The clinical picture includes recurrent fever, lymphadenopathy, rash, meningoencephalitis and myocarditis. Travelers should take precautions to avoid insect bites. ProMED, November 5, 2000. Public health authorities are reporting that as of October 31, an epidemic of pertussis had caused 2553 cases in New South Wales since mid-2000, including 1 fatality. Although young infants generally have the highest incidence of pertussis and its complications, in this outbreak there have been more cases in teenagers and adults.
Pertussis is highly communicable and transmission usually occurs by the respiratory route.
The vaccine does not provide adequate protection against severe disease in infants until after the third injection at six months of age. No pertussis-containing vaccine is currently licensed for persons 7 years of age or older. Vaccine reactions are thought to be more frequent in older age groups, and pertussis-associated morbidity and mortality decrease with increasing age. The CDC recommends that erythromycin or trimethoprim-sulfamethoxazole prophylaxis be administered for 14 days to all household and other close contacts of persons with pertussis, regardless of age and vaccination status. Immunization Newsbriefs, October 30. 2000.