Document Type

Master's Culminating Experience

Publication Date

2011

Abstract

Objective: In 2010, Columbus, Ohio experienced the largest outbreak of pertussis that it has had in the past 25 years. Similar outbreaks are occurring across the nation on an increasing basis. This descriptive study examines the 2010 outbreak and describes the demographics of the affected population. Comparison is made to previous and current pertussis incidence in Ohio and outbreaks elsewhere in the United States. Contributing factors to the increasing occurrence of pertussis outbreaks are discussed.

Methods: Raw data was obtained from the Columbus Public Health epidemiology department and is gathered through the Ohio Disease Reporting System (ODRS). Pertussis cases are those which have occurred in Franklin County, Ohio and Columbus, Ohio as reported by local physicians’ offices and hospitals. Information on the disease and recent trends was obtained from multiple journal articles and the CDC website as well as from personal communication with members of the epidemiology staff at Columbus Public Health.

Results: Raw data is analyzed in the form of charts and graphs and comparison is made between groups by age and race. Analysis of recent literature supports a trend toward increasing pertussis incidence nationwide with more significant outbreaks, most likely as a result of decreased vaccination compliance and waning of pertussis vaccine in adolescents and young adults. Review of current literature reveals several hypothesized contributing factors including increased surveillance, increased pertussis virulence, and false positive diagnostic tests, which may or may not be significant factors.

Conclusions: The Columbus outbreak is typical of a nationwide trend in pertussis. Pertussis outbreaks are on the rise despite fairly good overall immunization uptake. Physicians must be notified of current outbreaks to increase surveillance of at-risk populations. Parents must be given good information regarding immunizations and efforts must be expanded to decrease barriers to immunization. In addition, improved immunization education of providers and better surveillance must be implemented to maximize immunization coverage among children and adults. Providers become complacent; not considering pertussis as a diagnosis for many respiratory infections until public health authorities publicize outbreak information in the media. More consistent testing would give better data regarding baseline pertussis rates and outbreaks. A nationwide electronic record-keeping and tracking method should be developed to avoid “missed opportunities” to vaccinate patients. These systems improve providers ability to notify patients of due or overdue immunizations and negate the problem of lost shot records which are common occurrences.

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