Bordetella pertussis in a neonatal intensive care unit: identification of the mother as the likely source

Bordetella pertussis, the cause of whooping cough, is highly contagious. A female, twin 1, born at 34 weeks of gestation and present on a neonatal intensive care unit for 19 days, became apnoeic and bradycardic. A pernasal swab, sent when pertussis was clinically suspected, grew B. pertussis. Twin 2 had similar symptoms. The mother admitted having a prolonged cough. Polymerase chain reaction of pernasal swabs was positive for both twins, and the mother had positive pertussis serology. An incident management committee was convened. Fifty neonates and 117 healthcare workers were identified as contacts and were offered information, azithromycin chemoprophylaxis and/or pertussis vaccination according to UK national guidelines.