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Published on: February 23, 2014
Nosocomial pertussis infection of infants: still a risk in 2009
Jennifer M Paterson1, Vicky Sheppeard
1Sydney West Centre for Population Health, Parramatta, New South Wales. Jen_M_Paterson@wsahs.nsw.gov.au
Insights
A pertussis (whooping cough) infection in a vaccinated healthcare worker led to infections in four neonates. This highlights the need for vigilance against pertussis in neonatal settings, even with vaccination.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Neonatal Care
Background:
- Pertussis (whooping cough) poses a significant risk to vulnerable populations, including neonates.
- Healthcare settings, particularly maternity wards, are critical environments for preventing infectious disease transmission.
Purpose of the Study:
- To describe a pertussis outbreak in a neonatal unit originating from a healthcare worker.
- To outline the public health interventions implemented to control the spread.
- To emphasize the importance of maintaining awareness of pertussis in healthcare settings.
Main Methods:
- Investigation of a confirmed pertussis case in a healthcare worker.
- Identification and confirmation of pertussis in neonates under their care.
- Public health response including contact tracing and prophylaxis.
Main Results:
- Four neonates acquired pertussis infection from the infected healthcare worker.
- Three neonates had laboratory-confirmed pertussis; one was diagnosed clinically.
- The outbreak necessitated hospitalisation of infants and prophylactic treatment for 73 individuals.
Conclusions:
- Pertussis can occur in vaccinated individuals, necessitating ongoing clinical suspicion.
- Healthcare workers with respiratory symptoms should be evaluated for pertussis, especially when working with neonates.
- Prompt public health interventions are crucial to prevent further transmission in high-risk settings.
Abstract:
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.
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