An Outbreak of Pertussis in Rural Texas: An Example of the Resurgence of the Disease in the United States

During 2012, an increase in the number of pertussis cases or outbreaks was reported among most states within the United States. The majority of these cases included previously vaccinated children between the ages of 7–10 years. This underscores the growing concern regarding current immunization practices and vaccine efficacy, especially as it pertains to pertussis prevention within this age group. In the fall of 2012, an outbreak of pertussis occurred within a school district in a rural Texas county that was reflective of this national pattern. Our objective is to describe this outbreak, highlight the similarities with the national trend, and identify strategies for better disease prevention. The cases in this outbreak were interviewed and laboratory testing done. Information regarding exposure and immunization history among cases was obtained. Immunization audits of the affected institutions were also conducted. We performed a descriptive analysis of the collected data using EPI-INFO software v. 3.5.3. A total of 34 cases were identified in this outbreak, of which 23 were PCR confirmed and 11 were epidemiologically linked. Ages ranged from 5 months to 12 years, and 62% were among children aged 7–10 years. All cases were up-to-date on their pertussis vaccinations. Immunization coverage rate was over 90% within each of the affected institutions. The characteristics of this outbreak bear striking similarities to the current national trend in terms of age groups and immunization status of the affected cases. Increased focus on this vulnerable target group, including heightened scrutiny of vaccine efficacy and delivery, is indicated.