Pertussis in infants: how to protect the vulnerable?
DOI:
https://doi.org/10.33321/cdi.2008.32.44Keywords:
whooping cough, Bordetella pertussis, infants, household transmissionAbstract
In terms of adverse outcomes, infants remain the group most vulnerable to severe pertussis disease. Adult household contact is thought to be the main source of transmission to infants. This study reviews exposure history, vaccination status, admission outcome and quality of discharge coding of hospitalised infants with pertussis at a tertiary paediatric hospital. We identified cases between 1997 and 2006 from 2 sources: hospital discharge coding and positive Bordetella pertussis results from the hospital laboratory database. We assessed the completeness of each of these sources, compared with the dataset of all identified cases. We identified 55 hospitalised infants with pertussis. The 35 cases (64%) less than 3 months of age had greater risk of Intensive Care Unit admission, higher mortality, and were more likely to have parents as an identified source. On admission, only 5 cases (9%) were more than 2 weeks overdue for their previous scheduled pertussis vaccination. Discharge coding was more sensitive for identifying cases than the laboratory database. Nine cases (16%) had incorrect discharge coding. Even infants up to date for pertussis vaccine can have severe disease requiring hospitalisation. Immunising parents planning to have, or who have had, a newborn baby may help to prevent pertussis in infants. Commun Dis Intell 2008;32:449–456.
Downloads
References
Brotherton J, Wang H, Schaffer A, Quinn H, Menzies R, Hull B, et al. Vaccine Preventable Diseases and Vaccination Coverage in Australia, 2003 to 2005. Commun Dis Intell 2007;31(Suppl 1):S91–S101.
Brotherton J, McIntyre P, Puech M, Wang H, Gidding H, Hull B, et al. Vaccine Preventable Diseases and Vaccination Coverage in Australia, 2001 to 2002. Commun Dis Intell 2004;28(Suppl 2):S41–S45.
Wood N, Quinn H, McIntyre P, Elliott E. Pertussis in infants: Preventing deaths and hospitalisations in the very young. J Paediatr Child Health 2008;44:161–165.
Brotherton J, Wang H, Schaffer A, Quinn H, Menzies R, Hull B, et al. Vaccine Preventable Diseases and Vaccination Coverage in Australia, 2003 to 2005. Commun Dis Intell 2007;31(Suppl 1):S49–S54.
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;23:246–252.
World Health Organization. Pertussis vaccines– WHO position paper. Wkly Epidemiol Rec 2005;80:31–39. Available from: www.who.int/wer/2005/wer8004.pdf Assessed 30 May 2007.
Edwards K, Freeman DM. Adolescent and adult pertussis: disease burden and prevention. Curr Opin Pediatr 2006;18:77–80.
Galanis E, King A, Varughese P, Halperin S, IMPACT investigators. Changing epidemiology and emerging risk groups for pertussis. CMAJ 2006;174:451–452.
Senanayake S. Pertussis in Australia today – a disease of adolescents and adults that can kill infants. Aust Fam Physician 2007;36:51–56.
Hewlett EL, Edwards KM. Clinical practice. Pertussis–not just for kids. N Engl J Med 2005;352:1215–1222.
Crowcroft N, Pebody R. Recent developments in pertussis. Lancet 2006;367:1926–1936.
Bisgard KM, Pascual FB, Ehresmann KR, Miller CA, Cianfrini C, Jennings CE, et al. Infant pertussis: who was the source? Pediatr Infect Dis J 2004;23:985–989.
Owen R, Roche P, Hope K, Yohannes K, Roberts A, Liu C, et al. Australia's notifiable diseases status, 2005: annual report of the National Notifiable Diseases Surveillance System. Commun Dis Intell 2007;31:44–45.
Ward JI, Cherry JD, Chang SJ, Partridge S, Lee H, Treanor J, et al. Efficacy of an acellular pertussis vaccine among adolescents and adults. N Engl J Med 2005;353:1555–1563.
Quinn HE, McIntyre PB. Pertussis epidemiology in Australia over the decade 1995–2005 – trends by region and age group. Commun Dis Intell 2007;31:205–215.
National Health and Medical Research Council. The Australian Immunisation Handbook. 9th edn. Canberra: Australian Government Publishing Service, 2008.
Lee GM, LeBaron C, Murphy TV, Lett S, Schauer S, Lieu TA. Pertussis in adolescent and adults: should we vaccinate? Pediatrics 2005;115:1675–1684.
Lee G, Murphy TV, Lett S, Cortese MM, Kretsinger K, Schauer S, et al. Cost effectiveness of pertussis vaccination in adults. Am J Prev Med 2007;32:186–193.
Scuffham PA, McIntyre PB. Pertussis vaccination strategies for neonates—an exploratory cost effectiveness analysis. Vaccine 2004;22:2953–2964.
Forsyth KD, Wirsing von Konig CH, Tan T, Caro J, Plotkin S. Prevention of pertussis: recommendations derived from the second Global Pertussis Initiative roundtable meeting. Vaccine 2007;25:2634–2642.
Brotherton J, Wang H, Schaffer A, Quinn H, Menzies R, Hull B, et al. Vaccine Preventable Diseases and Vaccination Coverage in Australia, 2003 to 2005. Commun Dis Intell 2007;31(Suppl 1):S135–S139.
Knuf M, Schmitt HJ, Wolter J, Schuerman L, Jacquet JM, Kieninger D, et al. Neonatal vaccination with an acellular pertussis vaccine accelerates the acquisition of pertussis antibodies in infants. J Pediatr 2008;152:655–660.
National Health and Medical Research Council. The Australian Immunisation Handbook. 8th edn. Canberra: Australian Government Publishing Service, 2003.
Murphy TV, Slade BA, Broder KR, Kretsinger K, Tiwari T, Joyce PM, et al. Prevention of pertussis, tetanus, and diphtheria among pregnant and postpartum women and their infants. Recommendations of the Advisory Committee on Immunization Practice (ACIP). MMWR Morb Mortal Recomm Rep 2008;57(4):1–51. Available from: www.cdc.gov/mmwr/preview/mmwrhtml/rr57e0514a1.htm Accessed 1 June 2008.
Forsyth K. Pertussis, still a formidable foe. Clin Infect Dis 2007;45:1487–1491.
Cortese MM, Baughman AL, Zhang R, Srivastava P, Wallace G. Pertussis hospitalizations among infants in the United States, 1993 to 2004. Pediatrics 2008;121:484–492.
Kowalzik F, Barbosa AP, Fernandes VR, Carvalho PR, Avila-Aguero ML, Goh DY, et al. Prospective multinational study of pertussis infection in hospitalized infants and their household contacts. Pediatr Infect Dis J 2007;26:238–242.
Wendelboe AM, Njamkepo E, Bourillon A, Floret DD, Gaudelus J, Gerber M, et al. Transmission of Bordetella pertussis to young infants. Pediatr Infect Dis J 2007;26:293–299.
Kandola K, Lea A, White W, Santos M. A comparison of pertussis rates in the Northwest Territories: Pre- and postacellular pertussis vaccine introduction in children and adolescents. Can J Infect Dis Med Microbiol 2005;16:271–274.
Ratcliff R, Chang G, Kok T, Sloots T. Molecular diagnosis of medical viruses. Curr Issues Mol Biol 2007;9:87–102.
Palmer CM, McCall B, Jarvinen K, Nissen MD. Bordetella pertussis PCR positivity, following onset of illness in children under 5 years of age. Commun Dis Intell 2007;31:202–205.
Cherry JD, Grimprel E, Guiso N, Heininger U, Mertsola J. Defining pertussis epidemiology: clinical, microbiologic and serologic perspectives. Pediatr Infect Dis J 2005;24(Suppl):S25–S34.
Bonacruz-Kazzi G, McIntyre P, Hanlon M, Menzies R. Diagnostic testing and discharge coding for whooping cough in a children's hospital. J Paediatr Child Health 2003;39:586–590.
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2008 Communicable Diseases Intelligence
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
