Outbreaks of Pertussis in the United States : The Wisconsin Experience(B. Vaccine Schedules: Their Pelationship to Current Epidemiology)(II. The Eradication of Pertussis: Current Unsolved Epidemiologic, Clinical and Public Health Problems which Impede Thi

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概要

• 論文の詳細を見る

• To identify risk factors for pertussis in older age groups and to examine the effectiveness of erythromycin therapy and prophylaxis in reducing secondary spread, epidemiologic investigations of two outbreaks involving teenagers and adults were conducted. The first outbreak occurred in 1984 among residents of a facility for developmentally disabled persons (median age 17 years). Rates of culture-and/or serologically confirmed infection ranged from 6% to 91% in exposed wards (42% overall), with transmission continuing over a five-month period. Although residents age 10-19 years experienced the highest rates of infection, they were also more likely to be exposed compared with residents in other age groups. Infection rates were significantly lower on wards where erythromycin treatment and prophylaxis were initiated less than 2 weeks after onset of illness in the index case (overall attack rate=16% vs. 75% in wards where more than 4 weeks had elapsed; p<.0001). Early treatment with erythromycin was also effective in reducing pertussis severity. The second outbreak occurred over a six-month period among residents of a 3-county area in central Wisconsin in 1985, with adults accounting for 38% of 161 culture-positive cases. Exposure outside the home was the most important predictor of community-acquired infection (p<.001), with adolescents being at higher risk than persons in other age groups (odds ratio 3.2; p<.001). After known exposure to a culture-positive case individual in the same household, the risk of illness was similar in all age groups: delays of more than 2 weeks in initiating erythromycin therapy (for cases) and prophylaxis (for contacts) were the only factors associated with secondary spread (p<.01). These investigations illustrate that pertussis may be more common in teenagers and adults than has been appreciated in the past, and that levels of susceptibility in these age groups may be high enough to sustain an outbreak. However, the risk of illness appears to be related more to the likelihood of exposure to B. pertussis than to age-related increases in susceptibility, and can be reduced with appropriate use of erythromycin therapy and prophylaxis.

• 東海大学の論文
• 1988-09-22

著者

• Brink Edward

  Centers For Disease Control

• Manclark Charles

  Food And Drug Administration

• Wassilak Steven

  Centers For Disease Control

• PARTIARCA Peter

  Centers for Disease Control

• STEKETEE Richard

  Centers for Disease Control

• BIELLIK Robin

  Pan American Health Organization

• BURSTYN Don

  Food and Drug Administration

• DAVIS Jeffrey

  Wisconsin Division of Health

• Burstyn Don

  Food And Drug Administration:biogen Research Corporation

関連論文

• Structural and Functional Properties of a 69-Kilodalton Outer Membrane Protein of Bordetella pertussis(I. Characterization of Virulence Factors of Bordetella pertussis)(Current Studies on Future Vaccines)
• Biochemical Properties of Pertussis Toxin(I. Characterization of Virulence Factors of Bordetella pertussis)(Current Studies on Future Vaccines)
• Outbreaks of Pertussis in the United States : The Wisconsin Experience(B. Vaccine Schedules: Their Pelationship to Current Epidemiology)(II. The Eradication of Pertussis: Current Unsolved Epidemiologic, Clinical and Public Health Problems which Impede Thi

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