To study the epidemiology of pertussis in Greece and epidemiologic changes throughout a period of twenty-nine years, we conducted a retrospective analysis of available data of pertussis cases for the past twenty-nine years (1980–2008) and a prospective analysis of hospitalized pertussis cases from a children’s hospital in Athens for eight years (2001–2008). From 1980 through 2008, the incidence of pertussis in Greece declined from 11.2 to 0.05 cases per 100,000. Epidemic cycles occurring every 3 to 5 years were observed. Since pertussis circulation cannot be fully controlled by present immunization programs, efforts should be made to vaccinate infants at the recommended age, early diagnose, treatment as well as contact tracing of pertussis cases. Control of pertussis in social susceptible populations is necessary. A national program with adolescent and adult booster could decrease the circulation of B. pertussis. Despite an overall decrease for pertussis cases, pertussis is still a present and future challenge of public health service in Greece. 1. Introduction Pertussis remains one of the most frequent vaccine preventable diseases worldwide. Pertussis is still an important infectious disease with high morbidity and mortality worldwide, especially among infants in whom it is one of the leading causes of mortality. Although most often a persistent but relatively benign respiratory illness, pertussis can result in serious consequences, such as pneumonia, seizures, encephalopathy, and death, especially among infants. Despite high immunization rates in infants and children in many countries, pertussis remains endemic, with epidemics superimposed every 3–5 years [1–3]. Although the inception of childhood pertussis immunization programs has significantly reduced the occurrence of the disease in children, waning vaccine-induced immunity from the old vaccine permits the disease to affect adolescents and adults (after about 7 to 20 years from natural infection and 4 to 12 years from immunization), who in turn transmit the disease to nonimmunized or incompletely immunized infants who are more vulnerable to disease-related complications and higher mortality [4, 5]. Moreover, there is a clear lack of awareness regarding loss of immunity and occurrence of the disease in older patients. In recent years, acellular pertussis vaccines have been incorporated into the immunization programs of many developed countries, gradually replacing whole cell vaccines. The whole-cell vaccine has been initiated in the Greek national vaccination schedule since 1951, whereas the
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