LAUSR

From June to August 2018, 6 infants with pertussis aged between 1 and 9 months (4 were 3 months old, and the other two 1 month and 9 months old respectively) were admitted to a General Paediatrics Operating Unit. Their hospitalization period lasted between 3 and 11 days (mean 7.2 days). Three infants required oxygen therapy. No complications occurred. None of the mothers had been offered vaccination against pertussis during pregnancy. The epidemiology of pertussis is changing in Italy as well as in other countries with high vaccination coverage. The disease is now increasing as an incidence in adolescents (and adults) who have lost their immune protection, and especially in new-born infants who have not started or completed the primary vaccination course yet. The data from the European Annual Epidemiological Report for 2016 report the highest notification rate in children <1 year (73.6 cases per 100,000 population), similar to that observed in 2015 (73.1). The vaccination of pregnant women against pertussis is considered an effective and available preventive option adopted for some years and in a systematic way in different international contexts. Also in Italy, in the 2017–2019 National Vaccination Plan there is a recommendation to recall in pregnancy the immunization from pertussis with the trivalent vaccine (whooping cough, tetanus and diphtheria). The period indicated is between the 27th and the 36th week, ideally around the 28th week. The vaccine strategy for pertussis in pregnant women is effective in reducing neonatal deaths due to the disease, the need for hospitalization and the severity of the infection in infants under the age of 3 months. The vaccine does not pose any risk for pregnant women and newborns. From the description of our experience, of the 6 cases of hospitalized pertussis in just 3 months in a Pediatric department, 5 could be theoretically prevented by vaccination of the mother. The reported narrative experience testifies indirectly the resurgence of the cases of pertussis in a period when the newborn and the infant is most at risk to contract the disease and to have severe complications. Despite the available evidence and the consolidated experiences carried out, the application of this strategy, in some industrialized countries (including Italy), although recommended, it results largely sub-optimal. Pertussis prevention in newborns and infants is an urgent measure of public health.