BACKGROUND:
Outbreaks of pertussis have rarely been documented among adolescents and adults; however, of the 378 investigations conducted in Burnet County in 2002, data indicate that 54% (204) were over 10 years of age.
The knowledge and insights gained while investigating these pertussis cases focused on the need to re-educate health care professionals to consider the incidence of disease among this older age group. Affecting change in the medical practices took extensive educational campaigns.
In addition to the basic roles of public health in outbreak control, the incident command system was taught and field-tested in an actual clinic setting. Using the basic principles of the incident command system allowed both cross training of staff from other programs and prepared staff to practice a system that would be used in an actual emergency.

OBJECTIVE:
Identify disease incidence out of normal age range
Determine educational and training needs to address new trends
Recognize needs to implement Incident Command System to organize an event

METHOD:
Multiple outbreaks investigated
- Schools - Child Care Centers
- Businesses - Institutions
Press releases and media alerts in English and Spanish
Special community-wide vaccination clinics

RESULT:
Rapid reporting of possible cases of pertussis and astute assessment of data signaled the need to educate local health care providers concerning the increased age of cases. Staff from multiple programs were trained on the principles of the Incident Command System and subsequently field tested that knowledge in clinics in Burnet County. Patients were educated, vaccinated, tested and treated for pertussis.

CONCLUSION:
Pertussis outbreaks can and do affect the older population. Through education and media, this message affected change.

LEARNING OBJECTIVES:
Provided immunizations
Tested for disease
Treated symptomatic patients
Reinforced multi-program response team
Educated clients
Modeled Incident Command System