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Pertussis cases reach epidemic proportions in California
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California has reported more than 800 cases of pertussis in the past 2 weeks, and the number of cases has reached epidemic proportions, according to the California Department of Public Health.
As of June 10, there have been 3,458 cases of pertussis reported to the California Department of Public Health (CDPH) in 2014, which is more cases than reported in the entire year of 2013.
“Preventing severe disease and death in infants is our highest priority,” Ron Chapman, MD, MPH, director of the CDPH, said in a press release. “We urge all pregnant women to get vaccinated and we urge parents to vaccinate infants as soon as possible.”
According to the release, pertussis peaks every 3 to 5 years. The last peak in California was in 2010, so it is likely the state is experiencing another peak.
The most vulnerable population is infants who are too young to be fully immunized. Most of the pertussis hospitalizations have been in children aged 4 months and younger. There have been two infant deaths reported. The best way to prevent the disease in infants is for pregnant women to receive the Tdap vaccine, which the Advisory Committee on Immunization Practices recommends for all pregnant women in the third trimester of each pregnancy, regardless of previous vaccination.
“Unlike some other vaccine-preventable diseases, like measles, neither vaccination nor illness from pertussis offers lifetime immunity,” Chapman said. “However, vaccination is still the best defense against this potentially fatal disease.”
Perspective
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Douglas M. Baker, MD
It comes as no surprise that there are outbreaks of pertussis like this. Anecdotally, it seems that there is less public diligence regarding vaccinations these days. We have seen occasional cases of pertussis in our own ED, some clustered.
One of the means of combating resurgence of the disease has been the almost uniform replacement of Td booster vaccinations in adolescents and adults with Tdap. Several years ago, the CDC began to recommend administration of a single dose of Tdap universally to replace one decennial Td booster and to replace Td for wound prophylaxis for adults of any age who did not receive Tdap previously. They further recommend that adults of any age who previously have not received Tdap, including adults who have or anticipate having close contact with an infant younger than 12 months of age, should be given a single dose of Tdap, with no minimum interval suggested or required between Tdap and prior receipt of a tetanus- or diphtheria-toxoid containing vaccine.
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