De bestrijding van kinkhoest na een halve eeuw vaccineren

- Notification of laboratory-confirmed pertussis is mandatory in the Netherlands. Thus, the public health service can see to it that timely chemoprophylaxis (within 3 weeks after the onset of symptoms in the index case) is prescribed for all members of the household, should there be a vulnerable non-vaccinated or insufficiently vaccinated newborn in the family. However, it was shown that the delay in this notification was so long that intervention by the prescription of chemoprophylaxis could take place in time to protect a newborn infant in only 10 of the cases. The effectiveness of the notification system in facilitating timely chemoprophylaxis is therefore questioned and it is concluded that other ways to achieve such intervention, independent of notification, are needed. Doctors should always ascertain the presence of a newborn infant in the household of pertussis patients and consider chemoprophylaxis immediately, even ahead of notification. Even if not in time for effective prophylaxis, mandatory notification is still of utmost importance for the evaluation of pertussis immunisation. Surveillance data obtained from notification are used in scenario analysis and contribute to the underpinning of alternative immunisation policies. After all, major improvements in pertussis control can be expected from the addition of (re)vaccination of other target groups, such as mothers of newborns, adolescents or adults, to the national immunisation programme.

Ned Tijdschr Geneeskd. 2008;152:66-8