An examination of the roles of serologic, geographic, and demographic factors on the recurrence of pertussis in Minnesota

Abstract

Pertussis (whooping cough) is a vaccine-preventable respiratory infection that can occur in all ages and can result in life threatening complications, particularly among infants. Although outbreaks have historically occurred cyclically every 2 to 5 years, recent outbreaks in the United States have been the largest on record since the 1950's despite high vaccination coverage. The effective control of pertussis is complicated by the inability to directly obtain true estimates of incidence and population immunity from surveillance data. Pertussis infections in adults and previously vaccinated children often have a mild presentation, which can result in undetected infections. Additionally, vaccine coverage is not a direct measure of immune status due to imperfect vaccine effectiveness, waning immunity, and natural boosting. Additional data sources and analyses are needed to better understand and ultimately disrupt the epidemic cycle of pertussis. This research (1) tests the feasibility of conducting a pertussis seroprevalence study in the University of Minnesota's Driven to Discover building at the Minnesota State Fair (2) identifies spatial and spatio-temporal clusters of pertussis vaccine exemptions and incidence in Minnesota, and (3) develops a model of pertussis transmission in Minnesota to explore the impact of model parameters on disease dynamics. The ability to predict the occurrence of an outbreak based on serologic, geographic, and/or demographic characteristics of a population may identify opportunities to implement supplementary prevention strategies.