Expert consultation on pertussis

Pertussis is a bacterial respiratory infection caused by Bordetella pertussis . Pertussis is a highly contagious disease with a reproductive number (R0) of 15–17. The most severe symptoms occur in infants and young children whereas the disease is usually milder in adolescents and young adults, who constitute a reservoir and are a source of spread to young children. Pertussis remains endemic worldwide and tends to be a cyclic disease, peaking every 3–5 years. The most effective preventive measure is immunisation and, in developed countries, acellular vaccines are given usually in combination with other antigens.

Over the last 20 years, the epidemiology of the disease has remarkably changed. There has been a shift observed from mainly paediatric cases (normally children <10 years of age) towards adolescents, adults and children too young to have been vaccinated or to have completed the primary series.

Mortality rates are still unacceptable, both in developing and developed countries. Despite the relatively high global vaccination coverage (82%) among infants receiving three doses of pertussis-containing vaccines, it is estimated1 that in 2008 about 16 million cases of pertussis occurred worldwide, and 195 000 children died from the disease. 

Since 2011, increases in the number of pertussis cases have been repeatedly reported in different regions of the world, even in those with sustained high vaccination coverage. In the countries of the European Union/European Economic Area (EU/EEA), the situation is evolving similarly, with many countries observing a growing number of cases, mostly in very young infants, adolescents and adults. In summer 2012, the Netherlands, concerned about the growing number of cases and evolving epidemiology of the disease, requested the European Centre for Disease Prevention and Control (ECDC) to elaborate a common strategy to respond to the threat. Similar requests were made by other European countries. Therefore, ECDC organised a technical workshop in Barcelona, Spain, in November 2012 to seek a consensus on a common strategy to reduce the public health burden caused by pertussis in the EU/EEA countries. The agenda of the meeting can be found in the Annex.