Skip to main content
    • Aa
    • Aa

Seasonal patterns in time series of pertussis

  • S. C. De GREEFF (a1), A. L. M. DEKKERS (a2), P. TEUNIS (a1) (a3), J. C. RAHAMAT-LANGENDOEN (a1), F. R. MOOI (a4) and H. E. De MELKER (a1)...

To gain insight into pertussis disease dynamics, we studied age-specific long-term periodicity and seasonality of pertussis in The Netherlands. Hierarchical time-series models were used to analyse the monthly reported pertussis incidence in January 1996–June 2006 by age group. The incidence of pertussis showed a slightly increasing long-term trend with highest incidence rates seen in 1996, 1999, 2001 and 2004. For all age groups the annual peak incidence was found in August, except for the 13–18 years age group where the peak occurred in November. Monthly trends in adults showed high correlation with trends in age groups 0–4 years (0·94) and 5–12 years (0·92). We found no evidence for a relationship between annual rises in pertussis and the opening of schools. Concurrent annual fluctuations of pertussis incidence in adults and infants suggest frequent transmission within and between these age groups. Studying trends offers insight into transmission dynamics and may facilitate decisions on future vaccination strategies.

Corresponding author
*Author for correspondence: S. C. de Greeff, National Institute of Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands. (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

3.PE Fine , JA Clarkson . Seasonal influences on pertussis. International Journal of Epidemiology 1986; 15: 237247.

4.MC Gomes , Diphtheria, pertussis, and measles in Portugal before and after mass vaccination: a time series analysis. European Journal of Epidemiology 1999; 15: 791798.

5.DM Skowronski , The changing age and seasonal profile of pertussis in Canada. Journal of Infectious Diseases 2002; 185: 14481453.

6.M Tanaka , Trends in pertussis among infants in the United States, 1980–1999. Journal of the American Medical Association 2003; 290: 29682975.

9.NC Grassly , C Fraser . Seasonal infectious disease epidemiology. Proceedings of the Royal Society of London, Series B: Biological Sciences 2006; 273: 25412550.

10. PE Fine , JA Clarkson . Measles in England and Wales – I: an analysis of factors underlying seasonal patterns. International Journal of Epidemiology 1982; 11: 5–14.

11.M Brennan , Evidence for transmission of pertussis in schools, Massachusetts, 1996: epidemiologic data supported by pulsed-field gel electrophoresis studies. Journal of Infectious Diseases 2000; 181: 210215.

12.D Guris , Changing epidemiology of pertussis in the United States: increasing reported incidence among adolescents and adults, 1990–1996. Clinical Infectious Diseases 1999; 28: 12301237.

13.LP Celentano , Resurgence of pertussis in Europe. Pediatric Infectious Disease Journal 2005; 24: 761765.

14.B Ntezayabo , Pertussis resurgence in Canada largely caused by a cohort effect. Pediatric Infectious Disease Journal 2003; 22: 2227.

15.MS Dworkin . Adults are whooping, but are internists listening? Annals of Internal Medicine 2005; 142: 832835.

16.K Forsyth , Potential strategies to reduce the burden of pertussis. Pediatric Infectious Diseases Journal 2005; 24: S69–74.

18.SH Heisterkamp , Automated detection of infectious disease outbreaks: hierarchical time series models. Statistics in Medicine 2006; 25: 41794196.

19.R Davis , On autocorrelation in a Poisson regression model. Biometrika 2000; 87: 491505.

20.S Zeger . A regression model for time series of counts. Biometrika 1988; 75: 621629.

24.SC de Greeff , Impact of acellular pertussis preschool booster vaccination on disease burden of pertussis in The Netherlands. Pediatric Infectious Disease Journal 2008; 27: 218223.

29.HE de Melker , Reemergence of pertussis in the highly vaccinated population of the Netherlands: observations on surveillance data. Emerging Infectious Diseases 2000; 6: 348357.

31.HE de Melker , The incidence of Bordetella pertussis infections estimated in the population from a combination of serological surveys. Journal of Infection 2006; 53: 106113.

32.G De Serres , Morbidity of pertussis in adolescents and adults. Journal of Infectious Diseases 2000; 182: 174179.

34.KM Bisgard , Infant pertussis: who was the source? Pediatric Infectious Disease Journal 2004; 23: 985989.

36.J Mossong , Social contacts and mixing patterns relevant to the spread of infectious diseases. PLoS Medicine 2008; 5: e74.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *