title: Economic and Social Impact of Pertussis Among Adolescents in San Diego County.
abstract: OBJECTIVE
  During recent pertussis epidemics, adolescents have experienced a large burden of disease. We assessed the impact of pertussis among San Diego adolescents and their households.
  
  
  METHODS
  Parents of pertussis patients aged 13-17 years were surveyed about health care utilization, missed work and school, and other factors. Costs of medical visits, medication use, and lost wages were estimated.
  
  
  RESULTS
  The parents of 53 (of 108 [49%]) eligible 2013 pertussis patients were interviewed; 51 (96%) of these patients previously received tetanus, diphtheria, and acellular pertussis vaccine. Medical visits included primary care (81%), urgent care (11%), and emergency department (9%); all patients received antibiotics. Forty-seven households (89%) received a post-exposure prophylaxis recommendation, and five (9%) reported ≥1 unpaid parental leave day. Thirty-eight patients (72%) missed ≥1 school day (mean = 5.4 days). Societal costs were estimated at $315.15 per household and $236,047.35 in San Diego during 2013-2014.
  
  
  CONCLUSIONS
  Even among vaccinated adolescents, pertussis can result in considerable societal costs.
authors.affiliation: CDC/CSTE Applied Epidemiology Fellowship, Atlanta, Georgia; County of San Diego Health and Human Services Agency, San Diego, California; Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, San Diego, California. Electronic address: vvl5@cdc.gov.
authors.forename: Aiden K
authors.initials: AK
authors.lastname: Varan
authors.affiliation: California Department of Public Health, Richmond, California.
authors.forename: Kathleen H
authors.initials: KH
authors.lastname: Harriman
authors.affiliation: California Department of Public Health, Richmond, California.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Winter
authors.affiliation: County of San Diego Health and Human Services Agency, San Diego, California.
authors.forename: Melissa D
authors.initials: MD
authors.lastname: Thun
authors.affiliation: County of San Diego Health and Human Services Agency, San Diego, California.
authors.forename: Eric C
authors.initials: EC
authors.lastname: McDonald
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D002140:California; D017281:Cost of Illness; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines / Q000008:administration & dosage* / Q000191:economics; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007115:Immunization Schedule; D008297:Male; D014611:Vaccination / Q000191:economics; D014917:Whooping Cough / Q000191:economics
chemical_list: D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines
keywords: Absenteeism; Adolescent; Cost of illness; Health care utilization; Immunization; Pertussis; San Diego