Spatio-Temporal Comparison of Pertussis Outbreaks in Olmsted County, Minnesota, 2004-2005 and 2012: A Population-Based Study

dc.contributor.ORCID0000-0002-1428-1451 (Kim, D)
dc.contributor.authorWi, C. -I
dc.contributor.authorWheeler, P. H.
dc.contributor.authorKaur, H.
dc.contributor.authorRyu, E.
dc.contributor.authorKim, Dohyeong
dc.contributor.authorJuhn, Y.
dc.contributor.utdAuthorKim, Dohyeong
dc.descriptionSupplementary material is available on publisher's website. Use the DOI link below.
dc.description.abstractObjective: Two pertussis outbreaks occurred in Olmsted County, Minnesota, during 2004-2005 and 2012 (5-10 times higher than other years), with significantly higher incidence than for the State. We aimed to assess whether there were similar spatio-temporal patterns between the two outbreaks. Setting Olmsted County, Minnesota, USA Participants: We conducted a population-based retrospective cohort study of all Olmsted County residents during the 2004-2005 and 2012 outbreaks, including laboratory-positive pertussis cases. Primary outcome measure: For each outbreak, we estimated (1) age-specific incidence rate using laboratory-positive pertussis cases (numerator) and the Rochester Epidemiology Project Census (denominator), a medical record-linkage system for virtually all Olmsted County residents, and (2) pertussis case density using kernel density estimation to identify areas with high case density. To account for population size, we calculated relative difference of observed density and expected density based on age-specific incidence. Results: We identified 157 and 195 geocoded cases in 2004-2005 and 2012, respectively. Incidence was the highest among adolescents (ages 11 to <14 years) for both outbreaks (9.6 and 7.9 per 1000). The 2004-2005 pertussis outbreak had higher incidence in winter (52% of cases) versus summer in 2012 (53%). We identified a consistent area with higher incidence at the beginning (ie, first quartile) of two outbreaks, but it was inconsistent for later quartiles. The relative difference maps for the two outbreaks suggest a greater role of neighbourhood population size in 2012 compared with 2004-2005. Conclusions: Comparing spatio-temporal patterns between two pertussis outbreaks identified a consistent geographical area with higher incidence of pertussis at the beginning of outbreaks in this community. This finding can be tested in future outbreaks, and, if confirmed, can be used for identifying epidemiological risk factors clustered in such areas for geographically targeted intervention. © 2018 Author(s) (or their employer(s)).
dc.description.departmentSchool of Economic, Political and Policy Sciences
dc.description.sponsorshipCTSA Grant Number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH) and the resources of the Rochester Epidemiology Project (R01-AG34676) from the National Institute on Aging.
dc.identifier.bibliographicCitationWi, C. -I, P. H. Wheeler, H. Kaur, E. Ryu, et al. 2019. "Spatio-temporal comparison of pertussis outbreaks in Olmsted County, Minnesota, 2004-2005 and 2012: A population-based study." BMJ Open 9(5), doi: 10.1136/bmjopen-2018-025521
dc.publisherBMJ Publishing Group
dc.rightsCC BY-NC 4.0 (Attribution-NonCommercial)
dc.rights©2018 The Authors or their Employers
dc.source.journalBMJ Open
dc.subjectGeographical mapping
dc.subjectPublic health
dc.subjectWhooping cough
dc.subjectMinnesota--Olmsted County
dc.titleSpatio-Temporal Comparison of Pertussis Outbreaks in Olmsted County, Minnesota, 2004-2005 and 2012: A Population-Based Study


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