OBJECTIVES: Despite widespread vaccination programmes, pertussis remains a significant health burden in many countries. Low awareness of the disease, the high rate of asymptomatic cases in adults and difficulties with diagnosis could explain the under-reporting of pertussis. The lack of data on actual incidence constitutes an obstacle for public health authorities for the implementation of a vaccination strategy against pertussis in adults. The aim of this study was to evaluate the seroprevalence of antibodies against Bordetella pertussis infection in adults and to estimate the actual incidence of the disease compared with the reported incidence. STUDY DESIGN: Prospective, multicentre seroprevalence study. METHODS: The study was conducted in 2000 adult subjects aged ≥18 years who had not received pertussis vaccination within the last 5 years. All enrolled subjects provided a blood sample for serum testing of IgG antibodies against pertussis toxin, performed by enzyme-linked immunosorbent assay, to indicate if they had an acute infection or if they had been infected with pertussis within the last 12 months or earlier. Results were validated in accordance with the guidelines of the European Sero-epidemiology Network 2 and were expressed in ESEN units/ml. RESULTS: A positive concentration of anti-pertussis toxin antibodies, indicating previous pertussis infection, was demonstrated in 39.9% (n = 799) of all study subjects, and 0.40% (n = 8) of subjects had a concentration suggestive of a recent infection (within the last 12 months). The highest antibody seroprevalence was observed in subjects aged 18-29 years (1.46%). No cases of acute infection were detected. CONCLUSIONS: During the study period, the reported incidence of pertussis in the adult population was 0.84/100,000 inhabitants. Based on the seroprevalence results from this study, it is estimated that the actual incidence of pertussis could be as much as 699/100,000 inhabitants. The actual incidence of pertussis in adults in the Czech Republic could therefore be at least 200-fold higher than the reported incidence. These findings support the need for pertussis vaccination in the adult population.
- MeSH
- Bordetella pertussis immunology MeSH
- Adult MeSH
- Incidence MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Whooping Cough epidemiology prevention & control MeSH
- Pertussis Vaccine administration & dosage MeSH
- Prospective Studies MeSH
- Antibodies, Bacterial blood MeSH
- Seroepidemiologic Studies MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Geographicals
- Czech Republic epidemiology MeSH
Streptococcus pneumoniae causes considerable global paediatric morbidity and mortality, despite the availability of safe and effective pneumococcal conjugate vaccines (PCVs). To justify the introduction of PCVs, accurate information on the burden of disease is required. Here, we present an appraisal of the pneumococcal epidemiological situation in 11 Central European countries. The data are based on study findings presented at the 12th Central European Vaccine Advisory Group (CEVAG) meeting, held on 21-22 May 2010 in Sofia, Bulgaria, and a literature review of the PubMed database using the search terms 'pneumococcal' or 'Streptococcus pneumoniae', in combination with 'otitis media', 'pneumonia', 'meningitis' or 'bacteraemia/sepsis', and '[Central European country name]'. The incidence of pneumococcal disease appears to be lower in Central Europe than previously reported for Europe as a whole, with the highest risk in infants aged 0-2 years. The fatality rates in the under fives from invasive infections are up to 40%. A paucity of comprehensive country-specific data on pneumococcal disease burden arises from the lack of homogenous surveillance programmes. Standardised, active surveillance systems are required for the accurate evaluation of the pneumococcal disease burden in the region. Only then can the need for vaccination be addressed.
- MeSH
- Child MeSH
- Immunization MeSH
- Incidence MeSH
- Infant MeSH
- Humans MeSH
- Adolescent MeSH
- Otitis Media epidemiology immunology microbiology prevention & control MeSH
- Meningitis, Pneumococcal epidemiology immunology microbiology prevention & control MeSH
- Pneumococcal Vaccines administration & dosage MeSH
- Pneumonia, Pneumococcal epidemiology immunology microbiology prevention & control MeSH
- Child, Preschool MeSH
- Sepsis epidemiology immunology microbiology prevention & control MeSH
- Serotyping MeSH
- Streptococcus pneumoniae * classification immunology MeSH
- Vaccines, Conjugate administration & dosage MeSH
- Check Tag
- Child MeSH
- Infant MeSH
- Humans MeSH
- Adolescent MeSH
- Child, Preschool MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
- Geographicals
- Europe MeSH
Variola, vysoce infekční virové onemocnění, získala několik prvenství. Je to první onemocnění proti kterému byla objevena očkovací látka, první onemocnění, které se podařilo eradikovat a dnes je to první onemocnění, u kterého se vracíme zpět k očkování. Díky možnému riziku zneužití a umělého šíření v populaci je připomínán klinický obraz a epidemiologické charakteristiky onemocnění. Očkování má svá rizika a relativně značný výskyt nežádoucích reakcí. Je to zejména bolestivost v místě aplikace (86%), regionální lymfadenopatie (54%), únavnost (50%), bolesti hlavy (40%), myalgie (20%), a horečka (10%). Protože vakcína obsahuje živý virus vakcinie, který se replikuje v kůži, může dojít k rozšírení viru na jiná místa těla nebo na blízké osoby, u kterých se objeví stejné reakce jako u očkovaných. Vždy je potřeba zvážit zda riziko expozice variole je vyšší než riziko vzniku těchto reakcí. I přes to, že Ćeská republika vlastní dostatečnou zásobu vakcíny, nezvažuje možnost zahájení masové vakcinace.
- MeSH
- Cidofovir MeSH
- Cytosine analogs & derivatives administration & dosage MeSH
- Immunoglobulins administration & dosage MeSH
- Humans MeSH
- Smallpox history etiology prevention & control MeSH
- Risk MeSH
- Smallpox Vaccine administration & dosage contraindications adverse effects MeSH
- Vaccination MeSH
- Variola virus MeSH
- Check Tag
- Humans MeSH
