Pertussis in Chile

Overview

In January 2013, CDC-Latin American Pertussis Project conducted an initial assessment of the pertussis surveillance system and laboratory capacity in Chile. Chile’s Ministry of Health uses a standardized data collection form and case definition for pertussis (known as coqueluche). The national reference laboratory, Instituto de Salud Pública (ISP) (in Spanish), has diagnostic capacity in culture, serology, and real-time and isothermal polymerase chain reaction (PCR). Since late 2013, ISP has used real-time PCR as the primary pertussis diagnostic. 5 regional laboratories implemented real-time PCR in December 2015. In December 2015, the Chile Ministry of Health advised regional public health laboratories to phase out use of direct fluorescent antibody for pertussis diagnostics.

Case Definition

Chile’s case definition for suspected pertussis cases, adopted in 2017, include 3 age groups:

- Under 6 months: Cough, coryza, with or without fever, and at least one of the following symptoms:
  - Paroxysmal cough
  - Inspiratory whoop
  - Posttussive vomiting
  - Apnea
  - Cyanosis
- 6 months through 9 years: In the absence of a more likely diagnosis, paroxysmal cough of at least 7 days with or without fever and at least one of the following symptoms:
  - Inspiratory whoop
  - Posttussive vomiting
  - Apnea
- Over 9 years: Paroxysmal non-productive cough illness lasting for at least 14 days with at least one of the following symptoms:
  - Inspiratory whoop
  - Apnea
  - Sweating between coughing fits
  - Posttussive vomiting
  - Worsening of coughing in nighttime

The Ministry of Health confirms pertussis cases if they meet the case definition and have positive laboratory confirmation (by culture or real-time PCR) or epidemiologic link with a laboratory-confirmed case. Cases that meet the clinical case definition for which laboratory confirmation or epidemiologic link to a confirmed case are not available are considered probable cases, as specified in Chile’s surveillance guidelines [21 pages] (in Spanish).

Vaccine Abbreviations

DTP – Diphtheria and tetanus toxoids and whole cell pertussis vaccine
Tdap – Tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine
HB – Hepatitis B vaccine
Hib – Haemophilus influenzae serotype b vaccine

Immunization Program

Chile’s routine immunization schedule includes a pentavalent vaccine, which contains DTP (whole cell pertussis component), HB, and Hib, administered at 2, 4, and 6 months, with a booster given at 18 months. A dose of Tdap is given at 6 (1^st grade) and 13 (8^th grade) years. In October 2016, Chile’s Comité Consultivo de Inmunizaciones de la Sociedad Chilena de Infectología recommended a single dose of Tdap for pregnant women (to be administered between 27 and 36 weeks gestation). The Ministry of Health is in the process of adopting these recommendations.

View Chile’s complete vaccination schedule (in Spanish)