4. PERTUSSIS BY THE NUMBERS
• Reported pertussis cases in 2014: 28,660
• Year-to-date 2015: 3,526 (MMWR)
• Massachusetts 2014: 247
• California epidemic, 2014: 9,935
• Worldwide: 17 million cases; 300,000 deaths annually. Infant deaths higher in developing
countries
• Number one cause of infant death: Pneumonia due to secondary infection
• Mean cost of hospital stay due to pertussis infection:
• Infants: $9,580
• Children (1-11yrs): $4,729
• Adolescents/Adults: $5,310
• Average missed work days due to infection: 9.8
• If medically excluded: 21 days from onset of cough (or 5 days after antibiotics)
7. CHALLENGES
• The numbers of reported cases of pertussis per year do not seem that high,
relatively speaking.
• The biggest challenges facing pertussis control? Underreporting,
misdiagnosis, undiagnosed cases
• Pertussis in adults does not present typically; characteristic ‘whoop’
sometimes absent
• Specific laboratory testing for pertussis diagnosis, cases not confirmed until
laboratory results are available
• PCR (Polymerase Chain Reaction)
• Vaccination, education and awareness are the front lines of defense in
lowering pertussis incidence rates
9. 9
Framingham
Restaurant
Framingham
Worksite
PublicFramingham
Schools
Framingham BOH
MDPH
TdaP
Call providers: vaccination history
on high risk
Call case: family, significant others
Call from SLI to BOH + PCR for
Pertussis
Arrange for immunization at
worksites
Receive confirmation with copy of
lab
Send sample letters for worksites
Contact case: ID employers: exclude
Call worksites: identify CC,
exclusions
Report to worksite on exclusions
Complete confidential case report
TdaP Clinics at BOH office for public
10. GAP ANALYSIS- WHERE’S THE ISSUE?
• Significant hurdle: The unvaccinated
• Refusal to vaccinate based on philosophical reasons (other than medical/religious) =
not legal in MA!
• Currently, no legal ramification for not vaccinating for philosophical
reasons…should there be?
• Fear-mongering and myths prevail over data and facts
• Focus on the very small number of adverse event cases rather than the
millions who have been protected by the vaccine
• Too many relying on herd immunity instead of vaccinating…but not realizing that
herd immunity dwindles if not enough are vaccinated.
• 92-94% vaccination rate needed for pertussis herd immunity- recent
estimates show that only 21% of adults have received a Tdap booster
• Not enough adults knowing that a booster is important
• Just a plane ride away- unvaccinated/infected individuals traveling to and from USA
from endemic countries
11. GENZYME POPULATION RISK ASSESSMENT
• The population at Genzyme is at relatively high risk for pertussis infection!
• Exposure opportunities:
• Riding in the shuttle
• Meetings
• Break rooms
• Packed elevators
• Secondary attack rate is over 80% in non-immune household contacts (infants too young
to receive vaccine, the immunocompromised, or those for whom the vaccine is not
medically possible)
• Surfaces where droplets have landed are also contaminated
• IF YOU GET IT AT WORK….YOU WILL SHARE IT AT HOME!!
12. WHAT CAN YOU DO?
Get a Booster: Our parent company, Sanofi, is one of the leading manufacturers of Tdap
(Adacel)- the vaccine for adults to protect against Whooping Cough- and it is available at all
MA site Occupational Health Centers at no cost to employees!
Talk with your healthcare provider to discuss vaccine recommendations for you and your
family, or to address your questions/concerns regarding vaccination.
Be conscious: Cover your mouth and/or nose when you cough or sneeze, watch what you
touch, wash your hands frequently, stay home and recuperate if you are sick. If possible, limit
contact with infants, young children, the immunocompromised or the elderly when sick.
Protect yourself, and in turn, protect your family and loved ones!
Encourage vaccination and educate yourself and others on the dangers of pertussis.
13. TDAP BOOSTER CLINIC
• For interested employees, a Tdap booster clinic will be held at the Genzyme Framingham
Occupational Health Center on the following dates:
• Monday, April 6 10am-12pm
• Thursday, April 9 12pm-2pm
• Please call the Health Center at (508) 271-9800 to make an appointment so
adequate supply of boosters is on hand.
