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Infection
Published in: Infection 2/2017

01-04-2017 | Original Paper

Parents as source of pertussis transmission in hospitalized young infants

Authors: Giorgio Fedele, Maria Carollo, Raffaella Palazzo, Paola Stefanelli, Elisabetta Pandolfi, Francesco Gesualdo, Alberto Eugenio Tozzi, Rita Carsetti, Alberto Villani, Ambra Nicolai, Fabio Midulla, Clara Maria Ausiello, The Pertussis Study Group

Published in: Infection | Issue 2/2017

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Abstract

Purpose

This study was planned to collect evidences of familial pertussis transmission to infants younger than 6 months of age. Understanding the dynamics of transmission of pertussis in families is essential to plan effective prevention strategies that could be integrated in pertussis control.

Methods

The seroprevalence of IgG antibodies to pertussis toxin (PT-IgG) and prolonged cough symptoms were evaluated in parents of 55 infants aged <6 months hospitalized for confirmed pertussis. Parents of 33 infants with lower respiratory tract infection (LRTI) and parents of 57 healthy infants admitted as outpatients for hip ultrasound examination (HE) were enrolled as controls.

Results

Parents of pertussis cases had PT-IgG levels significantly higher as compared to LRTI and HE parents. More than 40 % were compatible as transmitters of pertussis to their babies, since they had a level of PT-IgG ≥ 100 IU/ml, which is considered diagnostic for a recent pertussis episode. Based on serology, the percentage of pertussis cases that had at least one parent as source of infection was 49.1 %. When cough symptoms were taken into account, the percentage of parents putative transmitters of the infection to their infants increased to 56.4 %.

Conclusions

Parents are scarcely aware of the household transmission of pertussis to their newborns. Our study highlights the need to advise parents about the likelihood of transmission to the newborn and to be particularly aware of coughing symptoms in the household. Since infection can be asymptomatic, a serological survey of family members should also be considered.
Literature
1.
2.
Zepp F, Heininger U, Mertsola J, Bernatowska E, Guiso N, Roord J, et al. Rationale for pertussis booster vaccination throughout life in Europe. Lancet Infect Dis. 2011;11:557–70.CrossRefPubMed
3.
Fedele G, Cassone A, Ausiello CM. T-cell immune responses to Bordetella pertussis infection and vaccination. Pathog Dis. 2015;7 (pii:ftv051).
4.
Ausiello CM, Cassone A. Acellular pertussis vaccines and pertussis resurgence: revise or replace? MBio. 2014;10(5):e01339–14.CrossRef
5.
Locht C. Pertussis: where did we go wrong and what can we do about it? J Infect. 2016 (pii: S0163-4453(16)30047-0).
6.
Mattoo S, Cherry JD. Molecular pathogenesis, epidemiology, and clinical manifestations of respiratory infections due to Bordetella pertussis and other Bordetella subspecies. Clin Microbiol Rev. 2005;18:326–82.CrossRefPubMedPubMedCentral
7.
8.
Yaari E, Yafe-Zimerman Y, Schwartz SB, Slater PE, Shvartzman P, Andoren N, et al. Clinical manifestations of Bordetella pertussis infection in immunized children and young adults. Chest. 1999;115:1254–8.CrossRefPubMed
9.
Tozzi AE, Celentano LP, Ciofi degli Atti ML, Salmaso S. Diagnosis and management of pertussis. CMAJ. 2005;15(172):509–15.CrossRef
10.
Gonfiantini MV, Carloni E, Gesualdo F, Pandolfi E, Agricola E, Rizzuto E, et al. Epidemiology of pertussis in Italy: disease trends over the last century. Euro Surveill. 2014;19:20921.CrossRefPubMed
11.
Nelson JD. The changing epidemiology of pertussis in young infants. The role of adults as reservoirs of infection. Am J Dis Child. 1978;132:371–3.CrossRefPubMed
12.
Wendelboe AM, Van Rie A, Salmaso S, Englund JA. Duration of immunity against pertussis after natural infection or vaccination. Pediatr Infect Dis J. 2005;24:S58–61.CrossRefPubMed
13.
14.
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;50:1339–45.CrossRefPubMed
15.
Wendelboe AM, Hudgens MG, Poole C, Van Rie A. Estimating the role of casual contact from the community in transmission of Bordetella pertussis to young infants. Emerg Themes Epidemiol. 2007;4:15.CrossRefPubMedPubMedCentral
16.
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;31:618–25.CrossRefPubMed
17.
Giammanco A, Chiarini A, Maple PA, Andrews N, Pebody R, Gay N, et al. European Sero-Epidemiology Network: standardisation of the assay results for pertussis. Vaccine. 2003;22:112–20.CrossRefPubMed
18.
Hallander HO, Andersson M, Gustafsson L, Ljungman M, Netterlid E. Seroprevalence of pertussis antitoxin (anti-PT) in Sweden before and 10 years after the introduction of a universal childhood pertussis vaccination program. APMIS. 2009;117:912–22.CrossRefPubMedPubMedCentral
19.
Palazzo R, Carollo M, Fedele G, Rizzo C, Rota MC, Giammanco A, et al. Evidence of increased circulation of Bordetella pertussis in the Italian adult population from seroprevalence data (2012-2013). J Med Microbiol. 2016 (Epub ahead of print ).
20.
Xing D, Wirsing von König CH, Newland P, Riffelmann M, Meade BD, Corbel M, et al. Characterization of reference materials for human antiserum to pertussis antigens by an international collaborative study. Clin Vaccine Immunol. 2009;16:303–11.CrossRefPubMed
21.
Hallander HO, Ljungman M, Storsaeter J, Gustafsson L. Kinetics and sensitivity of ELISA IgG pertussis antitoxin after infection and vaccination with Bordetella pertussis in young children. APMIS. 2009;117:797–807.CrossRefPubMed
22.
Guiso N, Berbers G, Fry NK, He Q, Riffelmann M, Wirsing von König CH, EU Pertstrain group. What to do and what not to do in serological diagnosis of pertussis: recommendations from EU reference laboratories. Eur J Clin Microbiol Infect Dis. 2011;30:307–12.CrossRefPubMed
23.
24.
25.
The Italian Vaccine Coverage Survey Working Group. Childhood vaccination coverage in Italy: results of a seven-region survey. Bull World Health Org. 1994;72:885–95.
26.
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;23:985–9.CrossRefPubMed
27.
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;23:246–52.CrossRefPubMed
28.
Long SS, Welkon CJ, Clark JL. Widespread silent transmission of pertussis in families: antibody correlates of infection and symptomatology. J Infect Dis. 1990;161:480–6.CrossRefPubMed
29.
Ward JI, Cherry JD, Chang SJ, Partridge S, Keitel W, Edwards K, et al. Bordetella Pertussis infections in vaccinated and unvaccinated adolescents and adults, as assessed in a national prospective randomized Acellular Pertussis Vaccine Trial (APERT). Clin Infect Dis. 2006;43:151–7.CrossRefPubMed
30.
Crowcroft NS, Booy R, Harrison T, Spicer L, Britto J, Mok Q, et al. Severe and unrecognised: pertussis in UK infants. Arch Dis Child. 2003;88:802–6 erratum in: Arch Dis Child. 2006;91:453.CrossRefPubMedPubMedCentral
31.
Warfel JM, Zimmerman LI, Merkel TJ. Acellular pertussis vaccines protect against disease but fail to prevent infection and transmission in a nonhuman primate model. Proc Natl Acad Sci USA. 2014;111:787–92.CrossRefPubMed
32.
Storsaeter J, Hallander H, Farrington CP, Olin P, Möllby R, Miller E. Secondary analyses of the efficacy of two acellular pertussis vaccines evaluated in a Swedish phase III trial. Vaccine. 1990;8:457–61.CrossRefPubMed
33.
Von Linstow ML, Pontoppidan PL, König C-HW, Cherry JD, Hogh B. Evidence of Bordetella pertussis infection in vaccinated 1-year-old Danish children. Eur J Pediatr. 2010;169:1119–22.CrossRef
34.
Dabrera G, Amirthalingam G, Andrews N, Campbell H, Ribeiro S, Kara E, et al. A case-control study to estimate the effectiveness of maternal pertussis vaccination in protecting newborn infants in England and Wales, 2012–2013. Clin Infect Dis. 2015;60:333–7.CrossRefPubMed
35.
van den Biggelaar AH, Poolman JT. Predicting future trends in the burden of pertussis in the 21st century: implications for infant pertussis and the success of maternal immunization. Expert Rev Vaccines. 2016;15:69–80.CrossRefPubMed
Metadata
Title
Parents as source of pertussis transmission in hospitalized young infants
Authors
Giorgio Fedele
Maria Carollo
Raffaella Palazzo
Paola Stefanelli
Elisabetta Pandolfi
Francesco Gesualdo
Alberto Eugenio Tozzi
Rita Carsetti
Alberto Villani
Ambra Nicolai
Fabio Midulla
Clara Maria Ausiello
The Pertussis Study Group
Publication date
01-04-2017
Publisher
Springer Berlin Heidelberg
Published in
Infection / Issue 2/2017
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-016-0943-6

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