Introducere. Tusea convulsivă, rămâne o ameninţare majoră pentru sugari. Pandemia COVID-19 a redus acoperirea vaccinală în Moldova (94,5% în 2019 ^ 87,2% în 2021), revenind parţial în 2023 (89,8%). Incidenţa pertussis a oscilat: minim în 2021 (0,2/100.000) şi maxim în 2024 (40,24), cu o creştere în 2023 (14,41). Scop. Evaluarea clinico-epi-demiologică a tusei convulsive la sugarii internaţi post-pandemie, cu accent pe impactul scăderii acoperirii vaccinale şi relevanţa protecţiei indirecte prin imunitatea de cocon. Material şi metode. Studiu retrospectiv s-a desfăşurat în Spitalul Clinic Municipal de Boli Contagioase de Copii, a inclus 136 de sugari internaţi cu tuse convulsivă în 2023-2024. Diagnosticul a fost confirmat prin PCR şi serologie IgM. S-au evaluat vârsta, statutul vaccinal, sursa infecţiei, forma clinică, complicaţiile, durata internării şi coinfecţiile. Rezultate. Incidenţa maximă a infecţiei a fost la sugarii de 1-2 luni (43%), urmaţi de 3-4 luni (26%) şi sub 1 lună (18%). Peste 85% erau nevaccinaţi sau parţial vaccinaţi. Transmiterea intrafamiliară a fost factor semnificativ, 95% dintre mamele testate fiind IgM pozitive. Manifestările clinice frecvente au inclus tuse paroxistică, apnee şi hipoxie. Formele severe au necesitat spitalizare prelungită (7-16 zile), oxigenoterapie şi macrolide. Durata medie a internării a fost 9,2 zile. Complicaţiile au inclus pneumonie (39%), encefalopatie (6%) şi apnee prelungită (15%). Coinfecţiile virale au fost prezente în 32% din cazuri. Concluzii. Studiul evidenţiază necesitatea urgentă de intensificare a prevenţiei prin relansarea campaniilor de vaccinare DTP, includerea vaccinării gravidelor contra pertussis şi consolidarea educaţiei parentale, alături de supravegherea activă a contactelor şi notificarea timpurie a cazurilor suspecte.
Introduction. Pertussis remains a significant threat to infants. In Moldova, vaccination coverage declined from 94.5% in 2019 to 87.2% in 2021 due to the COVID-19 pandemic, with partial recovery to 89.8% in 2023. Incidence dropped to 0.2/100,000 in 2021, then rose sharply to 14.41 in 2023 and peaked at 40.24 in 2024. Objective. To evaluate clinico-epidemiological characteristics of pertussis in hospitalized infants post-pandemic, focusing on the impact of reduced vaccination coverage and the importance of cocooning. Material and methods. A retrospective observational study at the Municipal Clinical Infectious Diseases Hospital for Children included 136 infants hospitalized with PCR- and IgM-confirmed pertussis during 2023-2024. Variables assessed were age, vaccination status, infection source, clinical form, complications, hospital stay, and co-infections. Results. The highest incidence was among infants aged 1-2 months (43%), followed by 3-4 months (26%) and under 1 month (18%). Over 85% were unvaccinated or partially vaccinated. Intrafamilial transmission was a significant factor, with 95% of tested mothers positive for IgM. Common clinical manifestations included paroxysmal cough, apnea, and hypoxia. Severe cases required prolonged hospitalization (7-16 days), oxygen therapy, and macrolide treatment. The average hospital stay was 9.2 days. Complications included pneumonia (39%), encephalopathy (6%), and prolonged apnea (15%). Viral co-infections were present in 32% of cases. Conclusion. The study highlights the urgent need to strengthen preventive measures through the relaunch of DTP vaccination campaigns, inclusion of maternal pertussis vaccination, and enhancement of parental education, alongside active contact surveillance and early notification of suspected cases.
