Pertussis epidemiology and demographics: Difference between revisions

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==Epidemiology and Demographics==
==Epidemiology and Demographics==
[[Image:Pertussis by geographical location.JPG|left|800px|thumb|Petsussis infection according to incidence within each State.]]
===Incidence===
===Incidence===
*In the United States, 5000-7000 cases are reported each year.  
*In the United States, 5000-7000 cases are reported each year.  
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#An increased amount of public health reporting.
#An increased amount of public health reporting.
#The increased sensitivity of PCR testing to diagnose pertussis.
#The increased sensitivity of PCR testing to diagnose pertussis.
{| style="font-size: 85%; width: 50%"
! style="width: 80px; background: #4479BA; text-align: center;" |{{fontcolor|#FFF|State}}
! style="width: 720px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Incidence (per 100,000)}}
! style="width: 720px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|No. of Cases}}
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Alabama'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" | 5.9
| style="background: #DCDCDC; padding: 5px; text-align: center;" |285
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Alaska'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |23.0
| style="background: #DCDCDC; padding: 5px; text-align: center;" |169
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Arizona'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |7.8
| style="background: #DCDCDC; padding: 5px; text-align: center;" |517
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Arkansas'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |9.7
| style="background: #DCDCDC; padding: 5px; text-align: center;" |286
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''California'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |22.8
| style="background: #DCDCDC; padding: 5px; text-align: center;" |8,723
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Colorado'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |24.3
| style="background: #DCDCDC; padding: 5px; text-align: center;" |1,282
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Connecticut'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |2.8
| style="background: #DCDCDC; padding: 5px; text-align: center;" |100
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Delaware'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |22.1
| style="background: #DCDCDC; padding: 5px; text-align: center;" |205
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''D.C.'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |3.4
| style="background: #DCDCDC; padding: 5px; text-align: center;" |22
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Florida'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |3.7
| style="background: #DCDCDC; padding: 5px; text-align: center;" |719
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Georgia'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |4.1
| style="background: #DCDCDC; padding: 5px; text-align: center;" |408
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Hawaii'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |2.7
| style="background: #DCDCDC; padding: 5px; text-align: center;" |38
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Idaho'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |22.8
| style="background: #DCDCDC; padding: 5px; text-align: center;" |367
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Illinois'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |5.9
| style="background: #DCDCDC; padding: 5px; text-align: center;" |764
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Indiana'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |7.5
| style="background: #DCDCDC; padding: 5px; text-align: center;" |492
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Iowa'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |7.2
| style="background: #DCDCDC; padding: 5px; text-align: center;" |222
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Kansas'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |14.9
| style="background: #DCDCDC; padding: 5px; text-align: center;" |431
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Kentucky'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |6.8
| style="background: #DCDCDC; padding: 5px; text-align: center;" |300
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Louisiana'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |2.0
| style="background: #DCDCDC; padding: 5px; text-align: center;" |90
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Maine'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |41.9
| style="background: #DCDCDC; padding: 5px; text-align: center;" |557
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Maryland'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |3.4
| style="background: #DCDCDC; padding: 5px; text-align: center;" |203
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Massachusetts'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |4.6
| style="background: #DCDCDC; padding: 5px; text-align: center;" |308
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Michigan'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |14.4
| style="background: #DCDCDC; padding: 5px; text-align: center;" |1424
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Minnesota'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |17.5
| style="background: #DCDCDC; padding: 5px; text-align: center;" |950
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Mississippi'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |2.3
| style="background: #DCDCDC; padding: 5px; text-align: center;" |68
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Missouri'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |9.2
| style="background: #DCDCDC; padding: 5px; text-align: center;" |558
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Montana'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |48.7
| style="background: #DCDCDC; padding: 5px; text-align: center;" |494
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Nebraska'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |19.6
| style="background: #DCDCDC; padding: 5px; text-align: center;" |366
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Nevada'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |5.2
| style="background: #DCDCDC; padding: 5px; text-align: center;" |144
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''New Hampshire'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |6.4
| style="background: #DCDCDC; padding: 5px; text-align: center;" |8.4
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''New Jersey'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |4.4
| style="background: #DCDCDC; padding: 5px; text-align: center;" |387
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''New Mexico'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |17.7
| style="background: #DCDCDC; padding: 5px; text-align: center;" |370
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''New York'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |8.0
| style="background: #DCDCDC; padding: 5px; text-align: center;" |901
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''New York City'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |1.4
| style="background: #DCDCDC; padding: 5px; text-align: center;" |122
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''North Carolina'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |7.6
| style="background: #DCDCDC; padding: 5px; text-align: center;" |752
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''North Dakota'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |7.2
| style="background: #DCDCDC; padding: 5px; text-align: center;" |52
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Ohio'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |12.6
| style="background: #DCDCDC; padding: 5px; text-align: center;" |1,463
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Oklahoma'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |3.7
| style="background: #DCDCDC; padding: 5px; text-align: center;" |142
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Oregon'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |10.6
| style="background: #DCDCDC; padding: 5px; text-align: center;" |416
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Pennsylvania'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |6.4
| style="background: #DCDCDC; padding: 5px; text-align: center;" |813
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Rhode Island'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |10.3
| style="background: #DCDCDC; padding: 5px; text-align: center;" |108
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''South Carolina'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |3.6
| style="background: #DCDCDC; padding: 5px; text-align: center;" |170
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''South Dakota'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |13.0
| style="background: #DCDCDC; padding: 5px; text-align: center;" |110
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Tennessee'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |5.1
| style="background: #DCDCDC; padding: 5px; text-align: center;" |330
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Texas'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |9.7
| style="background: #DCDCDC; padding: 5px; text-align: center;" |2,576
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Utah'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |32.4
| style="background: #DCDCDC; padding: 5px; text-align: center;" |940
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Vermont'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |6.7
| style="background: #DCDCDC; padding: 5px; text-align: center;" |42
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Virginia'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |6.1
| style="background: #DCDCDC; padding: 5px; text-align: center;" |505
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Washington'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |8.6
| style="background: #DCDCDC; padding: 5px; text-align: center;" |601
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''West Virginia'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |1.0
| style="background: #DCDCDC; padding: 5px; text-align: center;" |18
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Wisconsin'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |26.4
| style="background: #DCDCDC; padding: 5px; text-align: center;" |1,515
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Wyoming'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |10.6
| style="background: #DCDCDC; padding: 5px; text-align: center;" |62
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Total'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |10.4
| style="background: #DCDCDC; padding: 5px; text-align: center;" |32,971
|}


===Susceptible Populations===
===Susceptible Populations===

Revision as of 14:54, 14 January 2016

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]

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Overview

Pertussis results in high morbidity and mortality in many countries every year. Pertussis causes 20-40 million deaths worldwide, the majority of which occur in Africa and Southeast Asia.

Epidemiology and Demographics

Incidence

  • 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.
  • 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:

  1. Decreased use of the vaccination.
  2. Decrease in the level of vaccine induced immunity over the years.
  3. Increased circulation of the pathogen itself.

The following have been enacted to decrease incidence of pertussis and increase efficacy of treatment:

  1. Heightened awareness of whooping cough among health care providers.
  2. An increased amount of public health reporting.
  3. The increased sensitivity of PCR testing to diagnose pertussis.
State Incidence (per 100,000) No. of Cases
Alabama 5.9 285
Alaska 23.0 169
Arizona 7.8 517
Arkansas 9.7 286
California 22.8 8,723
Colorado 24.3 1,282
Connecticut 2.8 100
Delaware 22.1 205
D.C. 3.4 22
Florida 3.7 719
Georgia 4.1 408
Hawaii 2.7 38
Idaho 22.8 367
Illinois 5.9 764
Indiana 7.5 492
Iowa 7.2 222
Kansas 14.9 431
Kentucky 6.8 300
Louisiana 2.0 90
Maine 41.9 557
Maryland 3.4 203
Massachusetts 4.6 308
Michigan 14.4 1424
Minnesota 17.5 950
Mississippi 2.3 68
Missouri 9.2 558
Montana 48.7 494
Nebraska 19.6 366
Nevada 5.2 144
New Hampshire 6.4 8.4
New Jersey 4.4 387
New Mexico 17.7 370
New York 8.0 901
New York City 1.4 122
North Carolina 7.6 752
North Dakota 7.2 52
Ohio 12.6 1,463
Oklahoma 3.7 142
Oregon 10.6 416
Pennsylvania 6.4 813
Rhode Island 10.3 108
South Carolina 3.6 170
South Dakota 13.0 110
Tennessee 5.1 330
Texas 9.7 2,576
Utah 32.4 940
Vermont 6.7 42
Virginia 6.1 505
Washington 8.6 601
West Virginia 1.0 18
Wisconsin 26.4 1,515
Wyoming 10.6 62
Total 10.4 32,971

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.
  • The highest incidence of infection occurs in infants and young children.

Reported Pertussis Death versus Age

  • In 2014, a total of 13 Pertussis related deaths were reported in the United States.
  • Eight deaths were reported within infants of less than 3 months.
  • One death was reported within infants of between the ages of 3-11 months.
  • Two deaths were reported within children ages of 1-4 years.
  • Two deaths were reported within adults of ages 55+.


Pertussis infection incidence according to different age groups.

Age

  • 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.
  • In 2014, 32,971 cases of Pertussis were been reported within the United States.
  • 3,330 cases were reported in infants less than 6 months, accounting for 10.1% of all cases.
  • 875 cases were reported within infants between the ages of 6-11 months, accounting for 2.7% of all cases.
  • 6,082 cases were reported within children between 1-6 years of age, accounting for 18.5% of all cases.
  • 5,576 cases were reported within children between the ages of 7-10 years, accounting for 16.9% of all cases.
  • 11,159 cases were reported within children and teenagers between the ages of 11-19 years, accounting for 33.8% of all cases.
  • 5,839 cases were reported within adults of 20+ years, accounting for 17.7& of all cases.
  • Children below the age of 1 year are mostly affected.
  • Incidence decreases with increasing age.[1]

Gender

  • Gender is not associated with an increased risk of pertussis.[1]

References

  1. ↑ 1.0 1.1 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 |month= ignored (help)

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