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Pertussis in Massachusetts, 1981-1991: incidence, serologic diagnosis, and vaccine effectiveness

C D Marchant1, A M Loughlin, S M Lett

  • 1Massachusetts Public Health Biologic Laboratory, Massachusetts Centers for Disease Control, Boston.

The Journal of Infectious Diseases
|June 1, 1994
PubMed

Insights

Massachusetts pertussis surveillance shows infants under 6 months face high risks. Vaccination status impacts pertussis (whooping cough) incidence in children and adolescents. Serodiagnosis improves detection in older populations.

Area of Science:

  • Epidemiology
  • Immunology
  • Public Health

Background:

  • Massachusetts has monitored pertussis (whooping cough) incidence using a statewide diagnostic service since 1980.
  • Diphtheria-tetanus toxoid-pertussis (DTP) vaccination is provided, yet pertussis remains a concern.

Purpose of the Study:

  • To analyze pertussis incidence and morbidity trends in Massachusetts.
  • To evaluate the impact of DTP vaccination on pertussis cases.
  • To assess the utility of serodiagnosis for detecting pertussis in different age groups.

Main Methods:

  • Analysis of bacteriologically confirmed pertussis cases and hospitalizations from a statewide diagnostic service.
  • Review of DTP vaccination histories for individuals diagnosed with pertussis.
  • Serodiagnostic testing using single serum anti-pertussis toxin antibody ELISA for population-based diagnosis.

Main Results:

  • Infants under 6 months experienced disproportionately high morbidity, accounting for 44% of confirmed cases and 71% of hospital days.
  • Most children with pertussis had received fewer than 3 DTP doses, while adolescents often had received 4 or more doses.
  • Serodiagnosis significantly increased the detected incidence of pertussis in adolescents and adults.

Conclusions:

  • Bacteriologic methods likely underestimate the true incidence of pertussis.
  • Infants < 6 months are a vulnerable population requiring targeted prevention strategies.
  • Single serum anti-pertussis toxin antibody ELISA is a practical and effective method for diagnosing pertussis in adolescents and adults.

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