Pertussis epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
This disease results in high morbidity and mortality in many countries every year. Pertussis causes 20-40 million deaths worldwide, most of which occur in Africa and Southeast Asia.
Trends in Pertussis Disease in the United States
In the United States, 5000-7000 cases are reported each year. Incidence of pertussis has increased steadily since the 1980s. The incidence in 2002 was 3.01/100,000 when 8,296 cases of pertussis were reported.
In the United States, the highest recorded annual incidence of pertussis occurred in 1934 when greater than 260,000 cases were reported. The incidence of reported pertussis disease declined substantially in the 1940's as use of whole-cell DTP vaccines became widespread. By 1970, the reported incidence had declined greater than 99%; the fewest cases (1,010) were reported in 1976. However, since the early 1980s reported pertussis incidence has increased steadily. Cyclical peaks in incidence occurred in 1983, 1986, 1990, and in 1993. The number of reported cases has increased in all age groups, but the increase is greatest among persons aged greater than or equal to 5 years. Nevertheless, infants and young children continue to have the highest risk for pertussis and its complications, with 84% of the deaths due to pertussis occurring in infants less than 6 months of age.
Despite the availability of vaccination, the incidence of pertussis in the US has continued to increase in the past 10-15 years. The Center for Disease Control and prevention (CDC) reported the incidence of pertussis in 2005 to be 25,616, which is triple the incidence reported in 2001. There are several hypothesized reasons for the increase in incidence. Factors that may contribute to this increased incidence include; decreased use of the vaccination, decrease in the level of vaccine induced immunity over the years, and an increased circulation of the pathogen itself. Other factors include a a heightened awareness of whooping cough among health care providers, an increased amount of public health reporting, and the increased sensitivity of PCR testing to diagnose pertussis.
Susceptible Populations
Outbreaks of pertussis occur in under-vaccinated or un-vaccinated populations of individuals, such as those in particular religious communities. Outbreaks have also occurred in settings such as sports facilities, schools and health care facilities, where an infected individual has not been diagnosed and the infection has spread. In adults and adolescents, pertussis may simply present as a prolonged cough and poses a great risk of exposure to young and immunocompromised contacts.Females have an increased prevalence of morbidity and mortality from infection with pertussis. The highest incidence of infection occurs in infants and young children.
Age
- Children below the age of 1 year are mostly affected.
- Incidence decreases with the progression of age.[1]
References
- ↑ Mattoo S, Cherry JD (2005). "Molecular pathogenesis, epidemiology, and clinical manifestations of respiratory infections due to Bordetella pertussis and other Bordetella subspecies". Clin. Microbiol. Rev. 18 (2): 326–82. doi:10.1128/CMR.18.2.326-382.2005. PMC 1082800. PMID 15831828. Unknown parameter
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