Masters Thesis

Analysis of strategies and recommendations to combat the resurgence of Pertussis (Whooping Cough) Disease

Immunity to natural pertussis disease is not life-long and neither is the vaccine that has been developed and utilized to protect individuals from contracting this disease. For decades, a whole cell pertussis vaccine was used to combat disease with disease rates declining significantly in the 1950’s, 1960s, and 1970s. With increasing parental refusal because of the adverse effects from the vaccine, disease rates began to climb in the 1980 and 1990s. This led to the development of an acellular pertussis vaccine that was expected to be a solution to the problem; however, that did not turn out to be the case. Disease rates continued to climb, reaching epidemic proportions in the past decade and a half. Because of the resurgence of pertussis disease, it is apparent that current recommendations are not enough to combat this disease and new strategies/recommendations need to be explored. A review of current pertussis strategies was completed, utilizing studies conducted within the past two decades to ascertain if the current strategies are working, especially since the use of the acellular vaccine. There appears to be multiple factors playing a role in the resurgence of this disease and new ideas are needed if there is every going to be talk of eradicating this disease in the U.S. or worldwide. This paper proposes several recommendations that can influence the disease burden and help to reduce and/or eliminate disease. The recommendations are as follows: 1) In addition to the 11-12 year old booster dose, adding a booster dose of vaccine for children 7-8 years of age, since in recent years the disease burden has shifted to the 7-10 age group; 2) Adding an adult booster every 5 years since more and more disease is being diagnosed in this age group; and 3) development of a better acellular product, one containing currently circulating strains of the pertussis bacteria.

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