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{{Pertussis}}
{{Pertussis}}
==Overview==
==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.
In the United States, the incidence of pertussis is approximately 1.5 to 3.0 per 100,000 individuals, with approximately 5,000 to 7,000 cases reported annually. The incidence of pertussis is thought to be on the rise due to the decline in vaccination rate and diminished herd immunity. Infants and young children < 5 years of age are more commonly infected with pertussis than adults. There is no gender predilection for the development of pertussis. Pertussis-related deaths are rare, but are more common in developing countries, among infants < 6 months of age, and among adult patients with significant co-morbidities.


===Trends in Pertussis Disease in the United States===
==Epidemiology and Demographics==
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.
===Incidence===
*In the United States, the incidence of pertussis is approximately 1.5 to 3.0 per 100,000 individuals, with approximately 5,000 to 7,000 cases reported annually.
*Incidence of pertussis has increased steadily since the 1980s despite the availability of vaccination. It is thought that the decline in vaccination rate and diminished herd immunity may, at least in part, be responsible for the rise of the incidence.


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.
===Mortality===
*Pertussis is responsible for approximately 20-40 million deaths worldwide.
*The majority of pertussis-related deaths occur in Africa and Southeast Asia.
*Pertussis-related death is rare, but is more common among infants < 6 months of age and among adult patients with significant co-morbidities.


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.
===Age===
*Pertussis may infect individuals of all age groups.<ref name="pmid15831828">{{cite journal |author=Mattoo S, Cherry JD |title=Molecular pathogenesis, epidemiology, and clinical manifestations of respiratory infections due to ''Bordetella pertussis'' and other ''Bordetella'' species |journal=Clin. Microbiol. Rev. |volume=18 |issue=2 |pages=326–82 |year=2005 |month=April |pmid=15831828 |pmc=1082800 |doi=10.1128/CMR.18.2.326-382.2005 |url=}}</ref>
*Infants and young children < 5 years of age are more commonly infected with pertussis than adults.<ref name="pmid15831828">{{cite journal |author=Mattoo S, Cherry JD |title=Molecular pathogenesis, epidemiology, and clinical manifestations of respiratory infections due to ''Bordetella pertussis'' and other ''Bordetella'' species |journal=Clin. Microbiol. Rev. |volume=18 |issue=2 |pages=326–82 |year=2005 |month=April |pmid=15831828 |pmc=1082800 |doi=10.1128/CMR.18.2.326-382.2005 |url=}}</ref>


===Susceptible Populations===
{| {{table}}
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.
| align="center" style="background:#f0f0f0;"|'''Age'''
| align="center" style="background:#f0f0f0;"|'''Number of Cases'''
| align="center" style="background:#f0f0f0;"|'''Percentage (%)'''
| align="center" style="background:#f0f0f0;"|'''Age Incidence per 100,000 Individuals'''
|-
| < 6 months||3,330||10.1||169
|-
| 6-11 months||875||2.7||44.4
|-
| 1-6 years||6,082||18.5||25.1
|-
| 7-10 years||5,576||16.9||34
|-
| 11-19 years||11,159||33.8||29.6
|-
| 20+ years||58,839||17.7||2.2
|-
| Unknown||110||0.3||N/A
|-
| '''Total'''||'''32,971'''||'''100'''||'''10.4*'''
|}
<sup><nowiki>*</nowiki>Total age incidence per 100,000 calculated from 32,861 cases with age reported.</sup><br>
<sup>Table adapted from 2014 Final Pertussis Surveillance Report - Centers for Disease Control and Prevention.<ref name=CDCsurveillance>{{cite web |url=http://www.cdc.gov/pertussis/downloads/pertuss-surv-report-2014.pdf |title=2014 Final Pertussis Surveillance Report |date=2014 |website= www.cdc.gov |access-date= Jan 14, 2016}}</ref></sup>


===Age===
* Children below the age of 1 year are mostly affected.
* Incidence decreases with the progression of age.<ref name="pmid15831828">{{cite journal |author=Mattoo S, Cherry JD |title=Molecular pathogenesis, epidemiology, and clinical manifestations of respiratory infections due to Bordetella pertussis and other Bordetella subspecies |journal=Clin. Microbiol. Rev. |volume=18 |issue=2 |pages=326–82 |year=2005 |month=April |pmid=15831828 |pmc=1082800 |doi=10.1128/CMR.18.2.326-382.2005 |url=}}</ref>
===Gender===
===Gender===
* Gender is not associated with increase risk of pertussis.<ref name="pmid15831828">{{cite journal |author=Mattoo S, Cherry JD |title=Molecular pathogenesis, epidemiology, and clinical manifestations of respiratory infections due to Bordetella pertussis and other Bordetella subspecies |journal=Clin. Microbiol. Rev. |volume=18 |issue=2 |pages=326–82 |year=2005 |month=April |pmid=15831828 |pmc=1082800 |doi=10.1128/CMR.18.2.326-382.2005 |url=}}</ref>
* There is no gender predilection for the development of pertussis.<ref name="pmid15831828">{{cite journal |author=Mattoo S, Cherry JD |title=Molecular pathogenesis, epidemiology, and clinical manifestations of respiratory infections due to ''Bordetella pertussis'' and other ''Bordetella species |journal=Clin. Microbiol. Rev. |volume=18 |issue=2 |pages=326–82 |year=2005 |month=April |pmid=15831828 |pmc=1082800 |doi=10.1128/CMR.18.2.326-382.2005 |url=}}</ref>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Disease]]
[[Category:Bacterial diseases]]
[[Category:Pediatrics]]
[[Category:Infectious diseases]]
[[Category:Emergency medicine]]
[[Category:Pulmonology]]


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Latest revision as of 23:12, 14 January 2016

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

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Overview

In the United States, the incidence of pertussis is approximately 1.5 to 3.0 per 100,000 individuals, with approximately 5,000 to 7,000 cases reported annually. The incidence of pertussis is thought to be on the rise due to the decline in vaccination rate and diminished herd immunity. Infants and young children < 5 years of age are more commonly infected with pertussis than adults. There is no gender predilection for the development of pertussis. Pertussis-related deaths are rare, but are more common in developing countries, among infants < 6 months of age, and among adult patients with significant co-morbidities.

Epidemiology and Demographics

Incidence

  • In the United States, the incidence of pertussis is approximately 1.5 to 3.0 per 100,000 individuals, with approximately 5,000 to 7,000 cases reported annually.
  • Incidence of pertussis has increased steadily since the 1980s despite the availability of vaccination. It is thought that the decline in vaccination rate and diminished herd immunity may, at least in part, be responsible for the rise of the incidence.

Mortality

  • Pertussis is responsible for approximately 20-40 million deaths worldwide.
  • The majority of pertussis-related deaths occur in Africa and Southeast Asia.
  • Pertussis-related death is rare, but is more common among infants < 6 months of age and among adult patients with significant co-morbidities.

Age

  • Pertussis may infect individuals of all age groups.[1]
  • Infants and young children < 5 years of age are more commonly infected with pertussis than adults.[1]
Age Number of Cases Percentage (%) Age Incidence per 100,000 Individuals
< 6 months 3,330 10.1 169
6-11 months 875 2.7 44.4
1-6 years 6,082 18.5 25.1
7-10 years 5,576 16.9 34
11-19 years 11,159 33.8 29.6
20+ years 58,839 17.7 2.2
Unknown 110 0.3 N/A
Total 32,971 100 10.4*

*Total age incidence per 100,000 calculated from 32,861 cases with age reported.
Table adapted from 2014 Final Pertussis Surveillance Report - Centers for Disease Control and Prevention.[2]

Gender

  • There is no gender predilection for the development of pertussis.[1]

References

  1. ↑ 1.0 1.1 1.2 Mattoo S, Cherry JD (2005). "Molecular pathogenesis, epidemiology, and clinical manifestations of respiratory infections due to Bordetella pertussis and other Bordetella species". 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)
  2. ↑ "2014 Final Pertussis Surveillance Report" (PDF). www.cdc.gov. 2014. Retrieved Jan 14, 2016.

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