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Rebecca is a 19-year old college student. She lives in the dorm with her roommate, Sally. Shortly after Rebecca returned from Christmas vacation, she developed a fever and severe cough. Sally persuaded her to see a doctor. Because it was Saturday, Rebecca went to the ED of the local hospital. The physician there made a diagnosis of pertussis. Later that night he and the nurse in the ED became very busy with victims of a multivehicle accident. As a result, no one completed the health department form reporting Rebecca's pertussis until 2 days later. By the time a population health nurse contacted Rebecca to do pertussis case report, Sally and several other girls in Rebecca's dorm had also developed pertussis. Sally gave it to her boyfriend, who exposed those in his classes. One of the women in his English class just had a baby a month ago. 


The university has a policy that all students provide verification of immunizations on admission before enrolling in classes. The student health center reviews student immunization records and notifies student of any deficiencies. They do not, however, follow up on whether the deficient immunizations were obtained. There is also no mechanism for creating a registration hold for students with inefficient immunizations. A review of cases in this outbreak indicated that approximately three quarters of those affected, including the woman with the new baby, had not received a pertussis booster as adolescents and the remaining quarter had never been immunized for pertussis.

  1. In the context for this scenario, describe the pertussis pathogen in terms of what we know about the Stages in the Natural History of this disease. Refer back to the chapter on epidemiology for guidance & make sure to demonstrate your understanding of each stage as it relates to this condition and scenario. [11 points total; breakdown is indicated below] PLEASE HELP ME UNDERSTAND THE QUESTION

·   Susceptibility stage     [3 points]

·   Preclinical stage          [2 points]

·   Clinical stage            [3 points]

·   Resolution stage          [3 points]

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