Descriptive cohort study: epidemiological analysis of pertussis notifications, 2022–2025
1
1. Western Cape Government, Department of Health and Wellness, Communicable Disease Control and Outbreak Response, Cape Town, South Africa, Western Cape Health And Wellness, cape town, South Africa
2
2.Division of Public Health Surveillance and Response, NATIONAL INSTITUTE FOR COMMUNICABLE DISEASES, Johannesburg, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A3821
ABSTRACT
BACKGROUND:
Pertussis remains a vaccine-preventable cause of severe illness, particularly in young infants who are not yet fully immunised. It is classified as a category 1 notifiable medical condition.
METHODS:
We analysed pertussis notifications from four City of Cape Town (COCT) public hospitals—Tygerberg, Khayelitsha, Mitchell’s Plain, and Victoria—between 1 January 2022 and 31 December 2025. A descriptive cohort was developed using the earliest recorded diagnosis, notification, or symptom onset date. Records marked as discarded were excluded. Laboratory confirmation was determined based on diagnosis method, case type, or epidemiological classification. Outcomes assessed included hospital admission, high/critical care requirement, death, age distribution, and reported vaccination status.
RESULTS:
A total of 257 pertussis notifications were recorded across the four hospitals: Tygerberg 158 (61.5%), Khayelitsha 40 (15.6%), Mitchell’s Plain 40 (15.6%), and Victoria 19 (7.4%). Overall, 36.2% of cases were laboratory confirmed. Infants accounted for most cases, with 141 (54.9%) occurring in those younger than 3 months and 51 (19.8%) in those aged 3–11 months. Only a small proportion occurred in older children and adults. Severity of illness was substantial: 166 cases (64.6%) required hospital admission, 13 (5.1%) required ICU or High Care, and one death (0.4%) was reported. Vaccination data were incomplete; among available entries, 88 children were up to date and 12 were unvaccinated, while 157 records listed vaccination status as Unknown. Temporal trends showed increased activity in 2022 (61 cases), a larger peak in 2023 (95), a decline in 2024 (29), and resurgence in 2025 (72), with a notable peak in November 2025 (24 cases).
CONCLUSIONS:
Pertussis burden across COCT hospitals was concentrated in infants too young to be fully vaccinated, with high hospitalisation and measurable critical-care utilisation. These findings emphasise the importance of improving maternal Tdap uptake, ensuring timely infant vaccination, and strengthening completeness of immunisation data.
Pertussis remains a vaccine-preventable cause of severe illness, particularly in young infants who are not yet fully immunised. It is classified as a category 1 notifiable medical condition.
METHODS:
We analysed pertussis notifications from four City of Cape Town (COCT) public hospitals—Tygerberg, Khayelitsha, Mitchell’s Plain, and Victoria—between 1 January 2022 and 31 December 2025. A descriptive cohort was developed using the earliest recorded diagnosis, notification, or symptom onset date. Records marked as discarded were excluded. Laboratory confirmation was determined based on diagnosis method, case type, or epidemiological classification. Outcomes assessed included hospital admission, high/critical care requirement, death, age distribution, and reported vaccination status.
RESULTS:
A total of 257 pertussis notifications were recorded across the four hospitals: Tygerberg 158 (61.5%), Khayelitsha 40 (15.6%), Mitchell’s Plain 40 (15.6%), and Victoria 19 (7.4%). Overall, 36.2% of cases were laboratory confirmed. Infants accounted for most cases, with 141 (54.9%) occurring in those younger than 3 months and 51 (19.8%) in those aged 3–11 months. Only a small proportion occurred in older children and adults. Severity of illness was substantial: 166 cases (64.6%) required hospital admission, 13 (5.1%) required ICU or High Care, and one death (0.4%) was reported. Vaccination data were incomplete; among available entries, 88 children were up to date and 12 were unvaccinated, while 157 records listed vaccination status as Unknown. Temporal trends showed increased activity in 2022 (61 cases), a larger peak in 2023 (95), a decline in 2024 (29), and resurgence in 2025 (72), with a notable peak in November 2025 (24 cases).
CONCLUSIONS:
Pertussis burden across COCT hospitals was concentrated in infants too young to be fully vaccinated, with high hospitalisation and measurable critical-care utilisation. These findings emphasise the importance of improving maternal Tdap uptake, ensuring timely infant vaccination, and strengthening completeness of immunisation data.
| eISSN: | 2654-1459 |
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