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Pertussis epidemic in Oklahoma. Difficulties in preventing transmission
Insights
Low pertussis vaccination rates in Oklahoma led to an outbreak in 1983. Ensuring children receive routine diphtheria and tetanus toxoids and pertussis vaccine (DTP) is crucial for preventing future pertussis outbreaks.
Area of Science:
- Epidemiology
- Public Health
- Vaccinology
Background:
- Pertussis (whooping cough) outbreaks pose a significant public health risk, particularly among unvaccinated children.
- In 1983, Oklahoma reported 351 pertussis cases, with a majority affecting the primary vaccination age group.
Purpose of the Study:
- To analyze the pertussis outbreak in Oklahoma during 1983.
- To assess pertussis vaccination coverage among children aged 3 months to 6 years.
- To evaluate the effectiveness of outbreak control measures and identify strategies for prevention.
Main Methods:
- Retrospective analysis of reported pertussis cases from January 1 to December 31, 1983.
- Household surveys to determine immunization status in affected neighborhoods.
- Evaluation of vaccination campaign outcomes in Oklahoma County.
Main Results:
- Only 42% of pertussis cases in the 3-month to 6-year age group were appropriately immunized with diphtheria and tetanus toxoids and pertussis vaccine (DTP).
- A neighborhood survey revealed only 65% immunization coverage in the target age group.
- An intensive vaccination effort in Oklahoma County failed to reach the recommended 82% immunization target.
Conclusions:
- Pertussis outbreaks can be attributed to suboptimal vaccination rates.
- Outbreak control efforts may not achieve desired immunization levels.
- Routine, age-appropriate diphtheria and tetanus toxoids and pertussis vaccine (DTP) vaccination is the most effective strategy for preventing pertussis outbreaks in children under 7.
Abstract:
From Jan 1 to Dec 31, 1983, 351 cases of pertussis were reported in Oklahoma. Overall, 59% of the cases were among children 3 months to 6 years of age, the target age group for pertussis vaccination; only 42% of the patients in this age group were appropriately immunized for age with diphtheria and tetanus toxoids and pertussis vaccine (DTP). A survey of 185 households in the neighborhoods of three cases found that only 65% of 57 children 3 months to 6 years of age were appropriately immunized for their age. Aggressive control of the outbreak was attempted in Oklahoma County with recommendations for widespread vaccination against pertussis. However, the effort failed to immunize 82% of the 931 children in the initial target group. Nonetheless, analysis of the reported cases suggested that less than one fourth of the cases were potentially preventable by a single additional dose of DTP, ie, in individuals 3 months to 6 years of age with a history of at least one prior dose of DTP who were not appropriately immunized for age. The optimal solution to outbreak control is outbreak prevention by ensuring that the maximal number of children younger than 7 years of age receive routine age-appropriate DTP vaccination.