IntroductionPERTINENT is a pilot active surveillance system of infants hospitalised with pertussis in six European Union/European Economic Area countries (37 hospitals, seven sites).AimThis observational study aimed to estimate annual pertussis incidence per site from 2016 to 2018 and respective trends between 2017 and 2018. Pertussis cases were described, including their severity.MethodsWe developed a generic protocol and laboratory guidelines to harmonise practices across sites. Cases were hospitalised infants testing positive for Bordetella pertussis by PCR or culture. Sites collected demographic, clinical, laboratory data, vaccination status, and risk/protective factors. We estimated sites' annual incidences by dividing case numbers by the catchment populations.ResultsFrom December 2015 to December 2018, we identified 469 cases (247 males; 53%). The median age, birthweight and gestational age were 2.5 months (range: 0-11.6; interquartile range (IQR): 2.5), 3,280 g (range: 700-4,925; IQR: 720) and 39 weeks (range: 25-42; IQR: 2), respectively. Thirty cases (6%) had atypical presentation either with cough or cyanosis only or with absence of pertussis-like symptoms. Of 330 cases with information, 83 (25%) were admitted to intensive care units including five deceased infants too young to be vaccinated. Incidence rate ratios between 2018 and 2017 were 1.43 in Czech Republic (p = 0.468), 0.25 in Catalonia (p = 0.002), 0.71 in France (p = 0.034), 0.14 in Ireland (p = 0.002), 0.63 in Italy (p = 0.053), 0.21 in Navarra (p = 0.148) and zero in Norway.ConclusionsIncidence appeared to decrease between 2017 and 2018 in all but one site. Enhanced surveillance of hospitalised pertussis in Europe is essential to monitor pertussis epidemiology and disease burden.

Biodiversité et Epidémiologie des bactéries et pathogènes Institut Pasteur Paris France

Chief Innovation Unit and Clinical Trials Bambino Gesù Children Hospital Rome Italy

CIBER of Epidemiology and Public Health CIBERESP Barcelona Spain

Clinical Microbiology Service Complejo Hospitalario de Navarra Pamplona Spain

Direction des maladies infectieuses Santé Publique France Paris France

Epidemiological surveillance and response Public Health Agency of Catalonia Barcelona Spain

Epidemiology Department Epiconcept Paris France

European Centre for Diseases Prevention and Control Stockholm Sweden

Infectious Disease Epidemiology and Modeling Norwegian Institute of Public Health Oslo Norway

Instituto de Recerca Pediatrica Hospital Sant Joan de Deu Barcelona Spain

Instituto de Salud Pública de Navarra IdiSNA Navarre Institute for Health Research Pamplona Spain

Microbiology Our Lady's Children's hospital Crumlin Dublin Ireland

Multifactorial Disease and Complex Phenotype Research Area Bambino Gesù Children Hospital Rome Italy

National Institute of Public Health Prague Czech Republic

Research Temple Street Children's University Hospital Dublin Ireland

Sorbonne University INSERM Institut Pierre Louis d'Epidémiologie et de Santé Publique Paris France

Universitat Internacional de Catalunya Barcelona Spain

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