title: Investigation of Pertussis Cases in a Texas County, 2008-2012.
abstract: OBJECTIVE
  Within the past 25 years, there has been a dramatic increase in the incidence of pertussis cases in the United States. As such, this investigation reports on the high-risk groups and describes risk factors of pertussis cases in a large Texas county.
  
  
  METHODS
  This study was a cross-sectional analysis of data collected by health department employees using the Texas Department of State Health Service's Pertussis Case Track Record, which is the standard investigation form for collecting vital information on pertussis cases. We extracted and analyzed county-level data for a 5-year period (2008-2012). The study population at risk included all current residents in this county, and cases included all who were clinically diagnosed as having confirmed or probable pertussis cases that were reported to the health department according to the Centers for Disease Control and Prevention case definition. The vaccination status of a case was defined as fully vaccinated, partially vaccinated, or not vaccinated.
  
  
  RESULTS
  A total of 198 probable and confirmed pertussis cases were included in this analysis. Most of the cases were infants younger than 1 year old (n = 107). The largest category of cases was not vaccinated and of the rest, 32.8% were partially vaccinated, 17.2% had unknown vaccination status, and 13.1% were fully vaccinated. Only 48 (24.2%) sources of exposure were identified and they included fathers (14.6%), sisters (14.6%), brothers (14.6%), other children (14.6%), and mothers (12.5%). Many sources of exposure (n = 26, 54.1%) were unaware of their vaccination history. Hispanics accounted for 84.5% of cases in the younger than 1 year old group and 88.9% of cases were in the 1 to 2 years old group. With respect to race/ethnicity and vaccination status of the cases, 39.46% of Hispanics, 32% of whites, and 50% of blacks were reported to be unvaccinated.
  
  
  CONCLUSIONS
  Increasing pertussis vaccination coverage among children, as well as providing booster shots to adults with special attention on the Hispanic population, may prove to be an effective strategy for health departments.
authors.affiliation: From the University of Texas Health Science Center at Houston, San Antonio Regional Campus, School of Public Health, San Antonio, and San Antonio Metropolitan Health District, San Antonio, Texas.
authors.forename: Amanda
authors.initials: A
authors.lastname: Staudt
authors.affiliation: From the University of Texas Health Science Center at Houston, San Antonio Regional Campus, School of Public Health, San Antonio, and San Antonio Metropolitan Health District, San Antonio, Texas.
authors.forename: Anil T
authors.initials: AT
authors.lastname: Mangla
authors.affiliation: From the University of Texas Health Science Center at Houston, San Antonio Regional Campus, School of Public Health, San Antonio, and San Antonio Metropolitan Health District, San Antonio, Texas.
authors.forename: Hasanat
authors.initials: H
authors.lastname: Alamgir
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D003140:Communicable Disease Control / Q000379:methods / Q000458:organization & administration; D003430:Cross-Sectional Studies; D018563:Disease Notification / Q000379:methods / Q000706:statistics & numerical data; D062665:Epidemiological Monitoring; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D010567:Pertussis Vaccine / Q000627:therapeutic use*; D012307:Risk Factors; D018571:Sentinel Surveillance; D013781:Texas / Q000453:epidemiology; D014917:Whooping Cough / Q000208:ethnology / Q000517:prevention & control
chemical_list: D010567:Pertussis Vaccine