Whooping Cough- Worldwide, whooping cough affects 48.5 million people yearly resulting in nearly 295,000 deaths. This is despite generally high coverage with the DTP and DTaP vaccines, pertussis is one of the leading causes of vaccine-preventable deaths world-wide.
Before vaccines, an average of 157 cases per 100,000 persons were reported in the U.S., with peaks reported every two to five years; more than 93% of reported cases occurred in children under 10 years of age. The actual incidence was likely much higher. After vaccinations were introduced in the 1940s, incidence fell dramatically to less than 1 per 100,000 by 1970. Incidence rates have increased somewhat since 1980.
Pertussis is the only vaccine-preventable disease that is associated with increasing deaths in the U.S. The number of deaths increased from four in 1996 to 17 in 2001, almost all of which were infants under one year. In Canada, the number of pertussis infections has varied between 2,000 to 10,000 reported cases each year over the last ten years. Australia reports an average of 10,000 cases a year, but the number of cases has increased in recent years. In 2010 ten infants in California died and health authorities declared an epidemic. Doctors had been misdiagnosing the infants' condition despite having seen infants on multiple visits. In the U.S. pertussis in adults has increased significantly since about 2004.
Identify the clinical features and discuss medical management of Bordetella pertussis. Outline the epidemiologic features of pertussis, including occurrence, transmission, and communicability. Review current trends in the spread and surveillance of pertussis in the United States. Explain major issues associated with pertussis vaccination in children, adolescents, and adults including recommendations, adverse reactions, and contraindications.
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