KEYWORDS:
Pertussis, Surveillance, Trends, Statistics

BACKGROUND:
Public health agencies and private physicians in Texas are responding to a growing number of pertussis cases and outbreaks.

OBJECTIVE:
Analyze Texas surveillance data from 1993-2002. Look for trends to guide departmental policy-making and planning processes.

METHOD:
Surveillance data were submitted from across the state by public health agencies and other reporters. Case investigation questionnaires were reviewed for completeness and cases were classified as confirmed, probable, or dropped using a clinical case definition and laboratory confirmation criteria. EpiInfo was used for data entry and data analysis.

RESULT:
Over the past nine years, there has been a steady increase in the number of reported cases of pertussis, building with each three- to four-year cycle. The number of cases reported for 2000 and 2001 was 327 and 615, respectively. The age distribution of cases by age group in 2001 was 34% <1 year; 10% 1-4 years; 7% 5-9 years; 15% 10-14 years; 8% 15-19 years; and 26% 20 years of age and older. In 2001, laboratory confirmation by culture of PCR was most successful in infants (57%) and least successful in adults (2%). Incidence increased significantly for all infants <1 year of age from 24.9 per 100,000 in 1999 to 59.8 per 100,000 in 2001. Incidence for Hispanic infants <1 year of age increased from 22.3 per 100,000 in 1999 to 83.0 per 100,000 in 2001. The number of hospitalizations due to pertussis was 53, 106, and 145 in 1999, 2000, and 2001, respectively.

CONCLUSION:
Changes in reporting practices may account for some of the increase in reported cases, but corresponding increase in infant deaths and the number of laboratory-confirmed and hospitalized cases provide strong evidence of a resurgence of pertussis in communities across Texas.

LEARNING OBJECTIVES:
Present current pertussis trends in Texas.