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Title: Could this pertussis outbreak be due to cold chain disruption in Harper, Maryland County, May - June 2019?Authors: Harrison T. Duo1, Peter Adewuyi2, Joseph Mah1, Dedesco D. Gweh1, Roland Beyan1,National Public Health Institute of Liberia/Ministry of Health Partners in Health, LiberiaWorld Health OrganizationAFENET LiberiaEmails: harrisontduo@ / harrisontduo@Introduction:Pertussis is a contagious bacterial infection transmitted through airborne droplets of infected individuals. While complication and fatality rates are low, Pertussis outbreaks are clear indications of low vaccine coverage, as the pentavalent vaccine effectively prevents the disease. On May 15, 2019, the DSO of Harper was informed of pertussis cases in three communities. A team dispatched May 16, 2019 with the objectives to verify the rumor, establish the cause and to take all necessary actions to control the outbreak. MethodThe outbreak occurred in a catchment of a clinic in Harper District, the clinic has nine catchment communities with estimated population of 3,890 inhabitants.? We interviewed staff of the clinic, developed outbreak case definition, conducted active case search, line-listed cases with contacts, and conducted treatment and immunization outreach in affected communities.ResultsA total of 46 cases with 91 contacts were line-listed from two communities. During intervention, total of 128 cases were identified from 7 communities in and out of the clinic catchment, and treated with antibiotic and antipyretic. Attack rate was 33 per 1,000 population. Of all 128 cases, 29 (23%) children under 1yr and 48 (38%) women of childbearing age were vaccinated. Age affected range from 8 months to 65 years, 96% accounted for children 1yr to 15yrs while male accounted for 54%. The cause of the outbreak was not established, however, it may have been contributed by the clinic Fridge being down from November 2018 to February 2019, furthermore the clinic being closed from December 2018 to February 2019 for some spiritual reasons.ConclusionThis is a clinically confirmed outbreak of pertussis that occurred in Harper District affecting many communities. Male and age group 1 to 15years were mainly affected. Vaccine coverage was very low among cases. The possible risk factor could have been because the clinic was closed and cold chain disruption for a period last year.Keywords: Pertussis, outbreak ................
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