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Pertussis in young infants: apnoea and intra-familial infection

J Raymond1, J-B Armengaud2, C Cosnes-Lambe2

  • 1Laboratoire de Bacteriologie, Paris, France.

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|March 3, 2007
PubMed

Insights

Diagnosing pertussis in infants is improved by using real-time PCR on household contacts. This method aids in early detection and treatment of Bordetella pertussis, even when infant samples are initially negative.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Pertussis, a highly contagious respiratory infection, poses significant risks to infants.
  • Early and accurate diagnosis of pertussis in infants is crucial for timely intervention and preventing severe complications like apnea.
  • Real-time PCR is a sensitive diagnostic tool for detecting Bordetella pertussis.

Purpose of the Study:

  • To evaluate the utility of real-time PCR in diagnosing pertussis in infants presenting with compatible symptoms.
  • To assess the role of testing household contacts in confirming infant pertussis diagnoses.
  • To determine the frequency of apnea in infants with confirmed pertussis.

Main Methods:

  • Real-time PCR was performed on nasopharyngeal samples from 41 infants under 4 months old hospitalized with suspected pertussis.
  • Samples from family members and household contacts were also analyzed using real-time PCR.
  • Clinical data, including the presence of apnea, were compared between infants with confirmed pertussis and a control group.

Main Results:

  • Bordetella pertussis infection was confirmed by real-time PCR in 16 out of 41 infants.
  • In 4 infants, initial PCR tests were negative, but subsequent samples taken 5-7 days post-onset were positive.
  • PCR testing of household contacts yielded positive results in 15/16 families and 20/41 contacts, with 9 asymptomatic cases identified. Apnea was significantly more frequent in infants with confirmed pertussis (69%) compared to controls (28%).

Conclusions:

  • Real-time PCR testing of household contacts significantly aids in the diagnosis of pertussis in infants with clinical suspicion.
  • Early diagnosis facilitated by contact tracing enables prompt treatment for infants with pertussis.
  • Asymptomatic household contacts can be a source of Bordetella pertussis transmission to vulnerable infants.

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