Tuesday, March 18, 2008

Pertussis deaths—Oregon, 2008

Juventila Liko1, Michelle Barber2, and Martha Priedeman Skiles1. (1) Immunization Program, Oregon Public Health Division, Portland, OR, USA, (2) Acute and Communicable Disease Prevention, Oregon Public Health Division, Portland, OR, USA

Learning Objectives for this Presentation:
By the end of the presentation participants will be able to:
• Describe the trends of reported cases of pertussis among infants in Oregon from 2000 to 2008.
• Describe the demographic, diagnostic, risk factors and other patient characteristics associated with pertussis deaths.
• Identify key strategies to limit disease spread to vulnerable infants.

According to NIS, Oregon's coverage rate for the 3rd DTaP is 88.6 by 13 months of age. Despite high levels of immunizations, pertussis continues to cause fatal illness among vulnerable infants. Pertussis cases increased substantially since 2000 among all age groups, including infants. Although down from levels seen in 2004 and 2005, pertussis remains a problem in Oregon. Infants have the highest risk of pertussis-related complications and deaths (5 in the past 7 years) as well as the highest reported incidence—averaging 104 cases/100,000 annually since 2000 in Oregon.

To describe risk factors associated with pertussis deaths.

Data from surveillance databases, available medical records, autopsy reports, and death certificates will be analyzed to identify potential risk factors related to pertussis deaths.

The presentation will summarize the investigation of five pertussis deaths that occurred since 2000 in Oregon. All deaths occurred among infants with onset of pertussis symptoms at age <4 months.

Reported pertussis fatalities occur among infants too young to be fully protected by immunization. Clinicians should consider pertussis as a cause of illness among vulnerable infants who present with cough illness. Timely diagnosis of pertusiss in caregivers and other contacts of infants could prevent infant pertussis fatalities. Timely vaccination of infants and implementation of the recent ACIP recommendation for adult and adolescent vaccination could substantially reduce the burden of infant pertussis. This report highlights the need for more targeted outreach and education for those in contact with young infants.