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  • Title: A call for a pertussis surveillance system.
    Journal: EPI Newsl; 1992 Feb; 14(1):2-4. PubMed ID: 12285225.
    Abstract:
    Pertussis is the 3rd highest vaccine preventable cause of death among children 5 years old. It is most frequent in children 2 years old and is fatal for 12 month old infants. People tend to confuse it with other respiratory infections. Despite its importance and the fact that it is a reportable disease, health systems in the Americas do not have an adequate surveillance system for pertussis. The number of reported cases in the Americas fell 67% between 1980-1990 which corresponded with increased coverage of DPT3 vaccine (36.6-75.5%). Further the number of deaths decreased form 5016-1398 between 1978-1986, but only 17 countries reported deaths and none of them sent reports each year. Some countries reported a fall in cases with a parallel increase in immunization coverage while others reported no link between the 2. Thus the system in inadequate. A major constraint to establishing a surveillance system is determining a clinical case definition since symptoms vary from slight to fatal spastic coughing and vomiting. Further 3 doses of DPT are only 80% effective and the other 20% display atypical symptoms. Moreover a special medium is needed to isolate Bordetella pertussis and timing of the sample is crucial. PAHO suggests any cough lasting =or 14 days be a suspected case. A suspected case with 1 of the following should be a confirmed case: isolation of B. pertussis, positive serology, cough followed by vomiting, cough with inspiratory whoop, or contact with another confirmed case. Any pertussis reporting should be integrated with other reporting systems and all health facilities and private physicians should report cases. Health workers should regularly investigate cases in the community. Epidemiologists need to study data to determine trends. Besides once the system is operating, it should be evaluated regularly by comparing data from major hospitals and clinics with those from the Ministry of Health. PAHO will help counties to set up a surveillance system.
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