Pertussis disease in new mothers: effect on young infants and strategies for prevention.
ABSTRACT Pertussis, or whooping cough, is a major public health problem in the United States, with the incidence of disease and its associated complications having significantly increased in the adolescent and adult populations. These populations serve as the major transmission source of the disease to young infants, a group that is at the highest risk of severe morbidity and mortality from the disease. Studies have shown that new parents, especially mothers, are the source of disease transmission in more than 50% of the cases. Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis booster vaccines (Tdap) are licensed for use in adolescent and adult populations. The Centers for Disease Control and Prevention (CDC) recommends that the Tdap vaccine be given to postpartum women as soon as possible after delivery and before hospital discharge to protect them and their newborns against pertussis disease. The American College of Obstetricians and Gynecologists recommends that its membership follow the CDC recommendations. This article includes a further discussion of the rationale for this recommendation and provides possible strategies for vaccine implementation.
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ABSTRACT: There is a substantial gap between those people in the United States who identify as being favorable toward organ donation (~90%) and those registered as donors (~30%). A growing body of evidence suggests Department of Motor Vehicles (DMV) offices are effective sites for facilitating higher organ donor registration rates on a national scale. The goal of the current study was to determine the utility and sustainability of a message immediacy approach, which draws from theoretical concepts such as priming and cues to action. Message immediacy requires individuals be: (a) exposed to a message that prompts an action, (b) in an environment where a prescribed action or behavior can be enacted, and (c) favorable toward the promoted behavior or action. Thirty-four Michigan counties, divided into three implementation groups, received campaigns in October (Group 1), November (Group 2), and December (Group 3) of 2009. Registration rates for three to six months after campaign implementation indicate that the on-site message prompts almost doubled registration rates in DMV offices. Additionally, preliminary cost-effectiveness evidence suggests message immediacy offers a relatively inexpensive campaign strategy.Journal of Applied Communication Research 08/2012; 40(3). · 0.68 Impact Factor
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ABSTRACT: Pertussis is an acute infectious illness, caused by the bacteria Bordetella pertussis and commonly known as "whooping cough". Waning immunity after vaccination or after natural infection contributes significantly to the increasing incidence rates in adolescents and adults. Prevention of pertussis in industrialized countries is mainly based on immunization with acellular vaccines in combination with other antigens. A booster dose with an adult-formulation tetanus-diphtheria toxoid and acellular pertussis vaccine (Tdap) is now recommended for all adolescents by several countries, and replacement of the decennial Td dose with a single or more doses of Tdap is recommended for adults. Our review aims at describing the current knowledge on the impact of acellular pertussis vaccination in adolescents and adults, with particular focus on specific risk groups: adolescents, pregnant women and their newborns, and health care workers (HCWs), and secondly at suggesting possible immunization strategies. Data were retrieved by searches of Pubmed, references, from relevant articles and open-access websites. In countries where an adolescent booster dose was adopted, a certain decrease of incidence rates was observed. No serologic correlate of protection after immunization exists, but subjects with high antibody levels against pertussis antigens are less likely to develop the disease. Tdap vaccine was demonstrated to induce antibodies to pertussis antigens exceeding those associated with efficacy in infants, in both adolescents and adults. Tdap use in pregnant women seems to be safe and might represent a useful tool in order to prevent pertussis cases in the first months of life. Neonatal immunization with monovalent acellular pertussis vaccine can efficiently prime T and B cells and act as a basis for future immune responses. Cocooning strategies involving all those surrounding newborns have started to be implemented. Their impact on infant pertussis cases will be evaluated in the coming years. Coverage in HCWs should be increased, given their important role in pertussis transmission in health care settings. Despite the more recent position paper of WHO gives priority to infant and childhood vaccination against pertussis and leaves adolescent, adult and risk group immunization as an option for the future, data are quickly accumulating to support the need to consider pertussis vaccination as a crucial preventative intervention even in adolescents and special risk groups.Vaccine 06/2012; 30(35):5179-90. · 3.49 Impact Factor