欧洲疾控中心-百日咳-2023年年度流行病学报告（英）-2025.9_11页_1mb

Pertussis Annual Epidemiological Report for 2023 Summary

Core Content

Pertussis, also known as whooping cough, is a highly infectious bacterial disease affecting the respiratory tract, caused by Bordetella pertussis or Bordetella parapertussis. The 2023 Annual Epidemiological Report highlights the resurgence of pertussis in the European Union and European Economic Area (EU/EEA), with 26,033 cases reported by 29 countries. The notification rate was 6.7 cases per 100,000 population, the highest since 2019 but still below the 2019 level of 9 cases per 100,000.

Key Facts

• Case Distribution:
  • Two countries, Croatia and Denmark, accounted for over 40% of all reported cases.
  • 93% of cases were confirmed, 3% probable, and 4% possible.
  • The notification rate in 2023 was 6.7 per 100,000, up from previous years but still lower than 2019.
• Age Groups Affected:
  • Adolescents (10–14 years) and infants (<1 year) had the highest notification rates (34.1 and 33.4 per 100,000 respectively).
  • 52% of all cases were in individuals aged ≥15 years.
• Symptoms and Diagnosis:
  • Pertussis in adolescents and adults may be mild or atypical, making it harder to diagnose.
  • Infants may not exhibit the typical 'whoop' and may experience apnea during coughing fits.
• Vaccination Status:
  • Vaccination data was available for 18,457 cases.
  • 14% of cases were unvaccinated, 8% had one or two doses, 9% had three doses, and 46% had four or more doses.
  • 26% of infants had unknown vaccination status.
• Vaccination Coverage:
  • The weighted average DTP3 coverage in the EU/EEA was 92.8% in 2023, with some countries reporting as high as 99%.
  • Coverage in some countries decreased by up to 10% compared to 2019.
• Maternal and Booster Vaccination:
  • As of May 2025, 25 countries have maternal immunisation programmes, and 24 have adolescent booster programmes, while 13 have adult booster programmes.
• Hospitalisation and Outcomes:
  • 10% of reported cases were hospitalised, with 33% of hospitalised cases being under one year old.
  • 10 deaths were reported, including five in infants and five in individuals over 75 years.
• Laboratory Confirmation:
  • 67% of cases were confirmed by PCR, 0.7% by culture, 33% by serology, and 0.01% by oral fluid IgG.
  • Laboratory confirmation methods varied by country, with some having 100% confirmation rates.

Epidemiology

Geographic Distribution

• 29 EU/EEA countries reported data in 2023.
• Four countries (Denmark, Croatia, the Netherlands, and Austria) accounted for 64% of all cases.
• Croatia had the highest increase, from zero cases in 2022 to 4,806 in 2023.
• Notification rates increased in most countries compared to 2022, with the exception of Bulgaria, Hungary, and Iceland.

Seasonality and Trend

• A spike in cases was observed in spring 2020, followed by a sharp decline until 2022.
• In 2023, cases remained low until April and increased dramatically from May, peaking in November and December.

Age and Gender Distribution

• 52% of cases were in individuals aged ≥15 years.
• Adolescents (10–14 years) and infants (<1 year) had the highest notification rates.
• Males were overrepresented in infants under one year, while females were more affected in older age groups.

Vaccination Status and Coverage

• Vaccination status was known for 18,457 cases, with 29% having unknown status.
• Unvaccinated cases were highest in infants (<1 year) at 38% and children (1–4 years) at 19%.
• Adolescents (10–14 and 15–19 years) had the highest proportion of individuals vaccinated with four or more doses (59% and 55% respectively).
• DTP3 coverage among one-year-olds was high, with 92.8% in the EU/EEA, but varied widely across countries.

Public Health Implications

• The resurgence of pertussis indicates that the disease burden is still underestimated in Europe.
• High vaccination coverage is essential to reduce morbidity and mortality, especially in infants and young children.
• Strengthening surveillance systems, improving early diagnosis, and increasing booster doses for adolescents and adults are crucial.
• The low immunity in the population, possibly due to reduced pertussis circulation during the pandemic, contributes to the resurgence.
• There is a need for increased awareness and improved access to appropriate laboratory diagnosis to better understand the epidemiology and support policy decisions.