Estimation of the Underlying Burden of Pertussis in Adolescents and Adults in Southern Ontario, Canada

McGirr, Ashleigh; Tuite, Ashleigh R.; Fisman, David N.

doi:10.1371/journal.pone.0083850

Cited by 25 publications

(17 citation statements)

References 41 publications

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“…Based on R 0 estimates, pertussis is considered far more contagious than polio, smallpox, rubella, mumps, and diphtheria (262,263). Studies showed that one infected person can transmit B. pertussis to as many as 12 to 17 other susceptible individuals, while R 0 values for polio and smallpox (5 to 7), rubella (6 to 7), mumps (4 to 7), and diphtheria (6 to 7) are substantially lower (261)(262)(263)(264)(265)(266). Kretzschmar et al found that the R 0 for pertussis across five European countries (Finland, Germany, Italy, The Netherlands, and the United Kingdom) during the 1990s was approximately 5.5, which is lower than R 0 estimates in previous studies (267).…”

Section: Transmission Dynamics Of Pertussismentioning

confidence: 99%

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Pertussis: Microbiology, Disease, Treatment, and Prevention

et al. 2016

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SUMMARYPertussis is a severe respiratory infection caused byBordetella pertussis, and in 2008, pertussis was associated with an estimated 16 million cases and 195,000 deaths globally. Sizeable outbreaks of pertussis have been reported over the past 5 years, and disease reemergence has been the focus of international attention to develop a deeper understanding of pathogen virulence and genetic evolution ofB. pertussisstrains. During the past 20 years, the scientific community has recognized pertussis among adults as well as infants and children. Increased recognition that older children and adolescents are at risk for disease and may transmitB. pertussisto younger siblings has underscored the need to better understand the role of innate, humoral, and cell-mediated immunity, including the role of waning immunity. Although recognition of adult pertussis has increased in tandem with a better understanding ofB. pertussispathogenesis, pertussis in neonates and adults can manifest with atypical clinical presentations. Such disease patterns make pertussis recognition difficult and lead to delays in treatment. Ongoing research using newer tools for molecular analysis holds promise for improved understanding of pertussis epidemiology, bacterial pathogenesis, bioinformatics, and immunology. Together, these advances provide a foundation for the development of new-generation diagnostics, therapeutics, and vaccines.

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Section: Transmission Dynamics Of Pertussismentioning

confidence: 99%

“…Pertussis outbreaks have been also reported in North America, Europe, and Australia (182,195,202,203,254,264,(435)(436)(437)(438). In contrast, few data are available from Latin American, Asian, and African countries compared with Europe and the United States (174,(439)(440)(441)(442)(443)(444)(445)(446).…”

Section: Control Measures For Pertussis Outbreaksmentioning

confidence: 99%

Pertussis: Microbiology, Disease, Treatment, and Prevention

et al. 2016

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“…It is also possible that sociodemographic features such as income may affect reported rates of pertussis. It is likely that pertussis among both adolescents and adults in the US is endemic but largely underreported [9,10]. Higher income may influence who is more likely to seek care or to receive testing for nonspecific respiratory diseases, including many cases of pertussis.…”

Section: Introductionmentioning

confidence: 99%

Differences in Pertussis Incidence by Income among Oregon Teens during an Outbreak

Robison

Liko

Cieslak

2015

Journal of Vaccines

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That disease and poverty are connected is a cornerstone of public health thought. In the case of pertussis, however, it is possible that the expected relationship to poverty is reversed. Grounds exist for considering that increases in income are associated with increases in pertussis rates, both in terms of real risk through social and network features and through the possibility of greater likelihood of care seeking and detection based on income. Using reported adolescent pertussis cases from a 2012 outbreak in Oregon, pertussis incidence rates were determined for areas grouped by zip code into higher, middle, and lower median household income. Adolescents of ages 13–16 years in higher income areas were 2.6 times (95% CI 1.8–3.8) more likely as all others to have reported pertussis during the 2012 outbreak and 3.1 (95% CI 1.4–6.5) times as likely as those in lower income areas. The higher pertussis rates associated with higher income areas were observed regardless of Tdap rate differences. These results suggest that income may be associated with disease risk, likelihood of diagnosis and reporting, or both. Further evaluation of this finding is warranted.

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“…7 Pertussis among adolescents and adults may present with atypical or milder symptoms, 8 , 9 leading to under-diagnosis and under-reporting, and the risk of transmission to more vulnerable groups which could contribute to outbreaks in the population. 10 …”

Section: Introductionmentioning

confidence: 99%

Is adding maternal vaccination to prevent whooping cough cost-effective in Australia?

Bellinghen

Dimitroff

Haberl

et al. 2018

Human Vaccines & Immunotherapeutics

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Pertussis or whooping cough, a highly infectious respiratory infection, causes significant morbidity and mortality in infants. In adolescents and adults, pertussis presents with atypical symptoms often resulting in under-diagnosis and under-reporting, increasing the risk of transmission to more vulnerable groups. Maternal vaccination against pertussis protects mothers and newborns. This evaluation assessed the cost-effectiveness of adding maternal dTpa (reduced antigen diphtheria, Tetanus, acellular pertussis) vaccination to the 2016 nationally-funded pertussis program (DTPa [Diphtheria, Tetanus, acellular Pertussis] at 2, 4, 6, 18 months, 4 years and dTpa at 12–13 years) in Australia.A static cross-sectional population model was developed using a one-year period at steady-state. The model considered the total Australian population, stratified by age. Vaccine effectiveness against pertussis infection was assumed to be 92% in mothers and 91% in newborns, based on observational and case-control studies. The model included conservative assumptions around unreported cases.With 70% coverage, adding maternal vaccination to the existing pertussis program would prevent 8,847 pertussis cases, 422 outpatient cases, 146 hospitalizations and 0.54 deaths per year at the population level. With a 5% discount rate, 138.5 quality-adjusted life-years (QALYs) would be gained at an extra cost of AUS$ 4.44 million and an incremental cost-effectiveness ratio of AUS$ 32,065 per QALY gained. Sensitivity and scenario analyses demonstrated that outcomes were most sensitive to assumptions around vaccine effectiveness, duration of protection in mothers, and disutility of unreported cases.In conclusion, dTpa vaccination in the third trimester of pregnancy is likely to be cost-effective from a healthcare payer perspective in Australia.

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Estimation of the Underlying Burden of Pertussis in Adolescents and Adults in Southern Ontario, Canada

Cited by 25 publications

References 41 publications

Pertussis: Microbiology, Disease, Treatment, and Prevention

Pertussis: Microbiology, Disease, Treatment, and Prevention

Differences in Pertussis Incidence by Income among Oregon Teens during an Outbreak

Is adding maternal vaccination to prevent whooping cough cost-effective in Australia?

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