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Pertussis is increasing in unimmunized infants: is a change in policy needed?
S Ranganathan1, R Tasker, R Booy
1Department of Paediatrics, St Mary's Hospital Medical School at Imperial College, London, UK.
Insights
Pertussis (whooping cough) is increasingly affecting young infants in England and Wales. Despite intensive care, three of five infants studied died, highlighting the need for stronger public health measures.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- An accelerated immunization schedule was introduced for pertussis (whooping cough) in England and Wales.
- Pertussis notifications in young infants have shown an increasing trend in both proportion and absolute numbers since the schedule change.
Observation:
- Five infants, all under 3 months of age, were admitted to pediatric intensive care units with severe, life-threatening pertussis infections.
- Despite aggressive cardiorespiratory support, three of these infants unfortunately died.
Findings:
- Pertussis infection presents atypically and more severely in infants under 3 months of age.
- The disease continues to be a significant cause of morbidity and mortality in unimmunized infants.
Implications:
- Public health strategies to prevent pertussis in infants require strengthening.
- Consideration should be given to offering chemoprophylaxis to susceptible infant contacts.
- Booster vaccinations against pertussis for relevant populations may be warranted to reduce transmission.
Abstract:
The proportion and trend in absolute number of pertussis notifications in young infants has increased each year in England and Wales since the accelerated immunization schedule was introduced. We report five infants all less than 3 months of age admitted with life threatening pertussis infection to two paediatric intensive care units. Despite aggressive cardiorespiratory support measures, three of the infants died. Pertussis remains a significant cause of morbidity and mortality in unimmunized infants. In this age group presentation is likely to be atypical and infection more severe. Public health measures to prevent the disease could be strengthened. Chemoprophylaxis should be offered to susceptible contacts and booster vaccinations against pertussis considered.