Exploration of Contributing Factors in the Rise of Bordetella Pertussis Incidence Open Access

Abstract

Infectious diseases were once the leading cause of mortality in the United States. The discovery of vaccines, in addition to other public health advances, have reduced the impact of infectious diseases significantly; reducing the case count to zero for some of the diseases. Unfortunately, the incidence of many of these vaccine preventable diseases are on the rise again with many contributing factors. In this study, the pertussis outbreak in California in 2010 is used to explore contributing factors to the rise of cases.

Although the incidence of Bordetella pertussis is nowhere near where it was before the development of vaccines, there is reason to be concerned about the recent rise in incidence. The rate of pertussis incidence in 2012 was higher than any year since 1955 and 2014 is on track to be another record year with 17,325 cases reported from January 1^st through August 16, 30% higher than the same period in 2013. There are many factors which contribute to the continued rise in incidence. Using the California 2010 Outbreak, this study will explore some of those factors including problems with diagnosis, efficacy of the current vaccines, changes in pertussis itself, potential waning of vaccine protection, vaccine uptake and exemptions, and the influence of providers. Each of these plays a role in contributing to pertussis incidence.

Table of Contents

Table of Contents Section Page

Definition of Terms

2 Introduction 5 Methodology 11 Background 12

Problems with Detection/Diagnosis

24

Efficacy of Acellular Pertussis Vaccines/Changes in Pertussis

28

Potential Waning of Vaccine Protection

32

Vaccine Uptake/Vaccine Exemptions/ Provider Influence

41

Discussion and Conclusion

45

Future Research

49 References 51

About this Master's Thesis

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School	Rollins School of Public Health
Department	Career Masters of Public Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Education Health Sciences, Public Health
Keyword	Bordetella pertussis vaccination incidence rise
Committee Chair / Thesis Advisor	Miner, Kathleen R, Emory University
Committee Members	Orenstein, Walter, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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