title: Pertussis in Massachusetts, 1981-1991: incidence, serologic diagnosis, and vaccine effectiveness.
abstract: Massachusetts provides diphtheria-tetanus toxoid-pertussis (DTP) vaccine, and since 1980 has monitored pertussis with a statewide diagnostic service. The incidence of bacteriologically confirmed pertussis was 104.5 per 100,000 person-years in 1-month-old infants and declined progressively thereafter. Infants < 6 months old experienced disproportionate morbidity: 44% of bacteriologically confirmed pertussis, 64% of hospitalizations, and 71% of hospital days. Most children with pertussis had received < 3 DTP doses during childhood, whereas 87% of adolescents with pertussis had received > or = 4 doses. Serodiagnosis by single serum anti-pertussis toxin antibody ELISA increased the incidence of confirmed pertussis in persons 11-19 years old from 3.0 to 12.9 per 100,000 and in persons > or = 20 years old from 0.16 to 0.56 per 100,000. Bacteriologic methods underestimate pertussis incidence, but a single serum anti-pertussis toxin antibody ELISA is a practical method for population-based diagnosis in adolescents and adults.
authors.affiliation: Massachusetts Public Health Biologic Laboratory, Massachusetts Centers for Disease Control, Boston.
authors.forename: C D
authors.initials: CD
authors.lastname: Marchant
authors.forename: A M
authors.initials: AM
authors.lastname: Loughlin
authors.forename: S M
authors.initials: SM
authors.lastname: Lett
authors.forename: C W
authors.initials: CW
authors.lastname: Todd
authors.forename: L H
authors.initials: LH
authors.lastname: Wetterlow
authors.forename: R
authors.initials: R
authors.lastname: Bicchieri
authors.forename: S
authors.initials: S
authors.lastname: Higham
authors.forename: P
authors.initials: P
authors.lastname: Etkind
authors.forename: E
authors.initials: E
authors.lastname: Silva
authors.forename: G R
authors.initials: GR
authors.lastname: Siber
mesh_terms: D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage*; D004797:Enzyme-Linked Immunosorbent Assay; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D012044:Regression Analysis; D012698:Serologic Tests; D014917:Whooping Cough / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control
chemical_list: D015721:Diphtheria-Tetanus-Pertussis Vaccine