Patterns of Susceptibility in an Outbreak of <i>Bordetella pertussis</i>: Evidence from a Community‐Based Study
Notice bibliographique
Résumé
OBJECTIVE: To describe an outbreak of Bordetella pertussis and to assess which factors were associated with the development of clinical pertussis in children and adults during the outbreak. DESIGN: A case series was described to define the epidemiology of the pertussis outbreak. A school-based survey of children was used to measure the incidence of clinical pertussis over the previous six months. Vaccination records from the local public health facility were used to look at the relationship between age and vaccination parameters, and susceptibility to clinically diagnosed pertussis. A cross-sectional survey of teachers, parents and some hospital workers was used to assess these associations in adults. SETTING: An outbreak of pertussis in an isolated northern community in British Columbia. POPULATION STUDIED: All children in the community who attend daycare, kindergarten or school, and their parents were surveyed. In addition, some health care workers and mothers of preschool children were surveyed. MAIN RESULTS: A total of 31 suspected cases of pertussis were identified over a three-month period. Ninety per cent of the affected children who had available vaccination records had received four or five doses of pertussis vaccine. Sixty per cent of the town's 209 children returned completed surveys. Of these, 69% had available vaccination records. Thirty-six children (28%) reported symptoms that fit the case definition for pertussis over the previous three months. Attack rates were highest for the group of children aged 10 to 14 years. In a multivariate logistic regression analysis, receiving prophylactic medication and an increased number of years from the last vaccine dose were found to be significant predictors for developing pertussis. Thirty-four per cent of the estimated 291 adults in the community returned completed surveys. The attack rate of pertussis in the adults was only 9%. Being a member of the school staff and/or having a household contact with pertussis were significant predictors of developing pertussis. CONCLUSIONS: Immunity to pertussis appears to wane during childhood. Peak susceptibility appears to be during early adolescence. Adults do not seem to be at greater risk than adolescents for developing the disease, but it seems unlikely that this is due to better immunity. Rather, it is probably related to a lower risk of exposure to pertussis and a lower rate of progression to symptomatic disease when adults are infected.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,007 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».