Pertussis Morbidity in Children 12 to 59 Months of Age: A NSW Public Health Network Study.

BACKGROUND: Pertussis continues to be a significant public health problem despite high levels of vaccination. Although hospitalizations and deaths among children older than 12 months are much less frequent than among infants less than 6 months of age, only limited information is available for this age group on other measures of morbidity.

METHODS: A cross sectional study with a 6 week follow-up component was conducted in New South Wales, Australia in 2017 to measure morbidity among children 12 to 59 months of age notified to health authorities. Measures used included cough duration, cough severity, constitutional symptoms and impacts upon the family. Associations between these outcomes and age group, vaccination status, asthma, treatment and family structure were explored.

RESULTS: Three hundred and five of 472 (65%) notified cases were interviewed at baseline with approximately 20% having a severe cough with no trend in prevalence across age groups. Forty eight percent of cases had experienced 3 or more constitutional symptoms with rates significantly higher among younger children. Children who had received an 18 month booster vaccination were significantly less likely to experience 3 or more constitutional symptoms (OR 0.46, 0.22-0.97). Fifty one percent of cases were still coughing at 6 weeks. One third of carers initially reported having disrupted sleep 4 or more nights per week with substantial disruption to carers' sleep still recorded at 6 weeks.

CONCLUSIONS: Substantial morbidity was observed in this age group with some evidence that the reintroduction of an 18 month acellular pertussis booster lessened disease severity.