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Pertussis outbreak in an elementary school with high vaccination coverage
N Khetsuriani1, K Bisgard, D R Prevots
1National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. nkhetsuriani@cdc.gov
The Pediatric Infectious Disease Journal
|December 12, 2001
Summary
Pertussis outbreaks can occur in vaccinated schools. Maintaining high vaccination coverage and prompt treatment are crucial for preventing pertussis spread in elementary schools.
Area of Science:
- Epidemiology
- Infectious Disease Control
- Vaccinology
Background:
- Investigated a pertussis outbreak in a US elementary school with high vaccination rates.
- Aimed to evaluate vaccine effectiveness and identify outbreak contributors.
Purpose of the Study:
- Assess pertussis vaccine effectiveness in an elementary school setting.
- Identify factors contributing to a pertussis outbreak despite high vaccination coverage.
Main Methods:
- Conducted a survey and cohort study of 215 elementary school students.
- Included 36 initial cases and 16 secondary cases among contacts.
Main Results:
- Identified 52 pertussis cases (17% attack rate). Incomplete vaccination significantly increased pertussis risk (RR 5.1).
- Complete vaccination series showed 80% effectiveness. No waning immunity observed. Outbreak factors included community introductions, delayed diagnosis/treatment, and high contact rates.
- Delayed antimicrobial treatment (>14 days) increased transmission risk (RR 10.1).
Conclusions:
- Pertussis outbreaks are possible in highly vaccinated elementary schools.
- Prompt case/contact identification and timely treatment are key to limiting spread.
- Sustained high vaccination coverage is essential; healthcare providers need high suspicion for pertussis in school-aged children.