Regional Insights and Focus Areas for Pertussis Management in Latin America

Overview

The 2023 Global Pertussis Initiative meeting assessed pertussis burden and vaccination policies across 10 Latin American countries. Despite established vaccination programs, challenges such as underrecognition, suboptimal maternal vaccination coverage, and limited laboratory capacity persist, impacting disease control efforts.

Background

Pertussis, commonly known as whooping cough, is a contagious respiratory disease affecting individuals of all ages, with infants at highest risk of severe outcomes. Vaccination remains the cornerstone of pertussis control, involving primary series and booster doses across age groups, including vaccination during pregnancy to protect newborns. Latin America has experienced pertussis case increases since the 1990s despite longstanding immunization programs, prompting regional expert meetings to evaluate epidemiology, surveillance, and vaccination strategies. The 2023 meeting focused on 10 countries to update on pertussis management and address challenges including the impact of the COVID-19 pandemic on vaccination coverage.

Data Highlights

Key Findings

• Pertussis is a notifiable disease in all 10 Latin American countries assessed, with variable clinical case definitions and laboratory confirmation methods.
• Infants universally receive a 3-dose primary vaccination series plus at least two booster doses across the region.
• Vaccination during pregnancy is recommended or mandated in all countries except Paraguay and Venezuela, but coverage rates remain suboptimal.
• Challenges include poor disease awareness, underrecognition in adolescents and adults, and limited laboratory capacity impacting surveillance quality.
• Healthcare providers and the public need education on asymptomatic transmission by mothers and contacts and atypical pertussis presentations in older age groups.
• Improving vaccination coverage, especially maternal immunization and universal adult boosters, is critical to reducing pertussis burden in Latin America.

Clinical Implications

Clinicians should emphasize the importance of maternal pertussis vaccination and consider pertussis in differential diagnoses for adolescents and adults with prolonged cough. Strengthening laboratory capacity and surveillance systems will improve case detection and epidemiological understanding. Public health efforts must focus on increasing vaccination coverage across all age groups to protect vulnerable infants and reduce transmission.

Conclusion

Despite established vaccination programs, pertussis remains a public health challenge in Latin America due to surveillance limitations and suboptimal vaccine coverage, particularly in pregnancy. Targeted strategies to enhance awareness, laboratory capacity, and immunization policies are essential to control pertussis in the region.

References

1. Global Pertussis Initiative 2023 -- Regional Insights and Focus Areas for Pertussis Management in Latin America