OBJECTIVE: To describe a large communitywide pertussis outbreak where aggressive diagnostic and treatment measures were used to control the outbreak. DESIGN: Retrospective analysis, May 2003 through February 2004. SETTING: Fond du Lac County, Wisconsin (population 98,882). PARTICIPANTS: Health department personnel conducted case and contact investigations of suspected outbreak-associated illnesses using standard pertussis reporting forms and clinical evaluation and management protocols. Persons with compatible illness were tested for Bordetella pertussis using culture and for B pertussis DNA using polymerase chain reaction. Cases were classified using Council of State and Territorial Epidemiologists definitions. INTERVENTIONS: Health alerts and aggressive testing and treatment of suspected cases of pertussis illness and contact prophylaxis in the community. MAIN OUTCOME MEASURES: Incidences by age, onsets over time, and vaccine coverage in case patients. RESULTS: We identified 261 pertussis cases among county residents; 149 (57%) were laboratory confirmed. Of the first 57 case patients, 47% reported using a particular high school weight room. Pertussis incidence was high in all age groups; 86% of case patients were 10 years or older. Among 156 case patients with reported vaccination histories, 84% had received 5 or more doses of pertussis-containing vaccine. Adults reported significantly more severe pertussis symptoms than adolescents. CONCLUSIONS: Pertussis transmission among adolescents using a school weight room instigated a countywide outbreak with substantial incidence and morbidity among adolescents and adults. Aggressive testing and treatment in the outbreak response likely contributed to a sharp reduction in cases. This labor- and resource-intensive outbreak highlights potential benefits of pertussis booster vaccination among adolescent and adult populations.
OBJECTIVE: To describe a large communitywide pertussis outbreak where aggressive diagnostic and treatment measures were used to control the outbreak. DESIGN: Retrospective analysis, May 2003 through February 2004. SETTING: Fond du Lac County, Wisconsin (population 98,882). PARTICIPANTS: Health department personnel conducted case and contact investigations of suspected outbreak-associated illnesses using standard pertussis reporting forms and clinical evaluation and management protocols. Persons with compatible illness were tested for Bordetella pertussis using culture and for B pertussis DNA using polymerase chain reaction. Cases were classified using Council of State and Territorial Epidemiologists definitions. INTERVENTIONS: Health alerts and aggressive testing and treatment of suspected cases of pertussis illness and contact prophylaxis in the community. MAIN OUTCOME MEASURES: Incidences by age, onsets over time, and vaccine coverage in case patients. RESULTS: We identified 261 pertussis cases among county residents; 149 (57%) were laboratory confirmed. Of the first 57 case patients, 47% reported using a particular high school weight room. Pertussis incidence was high in all age groups; 86% of case patients were 10 years or older. Among 156 case patients with reported vaccination histories, 84% had received 5 or more doses of pertussis-containing vaccine. Adults reported significantly more severe pertussis symptoms than adolescents. CONCLUSIONS: Pertussis transmission among adolescents using a school weight room instigated a countywide outbreak with substantial incidence and morbidity among adolescents and adults. Aggressive testing and treatment in the outbreak response likely contributed to a sharp reduction in cases. This labor- and resource-intensive outbreak highlights potential benefits of pertussis booster vaccination among adolescent and adult populations.
Authors: Catherine J Staes; Per H Gesteland; Mandy Allison; Susan Mottice; Michael Rubin; Julie H Shakib; Rachelle Boulton; Amyanne Wuthrich; Marjorie E Carter; Molly Leecaster; Matthew H Samore; Carrie L Byington Journal: J Public Health Manag Pract Date: 2009 Nov-Dec
Authors: Andrew M Fine; Ben Y Reis; Lise E Nigrovic; Donald A Goldmann; Tracy N Laporte; Karen L Olson; Kenneth D Mandl Journal: J Am Med Inform Assoc Date: 2010 Jan-Feb Impact factor: 4.497
Authors: Gustaf Rydevik; Giles T Innocent; Glenn Marion; Ross S Davidson; Piran C L White; Charalambos Billinis; Paul Barrow; Peter P C Mertens; Dolores Gavier-Widén; Michael R Hutchings Journal: PLoS Comput Biol Date: 2016-07-06 Impact factor: 4.475