title: Pertussis-associated hospitalizations in American Indian and Alaska Native infants.
abstract: OBJECTIVE
  To investigate the burden of pertussis in American Indian and Alaska Native (AI/AN) infants.
  
  
  METHODS
  AI/AN pertussis-associated hospitalizations between 1980 and 2004 were evaluated using Indian Health Service (IHS)/tribal inpatient data, which include all reported hospitalizations within the IHS/tribal health care system.
  
  
  RESULTS
  Between 1980 and 2004, 483 pertussis-associated hospitalizations in AI/AN infants were documented; 88% of cases involved infants age < 6 months. For this entire period, the average annual hospitalization rate was 132.7 per 100,000 AI/AN infants (95% confidence interval [CI] = 121.3 to 145.2), and 234.5 per 100,000 AI/AN infants age < 6 months (95% CI = 213.1 to 258.1). Between 2000 and 2004, the annual hospitalization rate was 100.5 per 100,000 AI/AN infants (95% CI = 81.6 to 123.7), which exceeds the estimated 2003 pertussis hospitalization rate of 67.7 per 100,000 in the general US infant population (95% CI = 61.9 to 73.5). The highest pertussis hospitalization rates in 2000 to 2004 were in AI/AN infants in the Alaska and Southwestern IHS regions of the United States.
  
  
  CONCLUSIONS
  The burden of pertussis in AI/AN infants is high, particularly so in infants age < 6 months in the Alaska and the Southwestern IHS regions of the United States. Ensuring implementation of vaccination strategies to reduce the incidence of pertussis in AI/AN, infants, adolescents, and adults alike is warranted to reduce the burden of pertussis in AI/AN infants.
authors.affiliation: Office of the Director, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. tkm4@cdc.gov
authors.forename: Trudy V
authors.initials: TV
authors.lastname: Murphy
authors.forename: Shamsuzzoha B
authors.initials: SB
authors.lastname: Syed
authors.forename: Robert C
authors.initials: RC
authors.lastname: Holman
authors.forename: Dana L
authors.initials: DL
authors.lastname: Haberling
authors.forename: Rosalyn J
authors.initials: RJ
authors.lastname: Singleton
authors.forename: Claudia A
authors.initials: CA
authors.lastname: Steiner
authors.forename: Edna L
authors.initials: EL
authors.lastname: Paisano
authors.forename: James E
authors.initials: JE
authors.lastname: Cheek
mesh_terms: D000413:Alaska; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007198:Indians, North American; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D014917:Whooping Cough / Q000453:epidemiology*