
|
France [42] Case surveillance (outbreak hospital) July 1997 Adults 59 HCWs |
PCR, culture, or twofold rise in sera antibody titre |
10 (17%) | |
|
France [40] Population-based, national surveillance 2000–2005 All ages 595 cases |
PCR, culture, or serology |
Aged 0–15 years: 20 cluster cases; 2 sporadic cases; 175 cases outside of healthcare Aged > 15 years: 228 cluster cases; 2 sporadic cases; 101 cases outside of healthcare |
|
|
France [44] Healthcare based, case surveillance March and December 1999 Mean 42 years 127 patients with cough < 7 days |
PCR and/or a significant increase or decrease in anti-PT IgG between acute and convalescent sera |
70/183 confirmed cases; 32% (95% CI: 26–39) PCR-positive: 36 Confirmed: 40 |
|
|
France [46] Population-based, active sero-surveillance June to December 2005 18–60 years 331 travellers attending vaccination clinic |
PT IgG 20–124 IU/ml | Age years | Cases (%) |
| 18–29 (n = 134): | 43 (32.1) | ||
| 30–39 (n = 41): | 12 (29.3) | ||
| 40–49 (n = 89): | 28 (31.5) | ||
| 50–60 (n = 67): | 22 (32.8) | ||
| PT IgG ≥ 125 IU/ml |
18–29 (n = 134): 30–39 (n = 41): 40–49 (n = 89): 50–60 (n = 67): |
18 (13.4) 1 (2.4) 5 (5.6) 1 (1.5) |
|
|
France [45] Healthcare-based, case surveillance April to December 1999 18–88 years 217 with persistent cough |
≥ twofold change in anti–PT IgG or IgA change or PCR positive or culture positive | 103 (51.5%) | |
| ≥ twofold change in anti–PT IgG or IgA | 40 (20) | ||
| ≥ twofold change in anti–PT IgA | 60 (30.5) | ||
| PCR positive | 36 (18%) | ||
| Culture positive | 1 (0.5%) | ||
|
Germany [47] Population-based, active surveillance February 1993 to May 1995 Children 14,144 random sample |
PCR or anti-PT IgG levels > 95th centile of an age matched control cohort (defined as recent contact) |
180 4.8/1000 person-years |
|
|
Germany [48] Case surveillance (outbreak) 2005 Adults and children 75 cases in US military |
PCR, culture, or clinical case with epidemiological link to a confirmed case |
Age: cases (%) < 2 months–4: 11 (15) 5–9: 19 (25) 10–14: 20 (27) 15–19: 7 (9) ≥ 20: 18 (24) |
|
|
Germany [74] Population based, case surveillance 1992–1994 Children and adults 122 households with index case |
Culture or Anti-PT, anti-FHA or anti-pertactin levels increase by 100% |
84 cases adults 179 cases children |
|
|
Germany [49] Population based, case surveillance 1984–1987 Adults 1260 cases with pertussis symptoms |
Culture, anti-PT IgA titres ≥ 100 negative controls |
567 confirmed (45%) Aged < 1 year, 324 cases (11%) Aged > 20 years 169 (6%) |
|
|
Germany [50] Case surveillance (school outbreak) October 2005 to March 2006 Children 104 cases |
PCR, culture, or anti-IgG levels (cutoff not stated) |
Years since last vaccination: cases (%) < 5: 54 (1.9) 6: 48 (6.3) 7: 95 (14.7) 8: 79 (19.0) 9: 50 (32.0) 10: 17 (17.6) > 10: 13 (23.1) |
|
|
Germany [51] Five former East German States Population-based, national surveillance 1994–2007 |
Notified cases |
2007 39.3/100,000 inhabitants |
|
|
Germany [52] Brandenburg, case-cohort Aged < 18 years 2002–2012 3,219 cases |
Notified cases | 80.4 cases/100,000 inhabitants | |
|
Ireland [53] Case surveillance (outbreak) 2010 All ages 67 possible cases |
Culture, serology (test and cutoff not stated) |
7 confirmed (1 culture, 6 serology) 4 probable 56 possible cases Confirmed/probable/possible cases/100,000: 0–4 years: 77.3 10–14 years 75.8 > 19 years: 7.6 |
|
|
Ireland [54] Hospital based, case surveillance September 2003 to December 2009 All ages 1324 suspected cases |
PCR |
n (%) Total 145 (10.95) 7 months–11 years: 27 (5.4) 12–15 years: 1 > 15 years: 0 |
|
| Culture |
Total 76 (5.7) 7 months–11 years: 13 (2.6) 12–15 years: 1 > 15 years: 0 |
||
|
Luxembourg [55] Active-surveillance, migrant cohort May to September 2012 13–70 years 172 migrants arriving from 30 countries of 67 cases in 2010 |
Anti-PT IgG (no cutoff stated) |
40% Aged 13–20 years 43.8% Aged 41–50 years 37.5% |
|
|
Population-based, national surveillance 1996–2004 and 2005–2010 2001–2012 All ages Notified cases |
Notifications, various diagnostic methods |
Overall: 32/100,000 (1996–2004) to 37/100,000 (2005–2010) Aged ≥ 10 years: 15/100,000 (1996–2004) to 33/100,000 (2005–2010) Overall: 63/100,000 (2001–2012) Aged > 9 years: 6.8/100,000 (2005–2010) to 59.1/100,000 (2011–2012) |
|
|
The Netherlands [56] Case surveillance (outbreak convent) 1992 55–94 years 75 retired nuns and 24 staff members |
PCR, culture, threefold rise in ≥ threefold rise in sera antibody titre or anti-PT IgG ≥ 100 IU/ml |
Age: no. cases/total (%) 55–64 years: 8/16 (50) 65–74 years: 13/21 (62) 75–84 years: 16/27 (59) 85–94 years: 8/11 (73) |
|
|
The Netherlands [60] Population-based, national surveillance January 1998–2001 (without preschool booster) and 2002– December 2005 (with preschool booster) All ages Notified cases |
Notifications, various diagnostic methods |
Age: incidence/100,000 in 1998–2001: 2002–2005 0–5 months: 166.1: 132.3 6–11 months: 82.4: 84.9 1–4 years: 153.8: 86.5 5–9 years: 199.0: 168.6 10–19 years: 42.6: 68.2 20–59 years: 10.9: 15.7 ≥ 60 years: 7.0: 11.7 Total: 34.3: 35.3 |
|
|
The Netherlands [57] Population-based, national surveillance 1994–1996 All ages Notified cases |
PCR, culture, ≥ fourfold rise in sera antibody titre or anti-PT IgG > 20 IU/ml (up to 1996), anti-PT IgG >100 IU/mL (from 1997) |
Age: incidence/100,000: 0 years: 77.2 3–4 years: 87.4 5–9 years: 63.1 20–24 years: 1.2 30–44 years: 2.6–2.8 |
|
|
The Netherlands [61] Population-based, national surveillance 1989–1996 All ages Notified cases |
PCR, culture, ≥ fourfold rise in sera antibody titre or anti-PT IgG > 20 IU/ml (up to 1996), anti-PT IgG >100 IU/mL (from 1997) |
Notified cases 1989: 1986 0 years: 21: 7 1–4 years: 1: 30 5–9 years: 42: 39 10–14 years: 10: 11 15–19 years: 1: 2 ≥ 20 years: 5: 11 Total: 434: 2771 |
|
|
The Netherlands [63] Population-based, active surveillance February 2006 and July 2007 10–79 years 7903 random samples |
PT IgG ≥ 62.5 IU/mL |
Age, no. cases (%) 10–19 years: 81 (11) 20–34 years: 128 (9) 35–49 years: 109 (9) 50–64 years: 118 (9) 65–79 years: 144 (12) |
|
|
The Netherlands [62] Population-based, active surveillance 2011–2014 10–18 years 239 random samples |
PT IgG ≥ 50 IU/ml |
2012 (epidemic): 97/1000 person-years 2013—2014 (low-epidemic): 16/1000 person-years |
|
|
UK, England [70] Population-based, national surveillance 2010 to 2015 All ages 9163 reported cases |
PCR PT IgG ≥ 70 IU/ml |
No. cases (%) reported cases < 1 month: 101 (1) 1–3 months: 386 (4) 4–11 months: 146 (2) 1–9 years: 894 (10) ≥ 10 years: 7616 (83 |
|
|
UK, England [68] Population-based, national surveillance January 2013 to December 2015 All ages Notified cases |
PCR, culture |
Incidence/100,000 2012: 17.6 2013: 8.6 2014: 6.2 2015: 7.7 |
|
|
UK, England and Wales [67] Population-based, national surveillance 1987 to 1998 < 10 years Notified cases |
PT IgG ≥ 100 IU/ml |
Incidence/100,000: 1987: 211 1988: 71 1989: 160 1990: 204 1991: 69 1992: 29 1993: 51 1994: 48 1995: 23 1996: 29 1997: 36 1998: 20 |
|
|
UK, England and Wales [66] Population-based, national surveillance 1982 to 2012 All ages Notified cases |
PCR, culture |
Age: no. cases 2002: 2012: < 1 year: 98: 175 1–9 years: 59: 121 3–6 years: 60: 104 6–10 years: 48: 67 10–15 years: 71: 104 15–20 years: 80: 129 20–40 years: 346: 534 > 40 years: 471: 793 Total: 1233: 2027 |
|
|
UK, England [65] Population-based, national surveillance 2012 to 2013 All ages Notified cases |
PCR, culture |
Total cases (year) 304 (2010); 629 (2011); 5909 (2012); 3795 (2013) Age; year, cases (%) 1–4 years: 2010, 7 (2.3); 2011, 10 (1.6); 2012, 58 (1.0); 2013, 41 (1.1) 5–19 years: 2010, 59 (19.4); 2011, 124 (19.7); 2012, 1128 (19.1); 2013, 669 (17.1) ≥ 20 years: 2010, 186 (61.2); 2011, 349 (55.5); 2012, 4311 (73.0); 2013, 2984 (78.6) |
|
|
UK [71] Healthcare-based, case surveillance October 2001 and March 2005 6.5–12.5 years 62 with cough ≥ 2 weeks |
PCR | 62 (36.5%) | |
|
UK [72] Healthcare-based, case surveillance 1995 16–60 years 56 patients with cough |
PT IgG ≥ 100 IU/ml | 20/56 (35.7%) | |
|
UK [73] Healthcare-based, case surveillance March 1996 to November 1997 5–78 years (mean 31 years) 145 with cough ≥ 3 weeks |
PT IgG and IgA: ≥ 2 antibodies with levels ≥ 2 SD or at least one antibody with a level ≥ 3 SD, above the mean of the age matched controls | 40 (28%) | |
CI confidence interval, PCR polymerase chain reaction, PT pertussis toxin, IgG immunoglobulin, HCW healthcare worker, SD standard deviation