PERTUSSIS COMPLICATIONS IN GERMANY - 3 YEARS OF HOSPITAL-BASED SURVEILLANCE DURING THE INTRODUCTION OF ACELLULAR VACCINES

Between 1 November 1993 and 31 October 1996, admissions to paediatric departments for Bordetella pertussis complications were reported to a nationwide, hospital-based active surveillance system, The case defini tion included pertussis complicated by pneumonia, apnoea requiring ass isted ventilation, seizures, encephalopathy or a combination of these. Two hundred sixteen cases of pertussis complications were registered. 57.4% of them were in infants, 50.9% of them less than 6 months old. There were five deaths, three previously healthy children died, At the time of hospital admission, 106 cases would have been eligible for at least three doses of pertussis vaccine, only four (3.8%) had received the recommended number of immunisations. From the second quarter of 1 995, the reported number of cases declined. The decrease coincides wit h an improvement of pertussis vaccination coverage between 1992 and 19 95 due to an increased use of acellular vaccines, The reduction of com plicated pertussis was observed even in age-groups too young for the r ecommended vaccinations. The observed decrease could be due to the inc rease in vaccination coverage with interuption of the chain of transmi ssion to the younger age-groups, to a cyclic decrease in pertussis cas es, or to a combination of both, Continued surveillance will provide i nformation on the epidemiological trend of hospitalisations for pertus sis complications in the first European country to have introduced vac cination with acellular vaccines on a large scale.