Clin Exp Vaccine Res.  2018 Jan;7(1):70-75. 10.7774/cevr.2018.7.1.70.

Outbreak investigation of pertussis in an elementary school: a case-control study among vaccinated students

Affiliations
  • 1Division of Infectious Disease Control, Gyeonggi Provincial Government, Suwon, Korea.
  • 2Department of Epidemiology and Medical Informatics, Graduate School of Public Health, Korea University, Seoul, Korea. chun@korea.ac.kr
  • 3Office of Preventive Medicine, Centers for Disease Control, Taipei, Taiwan.
  • 4Department of Public Health Policy, Osan Public Health Center, Osan, Korea.
  • 5Division of Infectious Disease Research, Gyeonggi Province Institute of Health and Environment, Suwon, Korea.
  • 6Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
A pertussis patient from an elementary school, in Gyeonggi Province, Korea, was notified to public health authority on July 25, 2017. Epidemiologic investigation was conducted to identify the magnitude, possible source of infection and risk factors for this outbreak on August 17, 2017.
MATERIALS AND METHODS
A case was defined as the school student experiencing cough for more than two weeks with or without paroxysmal, whoop, or post-tussive vomiting. Control was defined as the student polymerase chain reaction-negative at the school. School based surveillance was implemented to identify additional cases.
RESULTS
From June 29 to August 27, 2017, nine patients of pertussis were identified from an elementary school. Among nine cases, eight were confirmed by polymerase chain reaction positive. All cases had cough, one (11%) had post-tussive vomiting, and one (11%) had fever. Eight cases had macrolide for 7 days in outpatient clinic, and one case admitted in a hospital. There was no significant difference of demographic factors including gender (p=0.49), age group (p=0.97), number of series of vaccination of pertussis (p=0.52), the number of participation of after school activity (p=0.28), and the time elapsed since last vaccination (p=0.42). However, we found the history of contact within the classroom or after-school activity was only the independent risk factor among all the demographic factors collected (odds ratio, 63.61; 95% confidence interval, 4.35 to 930.79).
CONCLUSION
The contributing factor for transmission is associated with the case-contact. Immediate identification of pertussis with use of appropriate diagnostic test may help to avoid a large number of cases.

Keyword

Pertussis; Disease outbreaks; Surveillance; Vaccines

MeSH Terms

Ambulatory Care Facilities
Case-Control Studies*
Cough
Demography
Diagnostic Tests, Routine
Disease Outbreaks
Fever
Gyeonggi-do
Humans
Korea
Polymerase Chain Reaction
Public Health
Risk Factors
Vaccination
Vaccines
Vomiting
Whooping Cough*
Vaccines

Figure

  • Fig. 1 The number of pertussis case patients during an outbreak in an elementary school: Osan City, Gyeonggi Province, Republic of Korea by epidemiologic weeks of the onset date of symptom from 26 of 2017 to 34 of 2017 and the date of case-notification from physicians.


Cited by  2 articles

Seroprevalence of Pertussis in Healthcare Workers without Adult Pertussis Vaccine Use at a University Hospital in Korea
Won Suk Choi, Su Hyun Kim, Dae Won Park
J Korean Med Sci. 2018;33(50):.    doi: 10.3346/jkms.2018.33.e321.

Immunogenicity and Safety of a Newly Developed Tetanus-Diphtheria Toxoid (Td) in Healthy Korean Adolescents: a Multi-center, Randomized, Double-blind, Active-Controlled Phase 3 Trial
Ui Yoon Choi, Ki Hwan Kim, Jin Lee, Byung Wook Eun, Hwang Min Kim, Kyung-Yil Lee, Dong Ho Kim, Sang Hyuk Ma, Jina Lee, Jong-Hyun Kim
J Korean Med Sci. 2021;36(49):e313.    doi: 10.3346/jkms.2021.36.e313.


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