Finding the ‘who’ in whooping cough: vaccinated siblings are important pertussis sources in infants 6 months of age and under
DOI:
https://doi.org/10.33321/cdi.2014.38.35Keywords:
pertussis, whooping cough, infants, source, vaccination, immunisationAbstract
Objectives: To describe the epidemiology of pertussis, and to identify changes in the source of pertussis in infants 6 months of age and under, during the 2008–2012 epidemic in south metropolitan Perth.
Design and setting: Analysis of all pertussis cases notified to the South Metropolitan Population Health Unit and recorded on the Western Australian Notifiable Infectious Disease Database over the study period. Information on the source of pertussis was obtained from enhanced surveillance data.
Results: Notification rates were highest in the 5–9 years age group, followed by the 0–4 years and 10–14 years age groups. There was a significant increase in the proportion of known sources who were siblings from the early epidemic period of 2008–2010, compared with the peak epidemic period of 2011–2012 (14.3% versus 51.4%, p = 0.002). The majority of sibling sources were fully vaccinated children aged 2 and 3 years.
Conclusions: The incidence of pertussis was highest in children aged 12 years and under in this epidemic. At its peak, siblings were the most important sources of pertussis in infants 6 months and younger, particularly fully vaccinated children aged 2 and 3 years. Waning immunity before the booster at 4 years may leave this age group susceptible to infection. Even if cocooning programs could achieve full vaccination coverage of parents and ensure all siblings were fully vaccinated according to national schedules, waning immunity in siblings could provide a means for ongoing transmission to infants. Recent evidence suggests that maternal antenatal vaccination would significantly reduce the risk of pertussis in infants 3 months of age and under. Commun Dis Intell 2014;38(3):E195–
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NNDSS Annual Report Writing Group. Australia’s notifiable disease status, 2011: Annual report of the National Notifiable Diseases Surveillance System. Commun Dis Intell 2013;37(4):E313–E393.
Campbell P, McIntyre P, Quinn H, Hueston L, Gilbert GL, McVernon J. Increased population prevalence of low pertussis toxin antibody levels in young children preceding a record pertussis epidemic in Australia. PLoS One 2012;7(4):e35874.
Kaczmarek MC, Valenti L, Kelly HA, Ware RS, Britt HC, Lambert SB. Sevenfold rise in likelihood of pertussis test requests in a stable set of Australian general practice encounters, 2000–2011. Med J Aust 2013;198(11):624–628.
Spokes PJ, Quinn HE, McAnulty JM. Review of the 2008–2009 pertussis epidemic in NSW: notifications and hospitalisations. N S W Public Health Bull 2010;21(7–8):167–173.
Clarke MF, Rasiah K, Copland J, Watson M, Koehler AP, Dowling K, et al. The pertussis epidemic: informing strategies for prevention of severe disease. Epidemiol Infect 2013; 141(3):463–471.
Gabutti G, Rota MC. Pertussis: a review of disease epidemiology worldwide and in Italy. Int J Environ Res Public Health 2012;9(12):4626–4638.
Skoff TH, Cohn AC, Clark TA, Messonnier NE, Martin SW. Early impact of the US Tdap vaccination program on pertussis trends. Arch Pediatr Adolesc Med 2012;166(4):344.
Sheridan SL, Ware RS, Grimwood K, Lambert SB. Number and order of whole cell pertussis vaccines in infancy and disease protection.[Erratum in JAMA 2012;308(14):1432.] JAMA 2012;308(5):454–456.
Witt MA, Katz PH, Witt DJ. Unexpectedly limited durability of immunity following acellular pertussis vaccination in preadolescents in a North American outbreak. Clin Infect Dis 2012;54(12):1730–1735.
Witt MA, Arias L, Katz PH, Truong ET, Witt DJ. Reduced risk of pertussis among persons ever vaccinated with whole cell pertussis vaccine compared to recipients of acellular pertussis vaccines in a large US cohort. Clin Infect Dis 2013;56(9):1248–1254.
Lam C, Octavia S, Ricafort L, Sintchenko V, Gilbert GL, Wood N, et al. Rapid increase in pertactin-deficient Bordetella pertussis isolates, Australia. Emerg Infect Dis 2014;20(4):626–633.
Octavia S, Sintchenko V, Gilbert GL, Lawrence A, Keil AD, Hogg G, et al. Newly emerging clones of Bordetella pertussis carrying prn2 and ptxP3 alleles implicated in Australian pertussis epidemic in 2008–2010. J Infect Dis 2012;205(8):1220–1224.
Klein NP, Bartlett J, Rowhani-Rahbar A, Fireman B, Baxter R. Waning protection after fifth dose of acellular pertussis vaccine in children. N Engl J Med 2012;367(11):1012–1019.
Misegades LK, Winter K, Harriman K, Talarico J, Messonnier NE, Clark TA et al. Association of childhood pertussis with receipt of 5 doses of pertussis vaccine by time since last vaccine dose, California, 2010. JAMA 2012;308(20):2126–2132.
Sheridan SL, McCall BJ, Davis CA, Robson JM, Hull BP, Selvey CE, et al. Acellular pertussis vaccine effectiveness for children during the 2009–2010 pertussis epidemic in Queensland. Med J Aust 2014;200(6):334–338.
Wiley KE, Zuo Y, Macartney KK, McIntyre PB. Sources of pertussis infection in young infants: a review of key evidence informing targeting of the cocoon strategy. Vaccine 2013;31(4):618–625.
Government of Western Australia Department of Health. Population health statistics. [online] Accessed on 20 August 2013. Available from: http://www.public.health.wa.gov.au/3/1489/1/population_health_statistics.pm
Baxter R, Bartlett J, Rowhani-Rahbar A, Fireman B, Klein NP. Effectiveness of pertussis vaccines for adolescents and adults: case-control study. BMJ 2013;347:f4249.
Torvaldsen S, Simpson JM, McIntyre PB. Effectiveness of pertussis vaccination in New South Wales, Australia, 1996–1998. Eur J Epidemiol 2003;18(1):63–69.
Quinn HE, Snelling TL, Macartney KK, McIntyre PB. Duration of protection after first dose of acellular pertussis vaccine in infants. Pediatrics 2014;133(3):e513–E519.
Rohani P, Zhong X, King AA. Contact network structure explains the changing epidemiology of pertussis. Science 2010;330(6006):982–985.
Donnan EJ, Fielding JE, Rowe SL, Franklin LJ, Vally H. A cross sectional survey of attitudes, awareness and uptake of the parental pertussis booster vaccine as part of a cocooning strategy, Victoria, Australia. BMC Public Health 2013;13(1):676.
Rivero-Santana A, Cuéllar-Pompa L, Sánchez-Gómez LM, Perestelo-Pérez L, Serrano-Aguilar P. Effectiveness and cost-effectiveness of different immunization strategies against whooping cough to reduce child morbidity and mortality. Health Policy 2014;115(1):82–91.
de Greeff SC, Mooi FR, Westerhof A, Verbakel JM, Peeters MF, Heuvelman CJ, et al. Pertussis disease burden in the household: how to protect young infants. Clin Infect Dis 2010;50(10):1339–1345.
Healy CM, Rench MA, Baker CJ. Implementation of cocooning against pertussis in a high-risk population. Clinical Infect Dis 2011;52(2):157–162.
Western Australia Department of Health, South Metropolitan Public Health Unit. Review of notifiable diseases in the South Metropolitan Area Health Service – 2011. Perth: Department of Health Western Australia; 2012.
Jardine A, Conaty SJ, Lowbridge C, Staff M, Vally H. Who gives pertussis to infants? Source of infection for laboratory confirmed cases less than 12 months of age during an epidemic, Sydney, 2009. Commun Dis Intell 2010;34(2):116–121.
Amirthalingam G, Andrews N, Campbell H, Ribeiro S, Kara E, Donegan K, et al. Effectiveness of maternal pertussis vaccination in England: an observational study. Lancet 2014;doi:10.1016/S0140–6736(14)60686–60683.
Donegan K, King B, Bryan P. Safety of pertussis vaccination in pregnant women in UK: observational study. BMJ 2014;349:g4219.
Edwards KM, Berbers GA. Immune responses to pertussis vaccines and disease. J Infect Dis 2014;209(suppl 1):S10–S15.
Elliott E, McIntyre P, Ridley G, Morris A, Massie J, McEniery J et al. National study of infants hospitalized with pertussis in the acellular vaccine era. Pediatr Infect Dis J 2004;23(3):246–252.
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