Published Date: 2012-05-23 21:11:07
Subject: PRO/EDR> Pertussis - Canada (04): (NB)
Archive Number: 20120523.1142647
PERTUSSIS - CANADA (04): (NEW BRUNSWICK)
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Wed 23 May 2012
From: Noortje Kunnen <Noortje.Kunnen@gnb.ca>
New Brunswick Department of Health [edited]
Since January 2012, New Brunswick (NB) has been experiencing an outbreak of pertussis. As of 22 May 2012, 548 confirmed cases have been reported to Public Health which is a significant increase compared with recent non-outbreak years (the last provincial outbreak In New Brunswick was reported in 2004 with 300 cases).
The outbreak is concentrated largely in the urban and surrounding areas of Moncton and Saint John, which are located in Health Region 1 and Health Region 2 of New Brunswick respectively. Approximately 53 percent of the cases are residents of Health Region 1 and 18 percent of the cases are from Health Region 2. A map outlining the 7 Health Regions of the Province can be found at: http://www.statcan.gc.ca/pub/82-583-x/2010001/article/11222-eng.pdf. However, cases continue to be reported in other areas of the province.
The highest proportion of cases are in children aged 10-14 years (47 percent of the cases), followed by people aged 20 years and up (19 percent of the cases), children aged 5-9 years (16 percent of the cases); adolescents aged 15-19 years (8 percent of the cases); children aged 1-4 years (6 percent of the cases) and infants under 1 year of age (3 percent of the cases). The highest rate of disease is in the 10-14 year age group (637 per 100 000); followed by 5-9 year olds (242 per 100 000); less than one year old (227 per 100 000); 1-4 year olds (114 per 100 000); 15-19 (93 per 100 000); and 20+ (18 per 100 000).
In New Brunswick pertussis containing vaccines are provided as primary series at 2, 4, 6 months of age; a booster at 18 months of age and between 4 and 6 years of age. 2 doses of vaccine are recommended for adolescents and adults. Most of the cases in the 10-14 age group (68 percent) and 4-9 age group (59 percent) have been immunized with 5 doses of pertussis containing vaccine: the primary series; the booster and the dose at 4-6 years.
The New Brunswick Office of the Chief Medical Officer of Health together with Regional Health Authorities implemented measures to improve immunization coverage of individuals who were not immunized in the last 5 years and who are in close contact with infants under one year of age and pregnant women. Immunization of pregnant women or postpartum immunization of mothers is recommended. A school-based Tdap immunization program for students in grades 6, 7 and 8 in the most affected areas is starting imminently to prevent the continued rise of pertussis in school age children and to further interrupt the transmission to infants. Students in less affected areas will be offered immunization in the 2012-2013 school year.
More information regarding the Pertussis outbreak, advice to physicians and the public is available at the Office of the Chief Medical Officer of Health website: http://www2.gnb.ca/content/gnb/en/departments/ocmoh/cdc/content/whooping_cough.html
Senior Program Advisor
Communicable Disease Control Unit
Office of the Chief Medical Officer of Health
Department of Health
Government of New Brunswick, Canada
[Pro-MED sincerely thanks Noortje Kunnen from the New Brunswick Department of Health for this 1st-hand report of pertussis in New Brunswick. As seen in the statistics, those 20 years old or older had the lowest rate of disease. It would be interesting to divide this group further to assess if there is any evidence that those immunized with the older killed, whole cell vaccine had a lower rate than those immunized with the acellular toxoid vaccine. - Mod.LL
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1GBH.]