Public Health: Pertussis Cases in Wisconsin

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Notes

The number of pertussis cases in Wisconsin started to increase rapidly, and DPH specialists had to take a range of measures to address the problem.

Situation

Who – health officers;

What – the outbreak of pertussis;

Where – Milwaukee and Waukesha;

When – in 2004;

Why –an outbreak of the disease in 2003;

How –staff and patient education, treatment guidelines, and improved testing.

Immediate issue

The number of people with pertussis was growing.

Basic issues

The lack of effective control and prevention strategy to protect citizens belonging to different age and income groups. At the same time, the symptoms of some infectious diseases can change over the years.

Problem

Steady growth of the incidence of pertussis. Importance: pertussis can cause breathing problems and cerebral blood flow problems. The problem was defined based on the discussion of pertussis incidence rates; this process was effective.

All team members should be equal partners during a discussion; even challenging ideas should be considered.

It would be important to know the number of cases of pertussis in different age groups.

Risk factors

Environmental (exposure to infected people), social (racial inequality, access to vaccines, age), economic (economic inequality).

Negative outcomes

Complications such as aphthae, vocal cord issues, an increased risk of cardiovascular diseases, ocular hypertension, etc.

Alternative strategies

Develop and enforce a plan immediately (vaccinations, accessible pertussis tests, hygiene-related education, and staff education).
Let each local health agency develop its own prevention strategy.

The preferred alternative is the first strategy that involves creating a plan at the beginning of the year. Focused attention must be paid to preventive measures to protect school students as children are susceptible to the disease (Ganeshalingham, McSharry, Anderson, Grant, & Beca, 2017). Also, educational measures helping people to recognize the disease and prevent its spread should be taken in relation to people from other age groups who have not come through the illness yet. The effectiveness of the vaccine should be increased as soon as possible. The strategy involves providing an immediate response, and this is why it can be expected to provide positive results.

Related issues

The issue is related to the growing number of cases of pertussis in two counties in Wisconsin. The problem that needs to be solved is related to additional difficulties as the way that the disease is manifested in children and adult patients have slightly changed, and there are numerous cases when its symptoms are atypical. What is more, cases of pertussis have started to occur even in those individuals who are fully immunized. The impact of the outbreak of the disease can be detrimental to the population’s health; even though pertussis can have no health consequences, its complications include various problems with the cardiovascular system, inflammations, cerebral hemorrhage, and hemophilia (Suryadevara et al., 2014). Even though fatal outcomes of the disease are not common, this risk still exists. The proposed strategy is to reduce the risk of pertussis and its complications for people of all ages. The desired end state is less than 30 cases of pertussis per year in both counties.

Action and implementation plan

Disseminate a written plan of action that includes preventive measures, tips on patient education, and measurable goals among healthcare specialists in both counties;
Design new educational materials on pertussis and hygiene measures and disseminate them among school communities in both counties; encourage teachers and school nurses to organize teacher-parent meetings devoted to the topic;
Inform the population about the atypical forms of the disease; provide more people with access to pertussis testing;
Define categories of people who have limited access to pertussis immunization services such as individuals with disabilities or senior citizens; develop alternative solutions to the problem;
Report new cases of the disease immediately.

Possible biases

Possible biases relate to the lack of information concerning the exact number of cases of the disease among children, adults, and older adults. Also, the divergence of opinions concerning the effective methods of pertussis prevention can impact the feasibility of the strategy. I do not think that my background and cultural identity have had a significant impact on decision-making. Nevertheless, I know many people who face socioeconomic inequality; due to that, I was focusing on advancing ideas of reducing risks for all groups of the population. As for the two concepts explained in the picture, our team was using them throughout the process in order to define the key trends that the alternative strategy should take into account and the relationships between different groups whose concerted efforts can address the problem. I suppose that the teamwork was successful as we have managed to reach an agreement concerning each question. Also, each point has been thoroughly discussed.

References

Ganeshalingham, A., McSharry, B., Anderson, B., Grant, C., & Beca, J. (2017). Identifying children at risk of malignant bordetella pertussis infection. Pediatric Critical Care Medicine, 18(1), e42-e47.

Suryadevara, M., Bonville, C. A., Cibula, D. A., Valente, M., Handel, A., Domachowse, J. R., & Domachowske, J. B. (2014). Pertussis vaccine for adults: Knowledge, attitudes, and vaccine receipt among adults with children in the household. Vaccine, 32(51), 7000-7004.

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