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Pertussis – October 2010

Pertussis – October 2010. Pertussis Incidence Rates in the U.S. and Oregon, 1995–2010. Source : Oregon pertussis surveillance data and CDC MMWR reports. Number of Reported Pertussis Cases by Age Group, Oregon, 2000-2010. Incidence of Reported Pertussis by Age Group, Oregon, 2000-2010.

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Pertussis – October 2010

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  1. Pertussis – October 2010

  2. Pertussis Incidence Rates in the U.S. and Oregon, 1995–2010 Source: Oregon pertussis surveillance data and CDC MMWR reports

  3. Number of Reported Pertussis Cases by Age Group, Oregon, 2000-2010

  4. Incidence of Reported Pertussis by Age Group, Oregon, 2000-2010 Age Group

  5. Pertussis Cases Among Infants, Oregon, 2000-2009

  6. Hospitalizations and complications among infants with pertussis, Oregon, 2000-2009 (N=464) * Percentages are based on total number with information. † Duration of hospitalizations (median: 3; range: 0-87 days) § Radiographically confirmed.

  7. Medical visits among infants with pertussis, Oregon, 1/1/2009-9/30/2009

  8. Death Due To Pertussis • 3 month-old male • Vaccinated • Plausible sources: family members • Presentation: cough, coryza, wheezing. • He was seen at ER twice. He was prescribed an infant inhaler. The child was on no medications, no antibiotics.

  9. Pertussis death, cont’d • Course/Complications: apnea. • The mother found the baby cold to touch and stiff with rigor mortis. The baby appeared to be healthy, plump and very well-cared-for. • Death certificate : SIDS • Labs: pertussis: PCR + from tissue (postmortem)

  10. POSTMORTEM DIAGNOSIS IHC Tracheal epithelium of an infant with fatal pertussis

  11. A Complicated Case of Pertussis • 6 week-old baby • Respiratory failure, acute renal failure, pulmonary hypertension intracranial hemorrhage, stroke, seizures, feeding difficulties, poor vision, cerebral palsy and oropharyngeal dysphagia. • Exchange transfusion: 10 • ECMO: 32 days • Days hospitalized: 87; ICU: 60 days • Discharged with permanent brain damage and severe neurological deficits.

  12. Effectiveness of postpartum Tdap vaccination in California hospitals K. Winter, K. Harriman, R. Schechter, J. Chang, J. Talarico California Department of Public Health

  13. Results • Pertussis incidence over time also declined significantly in hospitals with a postpartum Tdap vaccination policy from 2006 (when no postpartum Tdap policies existed) to 2009 (when 53 policies existed) • Increase in incidence was observed in control hospitals Pertussis cases per 100,000

  14. Three New Exciting Projects in Oregon • MAPS • Validation study • Post-partum study

  15. Winnable Battles in Pertussis Encouraging improved adherence to the current schedule Vaccinate mothers and families of newborns Vaccinate staff in birth and neonatal units with Tdap

  16. Thank You

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