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| |  Continuous Surveillance of Vaccine-Preventable Diseases Needed to Adopt Timely Health Interventions: Presented at ESPID By Lynda Jackson BRUSSELS, Belgium -- June 17, 2009 -- According to a study presented here at the 26th Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID), a severe outbreak of pertussis in Costa Rican infants that causes severe morbidity and mortality demonstrates the need for continuous epidemiologic surveillance of vaccine-preventable diseases to administer timely public health interventions. “In late 2005, Costa Rica suffered the worst pertussis outbreak in 40 years. We experienced 9 deaths in almost 2 years,” said Rolando Ulloa-Gutierrez, MD, Infectologia Pediatrica, Universidad de Costa Rica, San José, Costa Rica, on June 11. “In response to this public health problem, a new nationwide maternal vaccination program was introduced in spring 2007.” The researchers studied paediatric hospitalisations at 4 urban hospitals (1 paediatric hospital and 3 general hospitals with nursery beds) before introduction of the vaccination program. Children with laboratory-confirmed pertussis who were hospitalised from January 2004 to April 2007 were recruited, which represented most of the pertussis hospitalisations during this period. Of the 132 children (51.5% boys) included in the analysis, 43% were aged <2 months (not vaccinated) and 104 were aged <6 months. Symptoms included cough (94%), respiratory distress (73%), cyanosis (72%), vomiting (42%), and apnoea (11%). Nineteen children (14.4%) required admission to the paediatric intensive care unit, and all received mechanical ventilation. Nine children (6.8%) died (mean age 48.9 days). The number of deaths was 0 in 2004, 1 in 2005, 4 in 2006, and 4 in 2007. The 2 deaths from 2006 and the 4 deaths from 2007 occurred in a very short time span, between December 24, 2006, and February 23, 2007. Other complications included severe pneumonia (15.2%), respiratory failure (13.6%), and pulmonary hypertension (7.6%). [Presentation title: Multicenter Study of Pertussis (P) Associated Hospitalizations in Costa Rican (CR) Children (Ch) During a Severe Outbreak. Abstract P484]
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