Immunisation programmes are very effective in preventing childhood respiratory infecions and, depending on the country in question, usually have a coverage of about 90%. The number of cases of infections included in the immunisation schedule, such as pertussis, measles, H. influenzae , and pneumococcus, has decreased considerably over the past 20 years in all European countries.
Pertussis, or whooping cough, is an acute respiratory infection caused by the bacterium Bordetella pertussis . It is an endemic infection common to children everywhere and is included in the primary immunisation schedule of all European Union countries. It is often unrecognised, and increasingly may occur in adults. After immunisation, the symptoms of pertussis are mostly mild and result in a prolonged period of coughing (weeks to months). However, in neonates, pertussis can be life-threatening and can result in prolonged periods of intensive care.
Despite the high immunisation coverage, cycles of outbreaks of pertussis have continued to occur, because neither infection nor immunisation produces lifelong immunity to pertussis, in the same way that they do for diseases such as measles. B. pertussis continues to circulate in a manner similar to that of the pre-vaccine era. Outbreaks have been reported in all European countries, especially in infants and children (figure 8). Urgent requirements are: the development of vaccines resulting in lifelong immunity; a focus on public awareness of the symptoms of the disease and the danger of contagion, especially in relation to contact with newborns.
Measles is an acute illness caused by the measles virus of the genus Morbillivirus. It is one of the most contagious diseases, and clusters and outbreaks of the disease are common. Infection can cause significant disability and death. One of the most common and serious complications is measles pneumonia, which develops in 5–10% of children with measles. It is caused by direct invasion of the lungs by the measles virus (primary measles pneumonia) or may occur due to a secondary infection by other viral or bacterial pathogens.
More information on immunisation can be found in chapter 26.