Levri Kara M, Reynolds Laura, Liko Juventila, Dott Mary, Robinson Byron F, Cieslak Paul R
From the *Acute and Communicable Disease Prevention Section, Oregon Public Health Division, Portland, OR; †Epidemiology Workforce Branch, Centers for Disease Control and Prevention, Atlanta, GA; ‡Communicable Disease Services, Multnomah County Health Department, Portland, OR; and §Oregon Immunization Program, Oregon Public Health Division, Portland, OR.
Pediatr Infect Dis J. 2016 May;35(5):488-93. doi: 10.1097/INF.0000000000001061.
In 2012, Oregon observed its highest numbers of reported pertussis cases since 1953. The greatest morbidity occurred among infants <6 months of age, with higher rates among Hispanics than non-Hispanics. To explain this disparity, we analyzed pertussis surveillance data.
An analysis was conducted among infants <6 months of age in the Portland metropolitan area during 2010-2012. Characteristics examined were ethnicity (Hispanic or non-Hispanic), household size (>4 or ≤4 persons), pertussis vaccination status (upto-date or not up-to-date for age), child care center attendance (yes or no), infant birth weight (<2500 or ≥2500 g) and maternal age (<20 or ≥20 years).
Eighty-two infants <6 months of age with pertussis were identified. Twenty-eight case-infants (34%) were Hispanic, and 54 (66%) were non-Hispanic. By ethnicity, infants with pertussis were similar in illness confirmation method, sex, age, hospitalization status, vaccination status, child care center attendance, infant birth weight and maternal age. Hispanic infants were more likely than non-Hispanic infants to live in households with >4 persons. Univariate analysis showed Hispanic infants had approximately 2.3 times the risk for pertussis, compared with non-Hispanic infants, and infants living in households >4 persons had approximately 2.4 times the risk for illness, compared with those in households with <4 persons; stratified risk ratios did not differ between Hispanic (2.4; confidence interval: 1.0-5.7]) and non-Hispanic infants (2.0; confidence interval: 1.2-3.5).
A household size of >4 persons is a potential risk factor for pertussis; the magnitude of this risk is similar for Hispanic and non-Hispanic infants.
2012年,俄勒冈州报告的百日咳病例数为1953年以来最多。发病率最高的是6个月以下的婴儿,西班牙裔婴儿的发病率高于非西班牙裔婴儿。为了解释这种差异,我们分析了百日咳监测数据。
对2010 - 2012年波特兰市区6个月以下的婴儿进行分析。研究的特征包括种族(西班牙裔或非西班牙裔)、家庭规模(>4人或≤4人)、百日咳疫苗接种状况(是否按年龄接种)、是否参加日托中心(是或否)、婴儿出生体重(<2500克或≥2500克)以及母亲年龄(<20岁或≥20岁)。
共确定了82例6个月以下患百日咳的婴儿。28例(34%)病例婴儿为西班牙裔,54例(66%)为非西班牙裔。按种族划分,患百日咳的婴儿在疾病确诊方法、性别、年龄、住院状况、疫苗接种状况、是否参加日托中心、婴儿出生体重和母亲年龄方面相似。西班牙裔婴儿比非西班牙裔婴儿更有可能生活在人口>4人的家庭中。单因素分析显示,与非西班牙裔婴儿相比,西班牙裔婴儿患百日咳的风险约为2.3倍;与4人以下家庭的婴儿相比,生活在4人以上家庭的婴儿患病风险约为2.4倍;西班牙裔婴儿(2.4;置信区间:1.0 - 5.7)和非西班牙裔婴儿(2.0;置信区间:1.2 - 3.5)的分层风险比无差异。
家庭人口>4人是百日咳的一个潜在危险因素;西班牙裔和非西班牙裔婴儿的这种风险程度相似。