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Risk Factors for Pertussis Among Hispanic Infants: Metropolitan Portland, Oregon, 2010-2012
Kara M Levri1, Laura Reynolds, Juventila Liko
1From the *Acute and Communicable Disease Prevention Section, Oregon Public Health Division, Portland, OR; †Epidemiology Workforce Branch, Centers for Disease Control and Prevention, Atlanta, GA; ‡Communicable Disease Services, Multnomah County Health Department, Portland, OR; and §Oregon Immunization Program, Oregon Public Health Division, Portland, OR.
Insights
Larger households increase pertussis risk for infants. This risk factor affects Hispanic and non-Hispanic infants similarly, highlighting the need for targeted public health interventions.
Area of Science:
- Pediatric infectious diseases
- Public health surveillance
- Epidemiology
Background:
- Pertussis (whooping cough) cases surged in Oregon in 2012, peaking since 1953.
- Infants under 6 months experienced the highest illness burden.
- Disproportionately higher pertussis rates were observed in Hispanic infants compared to non-Hispanic infants.
Purpose of the Study:
- To investigate the reasons behind the observed ethnic disparity in pertussis incidence among young infants.
- To identify risk factors contributing to pertussis in infants under 6 months in the Portland metropolitan area.
Main Methods:
- Analysis of pertussis surveillance data for infants <6 months old (2010-2012).
- Examined factors including ethnicity, household size, vaccination status, child care attendance, birth weight, and maternal age.
- Compared characteristics between Hispanic and non-Hispanic infants with pertussis.
Main Results:
- Eighty-two infants <6 months had pertussis; 34% were Hispanic.
- Hispanic infants were more likely to reside in households with over 4 people.
- Living in households >4 persons was associated with approximately 2.4 times the risk of pertussis, similar for both ethnic groups.
Conclusions:
- Household size exceeding 4 persons is a significant risk factor for infant pertussis.
- The increased risk associated with larger households is comparable between Hispanic and non-Hispanic infants.
- Findings suggest household size is a key determinant of pertussis risk, irrespective of ethnicity.
Background:
In 2012, Oregon observed its highest numbers of reported pertussis cases since 1953. The greatest morbidity occurred among infants <6 months of age, with higher rates among Hispanics than non-Hispanics. To explain this disparity, we analyzed pertussis surveillance data.
Methods:
An analysis was conducted among infants <6 months of age in the Portland metropolitan area during 2010-2012. Characteristics examined were ethnicity (Hispanic or non-Hispanic), household size (>4 or ≤4 persons), pertussis vaccination status (upto-date or not up-to-date for age), child care center attendance (yes or no), infant birth weight (<2500 or ≥2500 g) and maternal age (<20 or ≥20 years).
Results:
Eighty-two infants <6 months of age with pertussis were identified. Twenty-eight case-infants (34%) were Hispanic, and 54 (66%) were non-Hispanic. By ethnicity, infants with pertussis were similar in illness confirmation method, sex, age, hospitalization status, vaccination status, child care center attendance, infant birth weight and maternal age. Hispanic infants were more likely than non-Hispanic infants to live in households with >4 persons. Univariate analysis showed Hispanic infants had approximately 2.3 times the risk for pertussis, compared with non-Hispanic infants, and infants living in households >4 persons had approximately 2.4 times the risk for illness, compared with those in households with <4 persons; stratified risk ratios did not differ between Hispanic (2.4; confidence interval: 1.0-5.7]) and non-Hispanic infants (2.0; confidence interval: 1.2-3.5).
Conclusions:
A household size of >4 persons is a potential risk factor for pertussis; the magnitude of this risk is similar for Hispanic and non-Hispanic infants.
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