Pertussis in Massachusetts, 1981-1991: incidence, serologic diagnosis, and vaccine effectiveness.
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.
Marchant
C D
CD
Massachusetts Public Health Biologic Laboratory, Massachusetts Centers for Disease Control, Boston.
Loughlin
A M
AM
Lett
S M
SM
Todd
C W
CW
Wetterlow
L H
LH
Bicchieri
R
R
Higham
S
S
Etkind
P
P
Silva
E
E
Siber
G R
GR
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
D015721:Diphtheria-Tetanus-Pertussis Vaccine