Infants at Greatest Risk in 2010 California Pertussis Epidemic

Most pediatric cases vaccinated according to national recommendations

FRIDAY, July 20 (HealthDay News) -- In the 2010 California pertussis epidemic, all deaths and most hospitalizations occurred in infants younger than 3 months of age, according to research published online July 19 in the Journal of Pediatrics.

Kathleen Winter, M.P.H., from the California Department of Public Health in Richmond, and colleagues evaluated clinical and demographic information for all pertussis cases reported to the department from Jan. 1 through Dec. 31, 2010.

The researchers found that the highest disease rates were seen for Hispanic infants younger than 6 months. Most hospitalizations and all deaths occurred in infants younger than 3 months. Nine percent of pediatric cases aged 6 months to 18 years were completely unvaccinated against pertussis, but most pediatric cases were vaccinated according to national recommendations. Fully-vaccinated preadolescents, particularly 10-year-olds, experienced high disease rates. Expanded recommendations for tetanus, diphtheria, and acellular pertussis vaccinations; public and provider education; distribution of free vaccine for contacts of infants and postpartum women; and clinical guidance on the diagnosis and treatment of pertussis in young infants were suggested as potential mitigation strategies.

"In the absence of better vaccines, it is imperative that strategies to protect young infants directly, such as maternal vaccination, be evaluated for effectiveness," write the authors. "In addition, it is critical that providers continue to be vigilant and promptly diagnose and treat young infants with pertussis."

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