Whooping cough dynamics in Chile (1932-2010): disease temporal fluctuations across a north-south gradient

BMC Infect Dis. 2015 Dec 30:15:590. doi: 10.1186/s12879-015-1292-2.

Abstract

Background: The spatial-temporal dynamics of Bordetella pertussis remains as a highly interesting case in infectious disease epidemiology. Despite large-scale vaccination programs in place for over 50 years around the world, frequent outbreaks are still reported in many countries.

Methods: Here, we use annual time series of pertussis incidence from the thirteen different regions of Chile (1952-2010) to study the spatial-temporal dynamics of Pertussis. The period 1975-1995 was characterized by a strong 4 year cycle, while the last two decades of the study period (1990-2010) were characterized by disease resurgence without significant periodic patterns.

Results: During the first decades, differences in periodic patterns across regions can be explained by the differences in susceptible recruitment. The observed shift in periodicity from the period 1952-1974 to the period 1975-1995 across regions was relatively well predicted by the susceptible recruitment and population size. However, data on vaccination rates was not taken into account in this study.

Conclusions: Our findings highlight how demography and population size have interacted with the immunization program in shaping periodicity along a unique latitudinal gradient. Widespread B. pertussis vaccination appears to lead to longer periodic dynamics, which is line with a reduction in B. pertussis transmission, but our findings indicate that regions characterized by both low birth rate and population size decreased in periodicity following immunization efforts.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Bordetella pertussis / pathogenicity
  • Child
  • Child, Preschool
  • Chile / epidemiology
  • Humans
  • Immunization Programs
  • Infant
  • Mass Vaccination
  • Middle Aged
  • Pertussis Vaccine
  • Population Density
  • Spatio-Temporal Analysis
  • Whooping Cough / epidemiology*
  • Whooping Cough / microbiology
  • Whooping Cough / prevention & control
  • Young Adult

Substances

  • Pertussis Vaccine