Pertussis is an acute disease of the respiratory tract

Size: px
Start display at page:

Download "Pertussis is an acute disease of the respiratory tract"

Transcription

1 Clinical Manifestations of Bordetella pertussis Infection in Immunized Children and Young Adults* Einat Yaari, MD; Yael Yafe-Zimerman, MD; Shepard B. Schwartz, MD; Paul E. Slater, MD, MPH; Pesach Shvartzman, MD; Nachum Andoren, PhD; David Branski, MD; and Eitan Kerem, MD Study objectives: The incidence and prevalence of pertussis in adults have increased in recent years. It has been shown that previously immunized adults and adolescents are the main sources of transmission of Bordetella pertussis. The aim of this study was to describe the clinical presentation and the clinical course of pertussis in children and young adults who were immunized previously against B pertussis. Design: Retrospective study. Subjects: Children and young adults who were reported by local physicians to the Department of Epidemiology in the Israeli Ministry of Health with serologically confirmed pertussis and who were immunized previously were included. Information sought included personal data, epidemiologic data, signs and symptoms, laboratory results, initial diagnosis, and treatment. Results: In the 95 previously immunized patients with serologically confirmed pertussis (mean age [ SD], years old; range, 5 to 30 years old), the mean duration from onset of symptoms until the final diagnosis of pertussis was days. The disease was usually atypical and generally mild. All the described patients had cough, usually prolonged, lasting weeks. Only 6% had the classic whoop. The mean WBC count was cells/mm 6, and the lymphocyte count was 40 12%. Two patients were admitted to the hospital for severe pneumonia. Among the reported cases, the proportion of patients between the ages of 10 and 45 years increased from 6.5% during the period from 1971 to 1980, to 26% during the period from 1980 to 1990, and to 38% during a 1989 outbreak. Conclusions: Pertussis in previously immunized individuals is usually characterized by an atypical and relatively mild clinical course. Patients suffer mainly from a prolonged and persistent cough. Early diagnosis may lead to prompt administration of therapy. Prophylaxis of exposed persons might be effective in decreasing both severity and transmission of the disease. (CHEST 1999; 115: ) Key words: pertussis, clinical course; pertussis, epidemiology; pertussis, immunization Pertussis is an acute disease of the respiratory tract caused by Bordetella pertussis and characterized by progressive, repetitive, and paroxysmal coughing. It is regarded as a vaccine-preventable childhood illness. Classic pertussis lasts for 6 to 8 weeks, and it *From the Department of Pediatrics (Drs. Yaari, Yafe-Zimerman, Schwartz, Branski, and Kerem) and Unit of Pediatric Respiratory Medicine (Dr. Kerem), Shaare Zedek Medical Center, Jerusalem, Israel; Department of Epidemiology (Dr. Slater), Israel Ministry of Health, Jerusalem, Israel; Department of Family Medicine (Dr. Shvartzman), Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel; and Government Central Laboratories (Dr. Andoren), Israel Ministry of Health, Jerusalem, Israel. Manuscript received May 12, 1998; revision accepted December 3, Correspondence to: Eitan Kerem, MD, Pediatric Respiratory Medicine, Shaare Zedek Medical Center, PO Box 3235, Jerusalem 91031, Israel; ek@cc.huji.ac.il may be divided into three stages of clinical illness: catarrhal, paroxysmal, and convalescent. Whooping cough, cyanotic spells, and brief apnea episodes may also occur. Leukocytosis (20,000 to 100,000 cells/ L) with absolute lymphocytosis is characteristic. A chronic cough may persist for several months. 1 Since the introduction of routine childhood immunization, pertussis morbidity and mortality have declined markedly. 2 However, despite widespread vaccination, the disease was not eradicated, and an increased incidence rate has been reported in the last 2 decades. 3 Cases have been reported primarily in nonimmunized or underimmunized populations, 3,4 although outbreaks in well-immunized populations have also occurred. Several reports of pertussis outbreaks have been documented recently among older children and young adults who were previously 1254 Clinical Investigations

2 immunized by vaccination Furthermore, the incidence and prevalence of pertussis in adults are far higher than previously reported Investigations of outbreaks have documented that adults develop infection with B pertussis and transmit the organism to susceptible children or other adults. Thus, previously immunized adults and adolescents are the main sources of transmission of B pertussis. 15,16 The period of immunity induced by the pertussis vaccine tends to wane within 5 to 10 years and is shorter than that induced by the disease itself. 17 Although the number of susceptible adults is increasing, it is difficult to determine the true incidence of pertussis in adults. Studies of adults with prolonged cough have found that 20 to 25% have serologic evidence of recent pertussis infection ,18 20 However, adults may have an atypical presentation of pertussis with a modified clinical course Because the signs and symptoms are usually nonspecific, pertussis is rarely considered in adults. This may lead to underdiagnosis and lack of, or a delay in, treatment. Furthermore, in vaccinated populations, adults maintain the ability to transmit B pertussis and are now the primary source of infection to susceptible children who may develop severe disease. Several studies on a small number of adult patients with pertussis reported the association between pertussis and chronic cough. However, to the best of our knowledge, the disease in previously immunized children and adults was documented in a limited number of patients. Therefore, the aim of this study was to investigate the clinical presentation and the course of the disease in previously immunized patients suffering from B pertussis infection. Materials and Methods Data regarding pertussis cases were obtained from the reports of local physicians of the Israel Ministry of Health. In Israel, physicians are required to report all cases of pertussis. Retrospectively, we analyzed all serologically confirmed cases between the years of 1986 and 1991 among individuals between the ages of 5 and 30 years old whose medical records were accessible. In all cases, the Pertussis Laboratory of the Ministry of Health Central Laboratories confirmed the diagnosis of pertussis. For the purpose of this study, serologic confirmation of pertussis required an agglutination titer 1:640, or a fourfold rise in agglutination titers obtained 2 to 3 weeks apart, or positive pertussis IgM levels determined by enzyme-linked immunosorbent assay method. 21 As cutoff, negative, and positive control, we used in-house standards calibrated by using a pertussis kit (Virotech GmbH; Russelsheim, Germany). Cultures were not taken. The reporting physicians were contacted and asked to complete a questionnaire based on the patient s medical records. Information sought included personal data, epidemiologic data, signs and symptoms, laboratory results, initial diagnosis, treatment, and complications. Results Since 1956, when pertussis immunization was first introduced in Israel, the number of yearly cases has declined from 10,000 in 1955 to 100 in 1996 (data reported by Israel Ministry of Health). Nonetheless, outbreaks of pertussis were reported between 1980 and Of the 1,091 cases reported between the years 1971 and 1980, the percentage of cases in the group aged 10 to 45 years was 6.5%. This figure increased during the next decade to 26% of the 754 reported cases. In 1989, 38% of the 219 reported cases occurred among individuals between the ages of 10 and 45 years. Of the 552 cases of pertussis reported to the Ministry of Health from January 1986 to December 1991, 283 were children and young adults between the ages of 5 and 30 years (mean age, years old; median, 10 years old). Only 180 patients completed pertussis vaccination during childhood (63%). Clinical information was available for 95 individuals (39% were male) aged 5 to 30 years (mean age, years old; median, 9 years old). Seventy patients were 5 to 10 years old, 16 were 11 to 14 years old, and 9 were 15 to 30 years old. In 66% of these 95 patients, a history of contact with other individuals with pertussis was documented. The mean duration from onset of symptoms until the final diagnosis of pertussis was days (range, 7 to 90 days; median, 14 days). In 46% of the cases, pertussis was the initial diagnosis; most of the patients who developed the disease were diagnosed in a small kibbutz community during a pertussis outbreak after the diagnosis of a first case. Various incorrect diagnoses were ascribed until the diagnosis of pertussis was established. Mycoplasma pneumoniae infection was the most common initial diagnosis (17%). Other initial diagnoses included sinusitis (7%), upper respiratory tract infection (4%), asthma (4%), laryngitis (3%), and suspected cystic fibrosis (1%). Table 1 shows the frequency of symptoms in the 95 vaccinated patients with serologically confirmed pertussis. The disease in these patients was atypical, because the clinical course was generally mild. All the described patients had cough, usually prolonged, lasting weeks (range, 1 to 24 weeks; median 3 weeks). The cough was productive in 7% of the patients, whereas the rest had a dry cough; only 6% had the classic whoop. Of the patients, 13% had temperature 37.5 C. Five of the patients visited an emergency department due to severe cough and dyspnea. Two required hospitalization: a 5-year-old girl with hypoxemia and a 10-year-old boy who CHEST / 115 / 5/ MAY,

3 Table 1 Rate of Symptoms of Pertussis Among Previously Immunized Patients (n 95) Symptoms developed secondary pneumonia with a small pleural effusion (pleurocentesis was not performed). CBC count was taken in 63 patients (66%). The mean WBC count was 8,700 2,600/mm 3 (range, 3,950 to 24,500/mm 3 ; median, 8,600/mm 3 ), and the lymphocyte count was 40 12% (range, 10 to 68%; median, 38%). A chest radiograph was performed on 41 patients (42%) and disclosed abnormalities in 8 (20%). Four radiographs showed enhanced interstitial markings, two revealed bilateral perihilar shadows, one showed a right lower lobe infiltrate with a small amount of pleural effusion that could not be tapped, and one showed a right middle lobe infiltrate. Sixty-eight patients (71%) received antibiotic therapy before the diagnosis of pertussis was made. The majority (78% of treated patients) received erythromycin, while others were treated with penicillin, amoxicillin, or doxycycline. In most patients there was no apparent clinical improvement with antibiotic therapy. Discussion % of Patients Cough 100 Dry cough 93 Paroxysmal nocturnal cough 21 Posttussive vomiting 13 Fever 13 Productive cough 7 Wheezing 7 Apnea 7 Whoop 6 Cyanosis 3 Hoarseness 2 In this study, the clinical presentation of pertussis in previously immunized children and young adults was found to be relatively mild yet protracted. The three typical stages of pertussis were absent. All patients had a prolonged cough that lasted for several weeks. The classic whooping cough was found in only a few patients, and lymphocytosis was generally absent. Thus, besides the long duration of cough, there may be no typical symptoms and signs that would alert the physician to consider the diagnosis of pertussis. Therefore, a heightened index of suspicion needs to be maintained. Considering the highly contagious potential of B pertussis, the history should be evaluated carefully to search for the presence of contacts suffering from similar symptoms. Many patients in our study were diagnosed in a small community during a pertussis outbreak after the diagnosis of the first case in an infant. Pertussis is rarely considered in adults until a child contact develops classic symptoms of the disease. 22 Long et al 23 underscored this fact in their study of the silent transmission of pertussis in families. Fifty percent of the contacts of pertussis had serologic evidence of a recent infection. Many had onset of illness before that of the index case. Most of the actual primary cases were 14 years old. Thus, adults are the most important source of pertussis infection in the community. Pertussis is much more common in adults than previously believed. In Israel, the proportion of adolescents and young adults among the reported pertussis cases increased dramatically from 6.5% from 1971 to 1980 to 26% from 1980 to 1990 and 38% during the 1989 outbreak. This trend is similar to that reported by the Centers for Disease Control and Prevention in the United States, 24 which found that the proportion of pertussis cases occurring in patients 10 years old increased from 15% from 1977 to 1978 to 28% during the time from 1992 to Before the vaccination era, the majority of pertussis cases occurred among infants. At that time, most of the population was exposed to pertussis and acquired natural immunity during the first years of life. Subsequent exposure to other infants and young children with pertussis served to boost immunity. However, the immunity induced by the whole-cell vaccination is shorter than the immunity induced by the disease itself, and tends to wane within 5 to 10 years. 17 Thus, several decades after the introduction of the pertussis vaccine, many adults became susceptible to pertussis. Although the vaccine has been very effective in controlling the disease, the transmission of B pertussis has not been eliminated by vaccination and still causes morbidity, even in the vaccinated population. 25 The 1993 pertussis outbreak in Cincinnati 6 occurred primarily among immunized children, demonstrating that the vaccine did not give full protection against the disease. It is now appreciated that adults are a major reservoir for the spread of the infection to infants. 15,16,20 Pertussis was also isolated from adults infected with HIV who complained of persistent cough. 26 Yet, many physicians are unaware that adults may themselves develop pertussis. 27 This, in addition to the nonspecific or relative lack of symptoms among adults with pertussis, has led to under-recognition of the disease in this age category. 18 The only typical finding of pertussis in our study was a prolonged and disturbing cough that lasted from several weeks to several months. Only 5% had whoop. Similarly, Wright et al 12 reported that cough 1256 Clinical Investigations

4 was found in 85% of the immunized adults with pertussis. Whoop and lymphocytosis were not observed. Prospective studies suggested that 20 to 25% of adults with persistent cough might have pertussis. 3,19 Therefore, epidemiologic studies are needed to determine the incidence of pertussis in adults with respiratory illness. In our study, the duration of time until the final diagnosis was days. This delay in diagnosis may be critical, because initiation of therapy after 3 weeks will not shorten the course of the disease or prevent its spread. 28 Early diagnosis of pertussis relies on clinical suspicion, and the definitive diagnosis of pertussis relies on laboratory tests. Cultures are difficult to obtain and need to be taken early in the course of the disease. 29 The percentage of positive cultures changes precipitously from 67 to 81% shortly after exposure to 25%, 14%, and 0% during the 3rd, 4th, and 5th weeks, respectively. Compared with cultures, direct fluorescent antigen detection is not more sensitive, and it is much less specific. Determination of antibody titer IgA and IgG to lymphocytosis promoting factor, filamentous hemagglutinin, and agglutinogens (antibodies against various virulent factors of B pertussis) is currently the most sensitive diagnostic test. 29,30 Polymerase chain reaction, using a specific probe for B pertussis, may offer an early diagnosis of pertussis with high specificity and sensitivity Pertussis in immunized children and young adults may be associated with morbidity. Five percent of the patients in our study visited an emergency department, and 2% were hospitalized. In addition, many patients had unnecessary and costly diagnostic evaluations and may have suffered from anxiety because of the undiagnosed chronic and protracted cough. Patients may experience loss of time from work or school due to the persistent cough of pertussis. Although the clinical presentation in immunized children and young adults is atypical and the course is usually benign, as shown in our study, pertussis may still cause morbidity. In conclusion, pertussis should be considered in the differential diagnosis of persistent cough in previously immunized children and adults. Given the relative unavailability of accurate diagnostic tests and the usual absence of whoop or lymphocytosis, a recommendation for prompt administration of erythromycin in patients presenting with persistent cough and the prophylaxis of exposed persons before culture or serologic results are available should be considered. This would be effective in decreasing both disease severity and transmission of B pertussis. 34 Because pertussis is not a life-threatening illness in adults, pertussis vaccination is not currently recommended in persons 6 years of age. However, the availability of the less reactogenic acellular vaccine may allow booster immunization and should be thoughtfully considered. References 1 Beherman RE, Kliegman R, eds. Nelson s textbook of pediatrics. 15th ed. Philadelphia, PA: WB Saunders, 1996; Cherry JD. The epidemiology of pertussis and pertussis immunization in the United Kingdom and the United States: a comparative study. Curr Probl Pediatr 1984; 14: Black S. Epidemiology of pertussis. Pediatr Infect Dis J 1997; 16(4 suppl):s85 S89 4 Isaacson J, Trollfors B, Taranger J, et al. How common is whooping cough in a nonvaccinating country? Pediatr Infect Dis J 1993; 12: Halperin SA, Bortolussi R, MacLean D, et al. Persistence of pertussis in an immunized population: results of the Nova Scotia Enhanced Surveillance Program. J Pediatr 1989; 115: Christie CD, Marx ML, Marchant CD, et al. The 1993 epidemic of pertussis in Cincinnati: resurgence of disease in a highly immunized population of children. N Engl J Med 1994; 331: Mink CA, Sirota NM, Nugent S. Outbreak of pertussis in a fully immunized adolescent and adult population. Arch Pediatr Adolesc Med 1994; 148: Rosenthal S, Strebel P, Cassiday P, et al. Pertussis infection in young adults during the 1993 outbreak in Chicago. J Infect Dis 1995; 171: Shvartzman P, Swartz T, Stopler T, et al. Outbreak of pertussis in a closed population with a high vaccination rate. Isr J Med Sci 1991; 27: de-melker HE, Conyn Van Spaendonck MA, Rumke HC, et al. Pertussis in the Netherlands: an outbreak despite high levels of immunization with whole-cell vaccine. Emerg Infect Dis 1997; 3: Nenning ME, Shinefield HR, Edwards KM, et al. Prevalence and incidence of pertussis in an urban population. JAMA 1996; 275: Wright SW, Edwards KM, Decker MD, et al. Pertussis infection in adults with persistent cough. JAMA 1995; 273: Mink CM, Cherry JD, Christenson P, et al. A search for Bordetella pertussis infection in university students. Clin Infect Dis 1992; 14: Robertson PW, Goldberg H, Jarvie BH, et al. Bordetella pertussis infection. Med J Aust 1987; 147: Cherry JD, Baraff LJ, Hewlett E. The past, present, and future of pertussis: the role of adults in epidemiology and future control. West J Med 1989; 150: Nelson JD. The changing epidemiology of pertussis in young infants: the role of adults as reservoirs of infection. Am J Dis Child 1978; 132: Jenkinson D. Duration of effectiveness of pertussis vaccine: evidence from a 10-year community study. BMJ (Clin Res Ed) 1988; 296: Aoyama T, Takeuchi Y, Goto A, et al. Pertussis in adults. Am J Dis Child 1992; 146: Herwaldt LA. Pertussis in adults: what physicians need to know. Arch Intern Med 1991; 151: Cromer BA, Boydos J, Hackell J, et al. Unrecognized pertussis infection in adolescents. Am J Dis Child 1993; 147: CHEST / 115 / 5/ MAY,

5 21 Mertsola J, Ruuskanen O, Kuronen T, et al. Serologic diagnosis of pertussis: comparison of enzyme-linked immunosorbent assay and bacterial agglutination. J Infect Dis 1983; 147: Deen JL, Mink CA, Cherry JD, et al. Household contact study of Bordetella pertussis infections. Clin Infect Dis 1995; 21: Long SS, Welkon CJ, Clark JL. Widespread silent transmission of pertussis in families: antibody correlates of infection and symptomatology. J Infect Dis 1990; 161: Centers for Disease Control. Reported vaccine-preventable diseases: United States, 1993, and the Childhood Immunization Initiative. MMWR Morb Mortal Wkly Rep 1994; 43: Fine PEM, Clarkson JA. The recurrence of whooping cough: possible implications for assessment of vaccine efficacy. Lancet 1982; 1: Colebunders R, Vael C, Blot K, et al. Bordetella pertussis as a cause of chronic respiratory infection in an AIDS patient. Eur J Clin Microbiol Infect Dis 1994; 13: Linneman CC Jr, Nasenbeny J. Pertussis in the adult. Annu Rev Med 1977; 28: Hewlett EL. Bordetella species. In: Mandell GI, Bennett JE, Dolin R, eds. Mandell, Douglas and Bennett s principles and practice of infectious diseases. 4th ed. New York, NY: Churchill Livingstone, 1995; Steketee RW, Wassilak SGF, Adkins WN Jr, et al. Evidence for a high attack rate and efficacy of erythromycin prophylaxis in a pertussis outbreak facility for the developmentally disabled. J Infect Dis 1988; 157: Muller FM, Hoppe JE, Von Konig W. Laboratory of pertussis: state of the art J Clin Microbiol 1997; 35: Huard S, Hackel C, Herzog A, et al. Specific identification of Bordetella pertussis by the polymerase chain reaction. Res Microbiol 1989; 140: Glare EM, Paton JC, Premier RR, et al. Analysis of repetitive DNA sequence from Bordetella pertussis and its application to diagnosis of pertussis using the polymerase chain reaction. J Clin Microbiol 1990; 28: Wadowsky RM, Michaels RH, Libert T, et al. Multiplex PCR-based assay for detection of Bordetella pertussis in nasopharyngeal swab specimens. J Clin Microbiol 1996; 34: Bass JW. Erythromycin for treatment and prevention of pertussis. J Pediatr Infect Dis 1986; 5: Clinical Investigations

EDUCATIONAL COMMENTARY PERTUSSIS

EDUCATIONAL COMMENTARY PERTUSSIS EDUCATIONAL COMMENTARY PERTUSSIS Educational commentary is provided through our affiliation with the American Society for Clinical Pathology (ASCP). To obtain FREE CME/CMLE credits click on Earn CE Credits

More information

PERTUSSIS The Unpredictable Burden of Disease. Lawrence D. Frenkel, MD, FAAP AAP/Novartis Grand Rounds Webinar February 7, 2013

PERTUSSIS The Unpredictable Burden of Disease. Lawrence D. Frenkel, MD, FAAP AAP/Novartis Grand Rounds Webinar February 7, 2013 PERTUSSIS The Unpredictable Burden of Disease Lawrence D. Frenkel, MD, FAAP AAP/Novartis Grand Rounds Webinar February 7, 2013 Pertussis Agent Bordetella pertussis Nonmotile, fastidious, gram-negative,

More information

Pertussis in the Elderly

Pertussis in the Elderly Pertussis in the Elderly Equity in Disease Prevention: Vaccines for the Elderly Melbourne, Australia Friday, 20 June 2014 David R. Johnson, MD, MPH Vice President and Global Medical Expert Sanofi Pasteur

More information

Survey of pertussis in patients with prolonged cough

Survey of pertussis in patients with prolonged cough Pertussis J Microbiol in patients Immunol with Infect prolonged cough 2006;39:54-58 Original Article Survey of pertussis in patients with prolonged cough Jen-Jan Hu 1, Chun-Yi Lu 2, Luan-Yin Chang 2, Chin-Hao

More information

Pertussis. Information for Physicians. Disease Information. Diagnostic Testing of Suspect Cases. Infectious Disease Epidemiology Program

Pertussis. Information for Physicians. Disease Information. Diagnostic Testing of Suspect Cases. Infectious Disease Epidemiology Program September 2007 Pertussis Disease Information Incubation Period: 7-10 days; rarely up to 21 days Infectious Period: From prodrome (early symptom) onset to 3 weeks after cough onset. Patients are considered

More information

Pertussis: An Emerging Infection. Holly K. Ehrke. Ferris State University

Pertussis: An Emerging Infection. Holly K. Ehrke. Ferris State University Running head: PERTUSSIS AN EMERGING INFECTION 1 Pertussis: An Emerging Infection Holly K. Ehrke Ferris State University PERTUSSIS AN EMERGING INFECTION 2 Abstract Pertussis is a highly contagious disease

More information

Pertussis Testing and Treatment Guidelines

Pertussis Testing and Treatment Guidelines Chicago Department of Public Health City of Chicago Rahm Emanuel, Mayor Pertussis Testing and Treatment Guidelines Date: August 1, 2012 To: Immunization Program Chicago Department of Public Health Bechara

More information

2013 About Pertussis (Whooping Cough)

2013 About Pertussis (Whooping Cough) 2013 About Pertussis (Whooping Cough) Pertussis Pertussis, also known as whooping cough, is a highly contagious and often serious disease, especially in young children. 1,2 In adolescents and adults it

More information

Summary of Key Points

Summary of Key Points Summary of Key Points WHO Position Paper on Vaccines against Pertussis September 2015 1 Background l Pertussis (whooping cough), caused by the bacterium Bordetella pertussis, was one of the most common

More information

It s all about the Whoop

It s all about the Whoop It s all about the Whoop Pertussis On Campus By Rebecca DiSaia Minus, MSN, RN, CNL Hear what Whooping cough sounds like Stages of Pertussis Catarrhal Stage Paroxysmal Stage Convalescent Stage (Recovery)

More information

California Pertussis Epidemic October John Talarico, D.O., M.P.H. Immunization Branch California Department of Public Health

California Pertussis Epidemic October John Talarico, D.O., M.P.H. Immunization Branch California Department of Public Health California Pertussis Epidemic October 2010 John Talarico, D.O., M.P.H. Immunization Branch California Department of Public Health Pertussis Background Pertussis is the most poorly controlled vaccine-preventable

More information

Objectives 3/3/2017. Disease Reporting in Georgia: The School Nurse s Role. Georgia Department of Public Health

Objectives 3/3/2017. Disease Reporting in Georgia: The School Nurse s Role. Georgia Department of Public Health Disease Reporting in Georgia: The School Nurse s Role Presentation to: Georgia s School Nurses Presented by: Ebony S. Thomas, MPH Date: Friday, March 10, 2017 Objectives Describe the school nurse s role

More information

Prince Edward Island Guidelines for the Management and Control of Pertussis

Prince Edward Island Guidelines for the Management and Control of Pertussis Prince Edward Island Guidelines for the Management and Control of Pertussis November 2015 Table of Contents 1. General Guidelines... 2 1.1 Clinical Presentation... 3 1.2 Epidemiology... 4 2. Diagnosis...

More information

JOURNAL OF CLINICAL MICROBIOLOGY, Feb. 2000, p Vol. 38, No. 2. Copyright 2000, American Society for Microbiology. All Rights Reserved.

JOURNAL OF CLINICAL MICROBIOLOGY, Feb. 2000, p Vol. 38, No. 2. Copyright 2000, American Society for Microbiology. All Rights Reserved. JOURNAL OF CLINICAL MICROBIOLOGY, Feb. 2000, p. 800 806 Vol. 38, No. 2 0095-1137/00/$04.00 0 Copyright 2000, American Society for Microbiology. All Rights Reserved. Specificity and Sensitivity of High

More information

CHAMPIONS for LUNG Health. Learn About Pertussis PERTUSSIS

CHAMPIONS for LUNG Health. Learn About Pertussis PERTUSSIS CHAMPIONS for LUNG Health PERTUSSIS Learn About Pertussis Pertussis, also known as whooping cough, is an extremely contagious respiratory infection caused by Bordetella pertussis bacteria. It can be especially

More information

PAEDIATRIC ACUTE CARE GUIDELINE. Pertussis. This document should be read in conjunction with this DISCLAIMER

PAEDIATRIC ACUTE CARE GUIDELINE. Pertussis. This document should be read in conjunction with this DISCLAIMER Princess Margaret Hospital for Children PAEDIATRIC ACUTE CARE GUIDELINE Pertussis Scope (Staff): Scope (Area): All Emergency Department Clinicians Emergency Department This document should be read in conjunction

More information

Case Report Pertussis Reinfection in an Adult: A Cause of Persistent Cough Not to Be Ignored

Case Report Pertussis Reinfection in an Adult: A Cause of Persistent Cough Not to Be Ignored Hindawi Case Reports in Infectious Diseases Volume 2017, Article ID 4786141, 4 pages https://doi.org/10.1155/2017/4786141 Case Report Pertussis Reinfection in an Adult: A Cause of Persistent Cough Not

More information

A PERTUSSIS EPIDEMIC IN NSW: HOW EPIDEMIOLOGY REFLECTS VACCINATION POLICY

A PERTUSSIS EPIDEMIC IN NSW: HOW EPIDEMIOLOGY REFLECTS VACCINATION POLICY A PERTUSSIS EPIDEMIC IN NSW: HOW EPIDEMIOLOGY REFLECTS VACCINATION POLICY Julia Brotherton and Jeremy McAnulty Communicable Diseases Branch NSW Department of Health Pertussis has traditionally been considered

More information

Pertussis. Gary Reubenson 10 September 2014

Pertussis. Gary Reubenson 10 September 2014 Pertussis Gary Reubenson 10 September 2014 Conflicts of Interest Sanofi Local Conference support Study sponsor Pfizer Local & International Conference Support Speakers fee Abbvie Speakers fee Overview

More information

Failure of Physicians to Consider the Diagnosis of Pertussis in Children

Failure of Physicians to Consider the Diagnosis of Pertussis in Children 840 Failure of Physicians to Consider the Diagnosis of Pertussis in Children Shelley Deeks, Gaston De Serres, Nicole Boulianne, Bernard Duval, Louis Rochette, Pierre Déry, and Scott Halperin From the Field

More information

Pertussis Update 8/22/2014. Objectives. Pertussis. Pertussis. Pertussis: from Latin meaning intense cough. Pertussis Diagnosis

Pertussis Update 8/22/2014. Objectives. Pertussis. Pertussis. Pertussis: from Latin meaning intense cough. Pertussis Diagnosis Objectives Pertussis Update Jim Dunn, PhD, D(ABMM) Director, Medical Microbiology and Virology Texas Children s Hospital Describe the current epidemiology of pertussis infections in the U.S. Discuss the

More information

Considerations for Public Health on Pertussis Case and Contact Management

Considerations for Public Health on Pertussis Case and Contact Management Considerations for Public Health on Pertussis Case and Contact Management September 2015 History of Pertussis and Immunization Pertussis outbreaks tend to be cyclical in nature, with increased disease

More information

Pedro Plans-Rubió 1,4 Encarna Navas. Angela Domínguez 3,4 Mireia Jané

Pedro Plans-Rubió 1,4 Encarna Navas. Angela Domínguez 3,4 Mireia Jané PharmacoEconomics Open https://doi.org/10.1007/s41669-018-0081-4 ORIGINAL RESEARCH ARTICLE Reduction of Direct Health Costs Associated with Pertussis Vaccination with Acellular Vaccines in Children Aged

More information

Pertussis: Clinical Review and Colorado s Epidemic

Pertussis: Clinical Review and Colorado s Epidemic Pertussis: Clinical Review and Colorado s Epidemic Today s Speakers: Robert Brayden, MD, Professor of Pediatrics, University of Colorado School of Medicine, Children s Hospital Colorado Lisa Miller, MD,

More information

Using the EMR to Improve Tdap Vaccination Rates in Pregnant Women

Using the EMR to Improve Tdap Vaccination Rates in Pregnant Women Using the EMR to Improve Tdap Vaccination Rates in Pregnant Women Webinar Guidelines 1 hour presentation including a Q&A discussion period at the end. Send your questions at any time during the presentation

More information

C ase reports, statutory notifications, and laboratory

C ase reports, statutory notifications, and laboratory 802 ORIGINAL ARTICLE Severe and unrecognised: pertussis in UK infants N S Crowcroft, R Booy, T Harrison, L Spicer, J Britto, Q Mok, P Heath, I Murdoch, M Zambon, R George, E Miller... See end of article

More information

NYS Trends in Vaccine Preventable Disease Control

NYS Trends in Vaccine Preventable Disease Control NYS Trends in Vaccine Preventable Disease Control Cindy Schulte, BSN, RN Bureau of Immunization 518-473-4437 crs01@health.state.ny.us 1 Objectives Participants will be able to identify disease outbreaks

More information

3. Rapidly recognize influenza seasons in which the impact of influenza appears to be unusually severe among children.

3. Rapidly recognize influenza seasons in which the impact of influenza appears to be unusually severe among children. 07-ID-14 Committee: Title: Infectious Disease Influenza-Associated Pediatric Mortality Statement of the Problem: In 2004, CSTE adopted influenza-associated pediatric mortality reporting with a provision

More information

California 2010 Pertussis Epidemic. Kathleen Winter, MPH Immunization Branch California Department of Public Health

California 2010 Pertussis Epidemic. Kathleen Winter, MPH Immunization Branch California Department of Public Health California 2010 Pertussis Epidemic Kathleen Winter, MPH Immunization Branch California Department of Public Health Overview Pertussis Background California Pertussis Epidemic Challenges and Success Ongoing

More information

Journal of Adolescent Health 37 (2005) 517.e1 517.e5. Original article. Manuscript received May 3, 2005; manuscript accepted August 10, 2005

Journal of Adolescent Health 37 (2005) 517.e1 517.e5. Original article. Manuscript received May 3, 2005; manuscript accepted August 10, 2005 Journal of Adolescent Health 37 (2005) 517.e1 517.e5 Original article Immunogenicity and reactogenicity of a reduced-antigen-content diphtheria-tetanus-acellular pertussis vaccine in healthy Taiwanese

More information

Medical Bacteriology- Lecture 13 Gram Negative Coccobacilli Haemophilus Bordetella

Medical Bacteriology- Lecture 13 Gram Negative Coccobacilli Haemophilus Bordetella Medical Bacteriology- Lecture 13 Gram Negative Coccobacilli Haemophilus Bordetella 1 Haemophilus "loves heme" Small gram-negative coccobacilli Non-spore forming Non-motile Growth is enhanced in CO2 Present

More information

Pertussis: Trends, Prevention and Challenges Flor M. Munoz, MD Associate Professor Pediatric Infectious Diseases

Pertussis: Trends, Prevention and Challenges Flor M. Munoz, MD Associate Professor Pediatric Infectious Diseases Pertussis: Trends, Prevention and Challenges Flor M. Munoz, MD Associate Professor Pediatric Infectious Diseases Disclosure I do not have any relevant conflicts of interest to disclose. Page 1 xxx00.#####.ppt

More information

Streptococcal Pharyngitis

Streptococcal Pharyngitis Streptococcal Pharyngitis Guideline developed by JC Beavers, MD, in collaboration with the ANGELS Team. Last reviewed by JC Beavers, MD on November 2, 2016. Preface Streptococcal pharyngitis (ie, strep

More information

Addressing an Epidemic: The Clinicians Role in Preventing Pertussis

Addressing an Epidemic: The Clinicians Role in Preventing Pertussis Welcome! Addressing an Epidemic: The Clinicians Role in Preventing Pertussis Mark Sawyer, MD. FAAP Presented by: California Department of Public Health Co-sponsor: California Immunization Coalition Joint

More information

Pertussis Toolkit for Schools

Pertussis Toolkit for Schools Pertussis Toolkit for Schools Burlington County Health Department December 2012 1 CONTENTS What to do if you suspect a case of pertussis in your school 3 Pertussis reporting form 5 Pertussis Fact sheet

More information

Bexar County Vaccine Update

Bexar County Vaccine Update Bexar County Vaccine Update Anil T. Mangla., MS., PhD., PHD., FRIPH Assistant Director, San Antonio Metro Health Associate Adjunct Professor University of Texas-School of Public Health Mercer University,

More information

Surveillance, Reporting and Control of Influenza and Pertussis. Steve Fleming, EdM Hillary Johnson, MHS Epidemiologists Immunization Program, MDPH

Surveillance, Reporting and Control of Influenza and Pertussis. Steve Fleming, EdM Hillary Johnson, MHS Epidemiologists Immunization Program, MDPH Surveillance, Reporting and Control of Influenza and Pertussis Steve Fleming, EdM Hillary Johnson, MHS Epidemiologists Immunization Program, MDPH Disclosures The speaker has no financial interest or conflict

More information

Pertussis, or whooping cough, was first recognized in

Pertussis, or whooping cough, was first recognized in INVITED COMMENTARY Coughing Up Answers: A Community s Response to Pertussis Joseph B. Bass Jr., Stacie R. Turpin-Saunders Pertussis is a highly contagious but vaccine-preventable disease. In spite of relatively

More information

Policy Objective. This policy applies to all staff employed by NHS Greater Glasgow & Clyde and locum staff on fixed term contracts.

Policy Objective. This policy applies to all staff employed by NHS Greater Glasgow & Clyde and locum staff on fixed term contracts. 1 of 9 Policy Objective To ensure that Healthcare Workers are aware of the actions and precautions necessary to minimise the risk of outbreaks and the importance of diagnosing patients clinical conditions

More information

Measles Surveillance in the United States: An Overview

Measles Surveillance in the United States: An Overview SUPPLEMENT ARTICLE Measles Surveillance in the United States: An Overview Dalya Güriş, Rafael Harpaz, Susan B. Redd, Natalie J. Smith, a and Mark J. Papania National Immunization Program, Centers for Disease

More information

Pertussis in adolescents and adults: should we vaccinate Lee G M, LeBaron C, Murphy T V, Lett S, Schauer S, Lieu T A

Pertussis in adolescents and adults: should we vaccinate Lee G M, LeBaron C, Murphy T V, Lett S, Schauer S, Lieu T A Pertussis in adolescents and adults: should we vaccinate Lee G M, LeBaron C, Murphy T V, Lett S, Schauer S, Lieu T A Record Status This is a critical abstract of an economic evaluation that meets the criteria

More information

Risk Factors for Complications in Hospitalized Young Infants Presenting With Uncomplicated Pertussis abstract

Risk Factors for Complications in Hospitalized Young Infants Presenting With Uncomplicated Pertussis abstract RESEARCH ARTICLE Risk Factors for Complications in Hospitalized Young Infants Presenting With Uncomplicated Pertussis abstract OBJECTIVE: We sought to identify risk factors for complications in hospitalized

More information

Estimating RSV Disease Burden in the United States

Estimating RSV Disease Burden in the United States Estimating RSV Disease Burden in the United States Brian Rha, MD, MSPH Medical Epidemiologist, Division of Viral Diseases Centers for Disease Control and Prevention Severe Acute Respiratory Infection Surveillance

More information

Vaccine Preventable Diseases. Overview MEASLES 4/8/2015. Amy Schwartz, MPH Immunization Surveillance Coordinator North Dakota Department of Health

Vaccine Preventable Diseases. Overview MEASLES 4/8/2015. Amy Schwartz, MPH Immunization Surveillance Coordinator North Dakota Department of Health Vaccine Preventable Diseases Amy Schwartz, MPH Immunization Surveillance Coordinator North Dakota Department of Health Measles Mumps Pertussis Meningococcal Disease Polio Rubella Hepatitis A Overview MEASLES

More information

Articles 87 Pertussis Outbreak Kit, Texas Department of Health, Version 1.0, 4/1/2002

Articles 87 Pertussis Outbreak Kit, Texas Department of Health, Version 1.0, 4/1/2002 Articles 87 View Pertussis United States, 1997-2000 at: http://www.cdc.gov/mmwr/preview/mmwrhtml /mm5104a1.htm View Pertussis Deaths United States, 2000 at: http://www.cdc.gov/mmwr/preview/mmwrhtml /mm5128a2.htm

More information

Announcements. Please mute your phones and DO NOT place us on hold. Press *6 to mute your phone.

Announcements. Please mute your phones and DO NOT place us on hold. Press *6 to mute your phone. Announcements Register for the Epi-Tech Trainings: 1. Log-on or Request log-on ID/password: https://tiny.army.mil/r/zb8a/cme 2. Register for Epi-Tech Surveillance Training: Confirm attendance: https://tiny.army.mil/r/dvrgo/epitechfy14

More information

Available from Deakin Research Online: Reproduced with the specific permission of the copyright owner.

Available from Deakin Research Online:   Reproduced with the specific permission of the copyright owner. Deakin Research Online Deakin University s institutional research repository DDeakin Research Online Research Online This is the published version (version of record) of: Horby, P., Macintyre, C. R., McIntyre,

More information

Streptococcus Pneumoniae

Streptococcus Pneumoniae Streptococcus Pneumoniae (Invasive Pneumococcal Disease) DISEASE REPORTABLE WITHIN 24 HOURS OF DIAGNOSIS Per N.J.A.C. 8:57, healthcare providers and administrators shall report by mail or by electronic

More information

Pertussis Epidemiology and Vaccine Impact in the United States

Pertussis Epidemiology and Vaccine Impact in the United States Pertussis Epidemiology and Vaccine Impact in the United States Stacey Martin, MSc Epidemiology Team Lead Meningitis and Vaccine Preventable Diseases Branch Centers for Disease Control and Prevention Presented

More information

The Present and Future Control of Pertussis

The Present and Future Control of Pertussis EDITORIAL COMMENTARY The Present and Future Control of Pertussis James D. Cherry Department of Pediatrics, David Geffen School of Medicine at University of California Los Angeles (UCLA), and Division of

More information

Preparation and Evaluation of Stained Pertussis Antigen for Serodiagnosis of Whooping Cough

Preparation and Evaluation of Stained Pertussis Antigen for Serodiagnosis of Whooping Cough Arch. Raz; Ins. 55 (2003) 89-96 89 Preparation and Evaluation of Stained Pertussis Antigen for Serodiagnosis of Whooping Cough Afsharpad t, K., Mohammadi, A. 2 and Mirchamsy, ".2 Short Communication /.

More information

Historical Review of Pertussis and the Classical Vaccine

Historical Review of Pertussis and the Classical Vaccine 5259 Historical Review of Pertussis and the Classical Vaccine James D. Cherry Department ofpediatrics, UCLA School ofmedicine, UCLA Children's Hospital, and UCLA Center for Vaccine Research, Los Angeles.

More information

Pertussis (Whooping Cough)

Pertussis (Whooping Cough) Pertussis (Whooping Cough) By: Jeanna Reed Etiological Agent! Bacterium: Bordetella pertussis. The genus Bordetella contains the species B pertussis and B parapertussis, which cause pertussis in humans.

More information

er of Cas ses Numb Mid 1940s: Whole cell pertussis vaccine developed *2010 YTD 2008: Tdap pphase- in for grades 6-12 started

er of Cas ses Numb Mid 1940s: Whole cell pertussis vaccine developed *2010 YTD 2008: Tdap pphase- in for grades 6-12 started Pertussis Update Stephanie Schauer, PhD Epidemiologist Wisconsin Immunization Program November 16, 2010 Pertussis Caused by bacterium Bordetella pertussis Highly communicable, with secondary attack rate

More information

- Mycoplasma pneumoniae (MP): important respiratory pathogen in children that cause many upper and lower respiratory tract diseases, including

- Mycoplasma pneumoniae (MP): important respiratory pathogen in children that cause many upper and lower respiratory tract diseases, including KHOA DICH VU HO HAP - Mycoplasma pneumoniae (MP): important respiratory pathogen in children that cause many upper and lower respiratory tract diseases, including wheezing, coryza, bronchopneumonia. -

More information

BORDETELLA MODULE 30.1 INTRODUCTION OBJECTIVES 30.2 MORPHOLOGY 30.3 CULTURE CHARACTERISTICS. Notes

BORDETELLA MODULE 30.1 INTRODUCTION OBJECTIVES 30.2 MORPHOLOGY 30.3 CULTURE CHARACTERISTICS. Notes 30 BORDETELLA 30.1 INTRODUCTION The genus are small Gram negative, non-motile, coccobacilli. This genus contains three species - pertussis, B. parapertussis, B. bronchiseptica. B. pertussisis associated

More information

Pertussis Pertussis Bordetella pertussis Pathogenesis Clinical Features

Pertussis Pertussis Bordetella pertussis Pathogenesis Clinical Features Pertussis Pertussis, or whooping cough, is an acute infectious disease caused by the bacterium Bordetella pertussis. Outbreaks of pertussis were first described in the 16th century, and the organism was

More information

ESCMID Online Lecture Library. by author

ESCMID Online Lecture Library. by author INFLUENZA IN CHILDREN Cristian Launes Infectious Diseases Unit. Department of Paediatrics. Hospital Sant Joan de Déu (Universitat de Barcelona) Innovation in Severe Acute Respiratory Infections (SARI),

More information

PERTUSSIS. Introduction

PERTUSSIS. Introduction PERTUSSIS Introduction Pertussis (whooping cough) is a highly contagious acute respiratory tract infection caused by the bacterium Bordetella pertussis. It is spread by aerosol droplets. Neither vaccination

More information

Outbreak of Pertussis in a University Laboratory

Outbreak of Pertussis in a University Laboratory ORIGINAL ARTICLE Outbreak of Pertussis in a University Laboratory Naoyuki Miyashita 1, Yasuhiro Kawai 2, Tetsuya Yamaguchi 2, Kazunobu Ouchi 2, Koji Kurose 3 and Mikio Oka 3 Abstract Objective Analysis

More information

Corynebacterium diphtheriae

Corynebacterium diphtheriae Corynebacterium diphtheriae Aerobic gram-positive bacillus Toxin production occurs only when C. diphtheriae infected by virus (phage) carrying tox gene If isolated, must be distinguished from normal diphtheroid

More information

Protecting the Innocent Bystander The Importance of Vaccination During Pregnancy

Protecting the Innocent Bystander The Importance of Vaccination During Pregnancy Disclosures Protecting the Innocent Bystander The Importance of Vaccination During Pregnancy Judy Guzman-Cottrill, DO Professor of Pediatrics Division of Infectious Diseases Oregon Health & Science University

More information

Pertussis. West Virginia Electronic Disease Surveillance System

Pertussis. West Virginia Electronic Disease Surveillance System Pertussis Electronic Disease Surveillance System Division of Surveillance and Disease Control Infectious Disease Epidemiology Program : 304-558-5358 or 800-423-1271 in Fax: 304-558-8736 Investigation Information

More information

In the setting of measles elimination in the United States, the current measles case definition lacks specificity.

In the setting of measles elimination in the United States, the current measles case definition lacks specificity. 12-ID-07 Committee: Infectious Disease Title: Public Health Reporting and ational otification for Measles I. Statement of the Problem In the setting of measles elimination in the United States, the current

More information

Measles: United States, January 1 through June 10, 2011

Measles: United States, January 1 through June 10, 2011 Measles: United States, January 1 through June 10, 2011 Preeta K. Kutty, MD, MPH Measles, Mumps, Rubella and Polio Team Division of Viral Diseases Centers for Disease Control and Prevention Atlanta, GA

More information

Influenza Backgrounder

Influenza Backgrounder Influenza Backgrounder Influenza Overview Influenza causes an average of 36,000 deaths and 200,000 hospitalizations in the U.S. every year. 1,2 Combined with pneumonia, influenza is the seventh leading

More information

Evaluation of Culture, Immunofluorescence, and Serology for the

Evaluation of Culture, Immunofluorescence, and Serology for the JOURNAL OF CLINICAL MICROBIOLOGY, Apr. 1989, p. 752-757 0095-1137/89/040752-06$02.00/0 Copyright 1989, American Society for Microbiology Vol. 27, No. 4 Evaluation of Culture, Immunofluorescence, and Serology

More information

Appendix B: Provincial Case Definitions for Reportable Diseases

Appendix B: Provincial Case Definitions for Reportable Diseases Infectious Diseases Protocol Appendix B: Provincial Case Definitions for Reportable Diseases Disease: Influenza Revised December 2014 Influenza 1.0 Provincial Reporting Confirmed cases of disease 2.0 Type

More information

Pertussis Pertussis Bordetella pertussis Pathogenesis Clinical Features incubation period

Pertussis Pertussis Bordetella pertussis Pathogenesis Clinical Features incubation period Pertussis Pertussis, or whooping cough, is an acute infectious disease caused by the bacterium Bordetella pertussis. Outbreaks of pertussis were first described in the 16th century, and the organism was

More information

Antimicrobial Stewardship in Community Acquired Pneumonia

Antimicrobial Stewardship in Community Acquired Pneumonia Antimicrobial Stewardship in Community Acquired Pneumonia Medicine Review Course 2018 Dr Lee Tau Hong Consultant Department of Infectious Diseases National Centre for Infectious Diseases Scope 1. Diagnosis

More information

PERTUSSIS, OR WHOOPING COUGH, IS AN ACUTE INFECTIOUS

PERTUSSIS, OR WHOOPING COUGH, IS AN ACUTE INFECTIOUS 6 Chapter Per ertussis PERTUSSIS, OR WHOOPING COUGH, IS AN ACUTE INFECTIOUS disease caused by the bacterium Bordetella pertussis. Outbreaks of pertussis were first described in the 16th century, and the

More information

Does This Coughing Adolescent or Adult Patient Have Pertussis?

Does This Coughing Adolescent or Adult Patient Have Pertussis? THE RATIONAL CLINICAL EXAMINATION CLINICIAN S CORNER Does This Coughing Adolescent or Adult Patient Have Pertussis? Paul B. Cornia, MD Adam L. Hersh, MD Benjamin A. Lipsky, MD Thomas B. Newman, MD, MPH

More information

Introduction to Measles a Priority Vaccine Preventable Disease (VPD) in Africa

Introduction to Measles a Priority Vaccine Preventable Disease (VPD) in Africa Introduction to Measles a Priority Vaccine Preventable Disease (VPD) in Africa Nigeria Center for Disease Control Federal Ministry of Health Abuja July 2015 Outline 1. Measles disease 2. Progress towards

More information

CASE SUMMARY: PERTUSSIS IN THE SOUTHERN HEALTH SANTÉ SUD REGION

CASE SUMMARY: PERTUSSIS IN THE SOUTHERN HEALTH SANTÉ SUD REGION CASE SUMMARY: PERTUSSIS IN THE SOUTHERN HEALTH SANTÉ SUD REGION By: Braden Arbuckle Home for the Summer Program, May to August 2017 Portage La Prairie, Manitoba Supervisor: Dr. Finney Introduction Pertussis,

More information

DISCLOSURES. I have no actual or potential conflicts of interest in this presentation.

DISCLOSURES. I have no actual or potential conflicts of interest in this presentation. OVERVIEW ON MEASLES Oneka B. Marriott, DO, MPH, FAAP, FACOP Assistant Professor of Pediatrics and Public Health Nova Southeastern University College of Osteopathic Medicine Presentation to FSACOFP Annual

More information

Pertussis Epidemiology and Vaccination in the United States and the Latin American Pertussis Project

Pertussis Epidemiology and Vaccination in the United States and the Latin American Pertussis Project Pertussis Epidemiology and Vaccination in the United States and the Latin American Pertussis Project Thomas Clark, MD, MPH Epidemiology Team Lead Meningitis and Vaccine Preventable Diseases Branch National

More information

Whooping cough-a study of severity in hospital cases

Whooping cough-a study of severity in hospital cases Archives of Disease in Childhood, 1981, 56, 687-691 Whooping cough-a study of severity in hospital cases D A ROBINSON, B K MANDAL, A G IRONSIDE, AND E M DUNBAR Communicable Disease Surveillance Centre,

More information

TETANUS, DIPHTHERIA, PERTUSSIS (Td/Tdap)

TETANUS, DIPHTHERIA, PERTUSSIS (Td/Tdap) TETANUS, DIPHTHERIA, PERTUSSIS (Td/Tdap) WHAT YOU NEED TO KNOW ARE YOU SURE YOU USE THE RIGHT MEASURES TO PROTECT YOURSELF AGAINST TETANUS, DIPHTHERIA OR PERTUSSIS? GET INFORMED! GET VACCINATED! GET PROTECTED!

More information

COHORT STUDY OF HIV POSITIVE AND HIV NEGATIVE TUBERCULOSIS in PENANG HOSPITAL: COMPARISON OF CLINICAL MANIFESTATIONS

COHORT STUDY OF HIV POSITIVE AND HIV NEGATIVE TUBERCULOSIS in PENANG HOSPITAL: COMPARISON OF CLINICAL MANIFESTATIONS COHORT STUDY OF HIV POSITIVE AND HIV NEGATIVE TUBERCULOSIS in PENANG HOSPITAL: COMPARISON OF CLINICAL MANIFESTATIONS Ong CK 1, Tan WC 2, Leong KN 2, Abdul Razak M 1, Chow TS 2 1 Respiratory Unit, Penang

More information

Spots and Pox: Contact Tracing and Follow Up for Measles and Chickenpox

Spots and Pox: Contact Tracing and Follow Up for Measles and Chickenpox Chickenpox Spots and Pox: Contact Tracing and Follow Up for Measles and Chickenpox Noelle Bessette, MPH Surveillance Specialist New Jersey Department of Health Vaccine Preventable Disease Program Caused

More information

Spots and Pox: Contact Tracing and Follow Up for Measles and Chickenpox

Spots and Pox: Contact Tracing and Follow Up for Measles and Chickenpox Spots and Pox: Contact Tracing and Follow Up for Measles and Chickenpox Noelle Bessette, MPH Surveillance Specialist New Jersey Department of Health Vaccine Preventable Disease Program Chickenpox Caused

More information

Case Presentation: Pertussis: The Resurgence of an Old Disease. Case Presentation: Case Presentation: Case Presentation: Case Presentation:

Case Presentation: Pertussis: The Resurgence of an Old Disease. Case Presentation: Case Presentation: Case Presentation: Case Presentation: Pertussis: The Resurgence of an Old Disease Controlling an Outbreak in Your Community You have finally finished your training! As a new healthcare provider, you are working in a Family Medicine office.

More information

Pediatric and Adolescent Infectious Disease Concerns

Pediatric and Adolescent Infectious Disease Concerns Pediatric and Adolescent Infectious Disease Concerns Sean P. Elliott, MD Professor of Pediatrics Associate Chair of Education, Department of Pediatrics University of Arizona College of Medicine Tucson,

More information

Western Veterinary Conference 2013

Western Veterinary Conference 2013 Western Veterinary Conference 2013 SA283 EMERGING CANINE INFECTIOUS RESPIRATORY DISEASES Stephanie D Janeczko, DVM, MS, Dipl. ABVP (Canine/Feline) ASPCA New York, NY, USA Management of infectious respiratory

More information

Objectives. Pneumonia. Pneumonia. Epidemiology. Prevalence 1/7/2012. Community-Acquired Pneumonia in infants and children

Objectives. Pneumonia. Pneumonia. Epidemiology. Prevalence 1/7/2012. Community-Acquired Pneumonia in infants and children Objectives Community-Acquired in infants and children Review of Clinical Practice Guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America - 2011 Sabah Charania,

More information

C O M M U N I C A B L E D I S E A S E S S U R V E I L L A N C E B U L L E T I N V O L U M E 1 2, N O. 4

C O M M U N I C A B L E D I S E A S E S S U R V E I L L A N C E B U L L E T I N V O L U M E 1 2, N O. 4 SURVEILLANCE FOR BORDETELLA PERTUSSIS, ATYPICAL BACTERIAL CAUSES OF PNEUMONIA, HAEMOPHILUS INFLUENZAE AND STREPTOCOCCUS PNEUMONIAE WITHIN THE SEVERE RESPIRATORY ILLNESS SURVEILLANCE PROGRAMME, 2013 Maimuna

More information

Upper...and Lower Respiratory Tract Infections

Upper...and Lower Respiratory Tract Infections Upper...and Lower Respiratory Tract Infections Robin Jump, MD, PhD Cleveland Geriatric Research Education and Clinical Center (GRECC) Louis Stokes Cleveland VA Medical Center Case Western Reserve University

More information

LEARNING FROM OUTBREAKS: SARS

LEARNING FROM OUTBREAKS: SARS LEARNING FROM OUTBREAKS: SARS IFIC - APECIH 2017 KATHRYN N. SUH, MD, FRCPC 29 SEPTEMBER 2017 www.ottawahospital.on.ca Affiliated with Affilié à SEVERE ACUTE RESPIRATORY SYNDROME (SARS) Nov 2002 southern

More information

No :

No : No.40 / - http://www.who.int/wer :( )..... ( ). / http://www.who.int/immunization/documents/positionpapers/en/index.html. :. ( ). ( ) ). (.... 1 .. (

More information

INTRODUCTION. Diphtheria is a widespread severe infectious disease that has the potential for causing epidemics.

INTRODUCTION. Diphtheria is a widespread severe infectious disease that has the potential for causing epidemics. DIPHTHERIA 1 INTRODUCTION Diphtheria is a widespread severe infectious disease that has the potential for causing epidemics. Clinical description: An illness characterized by laryngitis or pharyngitis

More information

TEMPORARY PROGRAMME PERTUSSIS VACCINATION FOR PREGNANT WOMEN

TEMPORARY PROGRAMME PERTUSSIS VACCINATION FOR PREGNANT WOMEN TEMPORARY PROGRAMME PERTUSSIS VACCINATION FOR PREGNANT WOMEN Richard Smithson Neil Irvine Maureen McCartney Consultant Health Protection October 2012 Pertussis/whooping cough The disease Whooping Cough

More information

Bacterial infections Diphtheria, Pertussis and Enteric fever. Dr Mubarak Abdelrahman Assistant Professor Jazan University

Bacterial infections Diphtheria, Pertussis and Enteric fever. Dr Mubarak Abdelrahman Assistant Professor Jazan University Bacterial infections Diphtheria, Pertussis and Enteric fever Dr Mubarak Abdelrahman Assistant Professor Jazan University Gram negative: Diplococci Bacilli Coccobacilli Gram Positive: Diplococci Chains

More information

Clinical and Public Health Impact of Nucleic Acid Amplification Tests (NAATs) for Tuberculosis

Clinical and Public Health Impact of Nucleic Acid Amplification Tests (NAATs) for Tuberculosis Clinical and Public Health Impact of Nucleic Acid Amplification Tests (NAATs) for Tuberculosis Amit S. Chitnis, MD, MPH; Pennan M. Barry, MD, MPH; Jennifer M. Flood, MD, MPH. California Tuberculosis Controllers

More information

Adult pertussis is unrecognized public health problem in Thailand

Adult pertussis is unrecognized public health problem in Thailand Siriyakorn et al. BMC Infectious Diseases (2016) 16:25 DOI 10.1186/s12879-016-1357-x RESEARCH ARTICLE Open Access Adult pertussis is unrecognized public health problem in Thailand Nirada Siriyakorn 1,2,

More information

Health Professionals Advice: Summer

Health Professionals Advice: Summer Health Professionals Advice: Summer 2013-2014 SITUATION UPDATE The Pertussis epidemic which began in May 2011 has continued all year, without any sign of abating. Between 1 January and 10 December 2013

More information

Disclosures. Objectives. Epidemiology. Enterovirus 68. Enterovirus species 9/24/2015. Enterovirus D68: Lessons Learned from the Frontline

Disclosures. Objectives. Epidemiology. Enterovirus 68. Enterovirus species 9/24/2015. Enterovirus D68: Lessons Learned from the Frontline Enterovirus D68: Lessons Learned from the Frontline Disclosures Jennifer Schuster, MD MSCI Children s Mercy Hospital Pediatric Infectious Diseases September 16, 2015 I have nothing to disclose I do not

More information

TB & HIV CO-INFECTION IN CHILDREN. Reené Naidoo Paediatric Infectious Diseases Broadreach Healthcare 19 April 2012

TB & HIV CO-INFECTION IN CHILDREN. Reené Naidoo Paediatric Infectious Diseases Broadreach Healthcare 19 April 2012 TB & HIV CO-INFECTION IN CHILDREN Reené Naidoo Paediatric Infectious Diseases Broadreach Healthcare 19 April 2012 Introduction TB & HIV are two of the leading causes of morbidity & mortality in children

More information

Upper Respiratory Infections. Mehreen Arshad, MD Assistant Professor Pediatric Infectious Diseases Duke University

Upper Respiratory Infections. Mehreen Arshad, MD Assistant Professor Pediatric Infectious Diseases Duke University Upper Respiratory Infections Mehreen Arshad, MD Assistant Professor Pediatric Infectious Diseases Duke University Disclosures None Objectives Know the common age- and season-specific causes of pharyngitis

More information

ACCP Evidence-Based Clinical Practice Guidelines

ACCP Evidence-Based Clinical Practice Guidelines Postinfectious Cough ACCP Evidence-Based Clinical Practice Guidelines Sidney S. Braman, MD, FCCP Background: Patients who complain of a persistent cough lasting > 3 weeks after experiencing the acute symptoms

More information

Trichinosis Table of Contents

Trichinosis Table of Contents Subsection: Trichinosis Page 1 of 9 Trichinosis Table of Contents Trichinosis Trichinosis (Trichinellosis) Fact Sheet Investigation of Trichinosis Surveillance Case Report (CDC 54.7) Subsection: Trichinosis

More information