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From control to re-emergence - the story of pertussis

From control to re-emergence - the story of pertussis. Winter Scientific Meeting Wednesday, 5 th December 2012. Dr Suzanne Cotter Dr Sarah Gee (PhD) Dr Darina O’Flanagan Health Protection Surveillance Centre www.hpsc.ie. Background. Highly contagious respiratory disease

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From control to re-emergence - the story of pertussis

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  1. From control to re-emergence - the story of pertussis Winter Scientific Meeting Wednesday, 5th December 2012 Dr Suzanne Cotter Dr Sarah Gee (PhD) Dr Darina O’Flanagan Health Protection Surveillance Centre www.hpsc.ie

  2. Background • Highly contagious respiratory disease • “100 day cough” • Morbidity and mortality highest among infants • Estimated worldwide deaths > 300,000/yr • Vaccine-preventable

  3. Clinical Course (in weeks) Communicable period (onset to 3 weeks after start of paroxysmal cough) Incubation period (typically 5-10 days; max 21 days) Convalescent stage (weeks to months) Catarrhal stage (1-2 weeks) -3 0 2 8 12 Onset Paroxysmal stage (1-6 weeks) Source: ACIP May 2012. Stacey Martin. http://www.cdc.gov/vaccines/ed/ciinc/Pertussis.htm 3

  4. Trends Pertussis notifications, Ireland 1948- 2012* DTP replaced by DTaP Tdap booster *2012 data weeks 1-39

  5. Pertussis notifications, 2001-2012* 372 229 114 *2012 data weeks 1-39

  6. Pertussis notifications by week, 2009-2012* NW -Late notifications 2011-2012 East and other Pertussis outbreaks, Leitrim

  7. Pertussis notifications and rate per 100,000 population, by HSE area* *Data as of 4/10/2012 (n=376)

  8. Pertussis notifications, by HSE Area, Interpreted Overall Lab Result, 2012* (n= 372) *2012 data weeks 1-39

  9. Pertussis notifications, ASIR (/100,000) 2012* (n=372) *2012 data weeks 1-39

  10. Pertussis notifications, 2001-2012*ASIR (/100,000) *2012 data weeks 1-39

  11. Pertussis notifications by age group and vaccination status (n=372)* *2012 data weeks 1-39

  12. Pertussis cases <1 year of age, by age in weeks at onset date and number of doses of pertussis vaccine. (n=138) *2012 data weeks 1-39. Onset date available for 98 of 138 events < 1 year

  13. Reported fatalities, 2011-2012 • 2012 – 2 infant deaths • 2011 – 1 infant death

  14. Pertussis notifications, England and Wales 2005-2012 Year Source: HPA http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317136496345 14

  15. Australia 1991-2011 Disease Watch. March 2012, Volume 16, Issue 1 » Ongoing pertussis epidemic in Western Australia

  16. Summary • Increase in pertussis in Ireland similar to that seen in other countries • Waning immunity contributory factor • Additional control measures needed • Booster doses for adolescents and HCWs • Antenatal vaccination • Cocooning strategy (difficult) • Diagnosis, chemoprophylaxis of susceptible

  17. Acknowledgements • Departments of Public Health • Clinicians, microbiologists • Notifying GPs

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