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Arch Pediatr Adolesc Med. 2008 Jan;162(1):79-85. doi: 10.1001/archpediatrics.2007.7.

A countywide outbreak of pertussis: initial transmission in a high school weight room with subsequent substantial impact on adolescents and adults.

Author information

1
Bureau of Communicable Diseases and Preparedness, Wisconsin Division of Public Health, Madison, Wisconsin 53702, USA.

Abstract

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.

PMID:
18180417
DOI:
10.1001/archpediatrics.2007.7
[Indexed for MEDLINE]

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