Epidemiology and Infection

Original Papers

Other Bacterial infections

The pertussis epidemic: informing strategies for prevention of severe disease

M. F. CLARKEa1a2 c1, K. RASIAHa1, J. COPLANDa3, M. WATSONa3, A. P. KOEHLERa3, K. DOWLINGa4 and H. S. MARSHALLa1a2

a1 Discipline of Paediatrics, Women's and Children's Hospital, part of Women's and Children's Health Network, SA, Australia

a2 Discipline of Paediatrics, University of Adelaide, SA, Australia

a3 Communicable Disease Control Branch, SA Health, SA, Australia

a4 Public Health Research Unit, Women's and Children's Hospital, part of Women's and Children's Health Network, SA, Australia

SUMMARY

To assess the impact of Bordetella pertussis infections in South Australia during an epidemic and determine vulnerable populations, data from notification reports for pertussis cases occurring between July 2008 and December 2009 were reviewed to determine the distribution of disease according to specific risk factors and examine associations with hospitalizations. Although the majority (66%) of the 6230 notifications for pertussis occurred in adults aged >24 years, the highest notification and hospitalization rate occurred in infants aged <1 year. For these infants, factors associated with hospitalization included being aged <2 months [relative risk (RR) 2·3, 95% confidence interval (CI) 1·60–3·32], Indigenous ethnicity (RR 1·7, 95% CI 1·03–2·83) and receiving fewer than two doses of pertussis vaccine (RR 4·1, 95% CI 1·37–12·11). A combination of strategies aimed at improving direct protection for newborns, vaccination for the elderly, and reducing transmission from close contacts of infants are required for prevention of severe pertussis disease.

(Received December 01 2011)

(Revised March 27 2012)

(Accepted April 14 2012)

(Online publication May 17 2012)

Key words

  • Australia;
  • epidemic;
  • epidemiology;
  • hospitalization;
  • pertussis;
  • prevention

Correspondence:

c1 Author for correspondence: Mrs M. F. Clarke, Discipline of Paediatrics, School of Paediatrics and Reproductive Health, Women's and Children's Hospital, 72 King William Road, North Adelaide, SA 5006, Australia. (Email: michelle.clarke@adelaide.edu.au)

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