Risk Factors for Community- and Household-Acquired Pertussis During a Large-Scale Outbreak in Central Wisconsin

• Published in: The Journal of infectious diseases Vol. 157; no. 6; pp. 1134 - 1141
• Main Authors: Biellik, Robin J., Patriarca, Peter A., Mullen, John R., Rovira, Elizabeth Z., Brink, Edward W., Mitchell, Paul, Hamilton, Gurdon H., Sullivan, Bradley J., Davis, Jeffrey P.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.06.1988; University of Chicago Press
• Subjects: Adolescent; Adolescents; Adult; Age Factors; Bacterial diseases; Bacterial diseases of the respiratory system; Biological and medical sciences; Bordetella pertussis; Child; Child, Preschool; Children; Disease Outbreaks; Diseases; Epidemiology; Erythromycin - therapeutic use; Female; Human bacterial diseases; Humans; Immunization; Infant; Infections; Infectious diseases; Male; Medical sciences; Middle Aged; Original Articles; Predisposing factors; Risk Factors; Vaccination; Whooping cough; Whooping Cough - epidemiology; Whooping Cough - genetics; Whooping Cough - prevention & control; Wisconsin; Wisconsin; Human; Epidemic; United States; Respiratory disease; North America; Epidemiology; Whooping cough; Infection; America; Risk factor; Bacteriosis; ENT disease; Child; Wisconsin
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/157.6.1134

To identify risk factors associated with community- and household-acquired pertussis, we studied 61 households (HHs) with members with culture-positive illnesses and compared their characteristics with 58 neighborhood control-HHs and 62 randomly selected control-HHs. Case-HHs weremore likely than either control group to have members 12–18 y of age (P < .01); these individuals accounted for 34% of all primary cases. A history of exposure outside the home was the most important predictor of community-acquired infection (P < .001), with adolescents being at higher risk than other age-groups (odds ratio, 3.2; P < .001). After known exposure to a culture-positive case in the same HH, the risk of illness was unrelated to age; lengthy delays in initiating erythromycin therapy and prophylaxis were the only factors associated with secondary spread (P < .01). The risk of pertussis may be related more to the likelihood of exposure than to age-related increasesin susceptibility,and the risk can be reduced with appropriate use of erythromycin.