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Re-emergence of pertussis in the post-vaccination era: A Malaysian perspective

06 Nov 2019
Q1. Could you please describe the current state of pertussis epidemiology,both local and globally?
Pertussis is a worldwide epidemic infectious disease, without breaks occurring every 2–5 years. In the prevaccine era, the incidence and case-fatality rates of pertussis were very high, especially among children aged younger than 5 years. The diphtheria-tetanus-pertussis combination vaccine (ie, DTP vaccine), which has been part of the World Health Organisation (WHO)’s Expanded Programme on Immunisation since 1974, has resulted in a dramatic decline in pertussis incidence and mortality. Without vaccination, the disease would have resulted in more than 1.3 million deaths globally in the year 2001.1

According to WHO, the global vaccination coverage of the DTP3 vaccine in 2013 was estimated at 84%2; in the same year, pertussis was reported to have caused as many as 63,000 deaths in children aged younger than 5 years worldwide.1 In 2018, WHO estimated that about 86% of infants (or 116.3 million infants) worldwide received DTP3, but approximately 19.4 million infants did not have access to routine immunisation services, including the DTP3 vaccine,during the same period.3

In Malaysia, the incidence of pertussis was less than 1/100,000 population prior to 2012, with no deaths in the preceding decade 4; however, the incidence of pertussis increased almost 22-fold from 41 cases in 2010 to 892 cases in 2018.5 According to the Ministry of Health (MOH), there were 22 deaths from pertussis in 2018 alone and 19 of the affected children had no prior history of vaccination.6

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Most Read Articles
2 days ago
Chest pain appears to be the principal complaint of patients hospitalized with a first myocardial infarction (MI), particularly among those in the youngest age group, a study has found.
Jairia Dela Cruz, 16 Sep 2020
In patients with heart failure with reduced ejection fraction (HFrEF) receiving angiotensin-converting-enzyme (ACE) inhibitors, high dosing confers benefits for the risk of death or hospitalization that are similar to that obtained with lower dosing, according to a systematic review and meta-analysis.
Pearl Toh, 2 days ago
Early and sustained treatments with simplified regimen are the key to achieving good asthma control, said experts during a presentation at the ERS 2020 Congress.
3 days ago
Women with pre-eclampsia are at higher risk of developing heart failure, a study suggests.