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Pertussis outbreak in an Amish Community: Kent County, Delaware, 2018.

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The Amish community experienced a pertussis outbreak in 2018, with most cases in unvaccinated children. Public health interventions, including vaccination and education, helped control the outbreak.

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Area of Science:

  • Public Health
  • Epidemiology
  • Infectious Disease

Background:

  • The Amish community's lifestyle and beliefs influence their approach to conventional preventive healthcare, including immunizations.
  • Low vaccination coverage in specific populations increases the risk of communicable disease outbreaks due to diminished herd immunity.
  • The Delaware Division of Public Health (DPH) has documented multiple pertussis outbreaks in the Amish community over the past two decades.

Purpose of the Study:

  • To investigate the 2018 pertussis outbreak within Delaware's Amish community.
  • To identify cases, determine the disease burden, and implement effective control strategies.
  • To assess the impact of public health interventions on outbreak containment.

Main Methods:

  • Active surveillance was employed, including interviews with 134 families.
  • Case identification involved confirming 181 probable and confirmed pertussis cases.
  • Control measures included community engagement, educational outreach, vaccination, treatment, and post-exposure prophylaxis.

Main Results:

  • The outbreak primarily affected children, with 77% of cases in those 10 years old or younger.
  • A significant majority (87%) of pediatric cases were unvaccinated.
  • The outbreak investigation was officially closed on December 20, 2018, after 63 days with no new cases.

Conclusions:

  • Pertussis outbreaks pose a significant risk to under-immunized populations like the Amish community.
  • Targeted public health interventions, including community engagement and vaccination programs, are crucial for controlling outbreaks.
  • Effective collaboration with the Amish community facilitated the successful containment of the 2018 pertussis outbreak.