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Epidemiol Health > Accepted Articles
Epidemiology and Health 2021;e2021053.
DOI: https://doi.org/10.4178/epih.e2021053    [Accepted] Published online Aug 18, 2021.
Recent increase in pertussis incidence in South Korea: An age-period-cohort analysis
Chanhee Kim2  , Seonju Yi3  , Sung-il Cho1 
1Graduate School of Public Health, Seoul National University, Seoul-si, South Korea
2Department of Disease Control Policy, Gyeonggi Provincial Government, Suwon-si, Gyeonggi-do, South Korea
3Central Disease Control Headquarters, Korea Disease Control and Prevention Agency, Cheongji-si, Chungcheongbuk-do, South Korea
Correspondence  Sung-il Cho ,Tel: 02-880-2717, Fax: 02-880-2717, Email: scho@snu.ac.kr
Received: Apr 11, 2021  Accepted after revision: Aug 18, 2021
Abstract
Objectives:
Pertussis or whooping cough, one of the most contagious diseases, is caused by the gram-negative bacterium Bordetella pertussis. Despite the high vaccination rate, South Korea recently experienced a resurgence of pertussis. This study explores the patterns and possible explanations of the resurgence of pertussis in South Korea using age-period-cohort analysis.
Method:
Using secondary data from the infectious disease portal of Korea Disease Prevention & Control Agency and Korea Statistical Information Service of Statistics Korea, this study analyzed the incidence of pertussis in South Korea to determine the factors contributing to the recent phenomenon using an age-period-cohort model.
Results:
Age effects indicated the most vulnerable age group to pertussis as those aged 0–2 years. The period effect showed a sharp increase after 2016. With the cohort effect, a significant decrease was observed from the beginning till the 1955 birth cohort. However, the risk started to increase again with the 2000s birth cohort.
Conclusions:
Three main possible explanations for our results are consistent with previous studies. First, the occurrence of pertussis was attributed to the contact rates. Second, opportunity for boosting immunity through natural exposure to the pathogen decreased due to the reduced number of circulating pathogens, in turn affecting the trend of pertussis. Lastly, the recent trends were also explained by variations in pathogens. Considering that the most significant increase in the incidence occurred in infants aged below 1 year, it is important to establish sufficient maternal immunity to provide passive immunity via the placenta for the infants.
Keywords: Vaccines; Immunization; Whooping Cough; Pertussis; Age-Period-Cohort Analysis


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