Pertussis epidemiology in Canada, 2005-2019.

Background: Pertussis, also known as whooping cough, is an endemic vaccine-preventable disease that affects the respiratory tract and is caused by the bacterium Bordetella pertussis. Between 1999 and 2004, the adolescent booster dose of pertussis was introduced across Canada. This report describes the epidemiology of pertussis in Canada from 2005 to 2019, the period after adolescent acellular vaccination was recommended.

Methods: We analyzed pertussis incidence by year, age groups, sex and geographic region using national surveillance data from the Canadian Notifiable Disease Surveillance System. Hospitalization data from the Discharge Abstract Database was used to investigate pertussis hospitalizations by sex and age. Deaths from pertussis were explored using Statistics Canada's vital statistics data. Vaccination coverage data was gathered from the 2019 Childhood National Immunization Coverage Survey and 2018-2019 Seasonal Influenza Vaccination Coverage Survey.

Results: Between 2005 and 2019, there were a total of 33,481 pertussis cases with the average annual incidence rate of 6.4 cases per 100,000 population. The highest average age-specific incidence rate was among infants under one year of age (n=68.7 cases per 100,000 population). There were a total of 1,593 pertussis hospitalizations; nearly 80% of these hospitalizations were infants under one year of age. Hospitalization rates were 8.2 times higher in infants three months or younger compared to infants four to 11 months of age. There were 17 deaths; all among infants under one year of age.

Conclusion: The highest morbidity and fatality of pertussis were among infants under one year of age. It is important to take measures to reduce transmission to infants who are too young to be vaccinated. Increasing vaccine coverage in children and pregnant women are important to reduce the burden of disease.