Nosocomial pertussis infection of infants: still a risk in 2009
DOI:
https://doi.org/10.33321/cdi.2010.34.43Keywords:
pertussis transmission, neonates, infants, health care worker, outbreakAbstract
The Sydney West Centre for Population Health investigated a confirmed pertussis infection in a health care worker on a maternity ward and identified pertussis infection in 4 neonates cared for by this case. This report describes the public health intervention to identify and prevent further cases. Of the 4 neonates, three were laboratory-confirmed cases and one was diagnosed on clinical grounds alone. All were cared for by the infected worker during only one shift and developed symptoms six to 16 days afterwards. No other possible source of infection was identified. This investigation highlights the need to maintain awareness, particularly amongst staff working with neonates, that pertussis infection can arise despite complete vaccination. Thus it is important to investigate new coughing illnesses and exclude symptomatic staff from contact with neonates until pertussis infection is excluded or effectively treated. The burden on the health system arising from a pertussis infection in a health care worker in a high-risk setting is also described with the hospitalisation of 4 infants, and prophylactic antibiotics given to 73 new mothers, infants and health care workers. Commun Dis Intell 2010;34(4):440–443.
Downloads
References
NSW Department of Health. Year in Review: communicable disease surveillance, NSW, 2008. N S W Public Health Bull 2009;20(9–10):141–151.
Australian Government Department of Health and Ageing, Immunise Australia Program. National Immunisation Program Schedule. Available from: http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/nips2 Accessed August 2009.
Australian Government, Medicare Australia. Australian Childhood Immunisation Register coverage report 31 March 2009. Available from: http://www.medicareaustralia.gov.au/provider/patients/acir/statistics.jsp Accessed August 2009.
Wood N, Quinn HE, McIntyre P, Elliot E. Pertussis in infants: Preventing deaths and hospitalisations in the very young. J Paediatr Child Health 2008;44(4):161–165.
Australian Government Department of Health and Ageing, Public Health Laboratory Network. Pertussis laboratory case definition. Available from: http://www1.health.gov.au/internet/main/publishing.nsf/Content/cda-phlncd-pertussis.htm
NSW Department of Health. Pertussis guidelines. Available from: http://www.health.nsw.gov.au/factsheets/guideline/pertusis.html
NSW Department of Health. Pertussis investigation form. Available from: http://www.health.nsw.gov.au/resources/publichealth/infectious/diseases/pdf/pertussis_form.pdf
Therapeutic Guidelines: Antibiotic. Version 13. Melbourne: Therapeutic Guidelines Limited; 2006.
Centers for Disease Control and Prevention. Outbreaks of pertussis associated with hospitals—Kentucky, Pennsylvania, and Oregon, 2003. MMWR Morb Mortal Wkly Rep 2005;54(3):67–71.
Edwards KM, Talbot TR. The challenges of pertussis outbreaks in healthcare facilities: is there a light at the end of the tunnel? Infect Control Hosp Epidemiol 2006;27(6):537–540.
Bryant KA, Humbaugh K, Brothers K, Wright J, Pascual FB, Moran J, et al. Measures to control an outbreak of pertussis in a neonatal intermediate care nursery after exposure to a healthcare worker. Infect Control Hosp Epidemiol 2006;27(6):541–545.
Wright EP, Joce R, Whincup G. Management of pertussis in a nurse at a special care baby unit. Commun Dis Public Health 2004;7(2):128–131.
Spearing NM, Horvath RL, McCormack JG. Pertussis: adults as a source in healthcare settings. Med J Aust 2002;177(10):568–569.
Friedman DS, Curtis R, Schauer SL, et al. Surveillance for transmission and antibiotic adverse events among neonates and adults exposed to a healthcare worker with pertussis. Infect Control Hosp Epidemiol 2004;25(11):967–973.
McCall BJ, Tilse M, Burt B, Watt P, Barnett M, McCormack JG. Infection control and public health aspects of a case of pertussis infection in a maternity health care worker. Commun Dis Intell 2002;26(4):584–586.
Broder KR, Cortese MM, Iskander JK, Kretsinger K, Slade BA, Brown KH, et al. Preventing tetanus, diphtheria, and pertussis among adolescents: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccines: recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep 2006;55(RR–3):1–34.
Baggett HC, Duchin JS, Shelton W, Zerr DM, Heath J, Ortega-Sanchez IR, et al. Two nosocomial pertussis outbreaks and their associated costs—King County, Washington, 2004. Infect Control Hosp Epidemiol 2007;28(5):537–543.
Calugar A, Ortega-Sánchez IR, Tiwari T, Oakes L, Jahre JA, Murphy TV. Nosocomial pertussis: costs of an outbreak and benefits of vaccinating health care workers. Clin Infect Dis 2006;42(7):981–988.
Ward A, Caro J, Bassinet L, Housset B, O’Brien JA, Guiso N. Health and economic consequences of an outbreak of pertussis among healthcare Workers in a hospital in France. Infect Control Hosp Epidemiol 2005;26(3):288–292.
Greer AL, Fisman DN. Keeping vulnerable children safe from pertussis: Preventing nosocomial pertussis transmission in the neonatal intensive care unit. Infect Control Hosp Epidemiol 2009;30(11):1084–1089.
NSW Department of Health. Occupational Assessment, Screening & Vaccination Against Specified Infectious Diseases. PD2007_006 2007: p16–18, 27.
Murphy TV, Slade BA, Broder KR, Kretsinger K, Tiwari T, Joyce PM, et al. Advisory Committee on Immunization Practices. Centers for Disease Control and Prevention. Prevention of pertussis, tetanus, and diphtheria among pregnant and postpartum women and their infants: recommendations of the Advisory Committee on Immunization Practices.[erratum in MWR Morb Mortal Wkly Rep 2008;57(26):723.] MMWR Recomm Rep 2008;57(RR–4):1–51.
McIntyre P, Wood N. Pertussis in early infancy: disease burden and preventive strategies. Curr Opin Infect Dis 2009;22(3):215–223.
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2010 Communicable Diseases Intelligence

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
