Peer-reviewed article
Post-Pandemic Resurgence of Pertussis in Southeastern Romania, 2024: Vaccination Gaps, Clinical Severity, and Regional Surveillance Performance.
Alina Plesea Condratovici, Mihaela Debita, Valerian Ionut Stoian, Catalin Plesea Condratovici, Ancuta Elena Tupu et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined a resurgence of pertussis (whooping cough) in southeastern Romania in 2024, affecting 326 confirmed cases. Over 72% of cases occurred in children not vaccinated according to schedule, mostly due to parental refusal or missed appointments. Pneumonia developed in 37% of cases overall, but in 81% of infants under two months. Being vaccinated on schedule reduced pneumonia risk by about half, highlighting vaccination as a key protection.
Key points
- 72.1% of confirmed pertussis cases were not vaccinated according to age-appropriate schedule
- Parental refusal (43.0%) and non-attendance (36.6%) were the main reasons for vaccination gaps
- Pneumonia occurred in 36.8% of confirmed cases, rising to 81% in infants under two months
- Age-appropriate vaccination reduced pneumonia risk (adjusted OR = 0.53, 95% CI 0.29–0.96)
- Significant variation existed between counties in PCR testing implementation (72–100%) and reporting delays
Limitations
The study describes observed patterns in one region of Romania during a specific nine-month period and cannot determine causation or predict future trends. The findings may not generalise to other regions or countries with different vaccination programmes and healthcare systems.
Abstract
BACKGROUND/OBJECTIVES: Following the COVID-19 pandemic, pertussis resurged sharply across Europe, with 209,674 cases reported in the EU/EEA in 2024. This study characterises the epidemiology of the 2024 pertussis resurgence across five counties of southeastern Romania, with emphasis on vaccination status, clinical severity, and regional surveillance performance. METHODS: A retrospective, population-based analysis was conducted on 452 cases notified between February 2024 and January 2025, extracted from the national surveillance database. A pre-specified reclassification of PCR-positive cases yielded 326 confirmed cases. Categorical, non-parametric, correlation, and multivariate logistic regression analyses were performed. RESULTS: The epidemic peaked in September 2024, with 56.0% of cases occurring between August and October. Children under five years accounted for 63.2% of confirmed cases, and 72.1% were not vaccinated according to age-appropriate schedule, predominantly due to parental refusal (43.0%) and non-attendance (36.6%). Pneumonia affected 36.8% of confirmed cases, ranging from 81.0% in infants under two months to 0% in adolescents. Age-appropriate vaccination was independently protective against pneumonia (adjusted OR = 0.53, 95% CI 0.29 to 0.96, p = 0.035; population attributable risk 37.3%). Significant inter-county heterogeneity was identified in PCR implementation (72 to 100%) and reporting delays. CONCLUSIONS: Vaccination gaps were the principal modifiable driver of the resurgence, supporting targeted coverage improvement and the introduction of a national maternal Tdap programme.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Age-appropriate pertussis vaccination (part of routine immunisation schedule)
- Population
- Children in five counties of southeastern Romania notified with pertussis between February 2024 and January 2025; 63.2% were under five years old
Key finding
Age-appropriate vaccination was independently protective against pneumonia (adjusted OR = 0.53, 95% CI 0.29–0.96, p = 0.035)
Condratovici et al. · PubMed (US National Library of Medicine) · 4 Jul 2026