National and international pertussis prevention strategies

Abstract

Introduction: Whooping cough is an acute respiratory infectious disease caused by Bordetella pertussis, which in severe cases, is even life-threatening. Despite being a vaccine-preventable disease, whose incidence and mortality have decreased, it has a sustained impact on public health, especially in young infants, who account for the majority of cases and deaths. This makes it an important pathology to prevent, detect and treat early. Objective: To describe and compare primary, secondary and tertiary prevention interventions for pertussis at a national and international level. Methodology: A search was carried out for systematic reviews, reviews and meta-analyses, published between 2013 and 2023, on the Pubmed, Cochrane Library and LILACS platforms. Also, gray literature from different corporations and ministries of health was consulted. Result: Vaccination is the most important primary prevention measure for whooping cough, preventing infant morbidity and mortality, but without evidence in other age ranges. In secondary prevention, qPCR appears to increasingly outperform culture. In tertiary prevention, treatments include antibiotic therapy, mechanical support measures and leukoreduction therapies. Discussion: Compared to international strategies, in Chile the insufficient coverage of maternal vaccination and health personnel, together with the lack of consensus and regulation in diagnostic techniques, limit the effectiveness of prevention and diagnosis. Conclusion: Whooping cough continues to be a public health problem, so it is important to promote, standardize and ensure the proper execution of the measures established at different levels of complexity.