Abstract
IntroductionOn April 17/2017 Janamora district, Amhara regional state health officials reported an increasing number of people with a cough. The objectives of this study was to investigate the outbreak, describe risk factors and implement control measures.MethodsWe conducted a community based unmatched 1:1 case-control study April 22-May 10, 2017. We used a probable case definition (≥2 weeks cough with vomiting, apnea, or inspiratory whoop) to identify suspected pertussis cases. Neighbors of cases were considered as controls. We conducted a door-to-door active case search and reviewed medical records, assessed vaccination status by parental interview or vaccination card. We implemented multivariable logistic regression to identify independent factors associated with the outbreak.ResultsWe investigated 60 cases and 60 controls. Most (68.3%) of the cases were under the age of 15. The majority (86.6%) of pertussis suspected cases, and 83.4% controls had not received any pertussis vaccine. The overall attack rate was 0.13% and the case fatality rate was 3.3%. The age-specific attack rate for under-five children was 0.33%. Females were more likely to have pertussis (AOR: 2.91; 95% CI: 1.17-7.22), contact with pertussis suspected person (AOR: 6.29; 95% CI: 2.53-15.62) and living in a relatively poorly ventilated house (AOR: 3.01; 95% CI: 1.17-7.70) were also significant risk factors of pertussis.ConclusionWeak supplementary immunization activities might have contributed to the outbreak. Treating household contacts and integration of diagnostic laboratory test of pertussis into the local health system is of paramount importance to detect outbreaks early on.
Highlights
Pertussis, known as "whooping cough," is a contagious, acute respiratory illness caused by the gramnegative Coccobacillus bacterium Bordetella pertussis [1,2,3,4] a fastidious, toxin-producing bacillus that causes damage to the respiratory tract and is characterized by intermittent paroxysms of severe coughing lasting from 6 to 10 weeks [4, 5].Pertussis is mainly transmitted by large droplet infection or direct contact with respiratory discharges [4, 6]
The outbreak occurred in Amhara National Regional State, Janamora district, Bahir Amba kebele which is one of the 34 rural kebeles found in the district
We identified a total of 60 suspected pertussis cases and 2 deaths were reported
Summary
Pertussis is mainly transmitted by large droplet infection or direct contact with respiratory discharges [4, 6]. Pertussis sometimes lacks fever and classically progresses through three stages [7,8,9,10]. Incomplete immunization puts children at greater risk of acquiring the disease [11]. The worldwide increase in vaccination coverage against pertussis has substantially reduced the morbidity and mortality associated with this disease [6, 12, 13]. Over 10 million cases and as many as 400,000 pertussis-related deaths occur annually, with 90%
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