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| Impact of antivaccine movements |
A study was undertaken to compare the prevalence of pertussis in countries that maintain high vaccination rates with those that have lower rates due to antivaccine movements. In the countries where vaccination has been maintained such as the United States, Hungary, Poland, and the former East Germany, the incidence of pertussis was 10 to 100 times lower than in countries where immunization has waned. These countries include Sweden, Japan, the United Kingdom, the Russian Federation, Ireland, Italy, the former West Germany, and Australia.
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Treatment and protection
Treatment of pertussis generally is supportive care, along with erythromycin as the antibiotic of choice. It has varying effectiveness in reducing symptoms, but aids in eradication of B. pertussis from secretions, thus reducing infectivity. Because of the high degree of communicability, a 14-day course of the medication for household and close contacts of those with pertussis is recommended as chemoprophylaxis, even for those previously vaccinated.2 If erythromycin is not tolerated or contraindicated, trimethoprim-sulfamethoxazole is an alternative.1
Priorities
The reemergence of pertussis is another example of a contagious illness that can go undetected and spread quickly. Nurses must make it a priority to protect themselves and others from this and other respiratory illnesses. (See “Respiratory Etiquette” sidebar.)
Patients with suspected or confirmed pertussis should be placed on droplet precautions in addition to standard precautions. Public health officials should be notified as soon as possible to aid in tracing contacts and providing chemoprophylaxis.
Pertussis 2003 Outbreak Digest
Source: 2003 CDC Pertussis Surveillance Data.
Click here to view larger table.
(144K, requires Adobe Acrobat).
Barbara Barzoloski-O’Connor, RN, MSN, is a contributing writer to Nursing Spectrum.
References
1. Guidelines for the control of pertussis outbreaks. CDC website . Available at www.cdc.gov. Accessed October 11, 2004.
2. The Pink Book – Pertussis. CDC website. Available at: www.cdc.gov/nip/publications/pink/pert.pdf. Accessed October 11, 2004.
3. Fatal case of unsuspected pertussis diagnosed from a blood culture — Minnesota, 2003. CDC website. Available at www.cdc.gov/mmwr/ preview/mmwrhtml/mm5306a5.htm. Accessed October 11, 2004.
4. Diphtheria, tetanus, and pertussis: Recommendations for vaccine use and other preventive measures — Recommendations of the Immunization Practices Advisory Committee. CDC website. Available at www.cdc.gov/ mmwr/preview/mmwrhtml/00041645.htm. Accessed October 11, 2004. |
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