CDC researchers are raising concerns because overall incidence of pertussis was higher (1.5-fold; 95% CI, 1.37-1.60) among Hispanic or Latino adults compared with non-Hispanic or non-Latino adults.
A report in Open Forum Infectious Diseases suggested that the reason for higher incidence rates could potentially be related to household size or lower pertussis vaccine uptake among adult Hispanic or Latino cases. The CDC study team noted that severe pertussis incidence was similar among black or African American and American Indian or Alaska Native (AI/AN) persons compared with white people.
“An increased pertussis burden has been demonstrated among Hispanic or Latino and American Indian or Alaska Native (AI/AN) infants. However, data on potential disparities among other age and racial groups are limited,” the researchers wrote.
In an attempt to find the reason for the disparities, the study team analyzed pertussis cases reported through Enhanced Pertussis Surveillance from 2010 to 2017. The researchers calculated pertussis and severe pertussis incidence by race (white, black, African American, AI/AN, and Asian or Pacific Islanders), ethnicity (Hispanic or Latino and non-Hispanic or non-Latino), and age.
“Compared with white persons, overall incidence was lower among black or African American (incidence rate ratio [IRR], .57; 95% confidence interval [CI], .53-.61), AI/AN (IRR, 0.65; 95% CI, .58-.72), and Asian or Pacific Islander persons (IRR, 0.39; 95% CI, .35-.43),” the authors noted. “Among infants, severe pertussis incidence was 1.4-fold higher (95% CI, 1.03-1.82) among black or African American infants than among white infants, and 2.1-fold higher (95% CI, 1.67-2.57) among Hispanic or Latino infants than non-Hispanic or non-Latino infants.”
The researchers concluded that the contrast between lower reported incidence but similar or higher severe pertussis incidence among black or African American and AI/AN patients compared with white patients “warrants further investigation and may reflect underdiagnosis or underreporting of mild disease.”
Background information in the article pointed out that pertussis, commonly referred to as whooping cough, is a highly contagious, vaccine-preventable disease caused by the bacterium Bordetella pertussis. Clinical manifestations of pertussis can vary from mild-cough illness to severe disease and death in infants, especially during the early months of the infant’s life.
The CDC authors warned that reported pertussis incidence in the United States had been increasing since the late 1980s until the start of the COVID-19 pandemic in 2020, with some large peaks in reported disease, despite stable or increasing pertussis vaccination coverage.
“In 2019, vaccine coverage was 90% with tetanus, diphtheria, and acellular pertussis vaccine among adolescents, whereas vaccine coverage with 4 doses of diphtheria, tetanus, and acellular pertussis-containing vaccine (DTaP) was 81% among 2-year-olds,” the researchers explained.
The researchers added that several studies have suggested differences in pertussis epidemiology by race and ethnicity in the U.S.
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