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Published on: February 23, 2014
Nosocomial pertussis in neonatal units
H C Maltezou1, L Ftika, M Theodoridou
1Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece.
Insights
Healthcare workers (HCWs) are a significant source of nosocomial pertussis outbreaks in neonatal units. Early recognition, isolation, and post-exposure prophylaxis are crucial for protecting vulnerable infants from this preventable disease.
Area of Science:
- Infectious Diseases
- Public Health
- Neonatal Care
Background:
- Pertussis (whooping cough) remains a significant public health challenge globally.
- Neonatal intensive care units (NICUs) are vulnerable to nosocomial pertussis outbreaks.
- Premature infants and young infants in NICUs are at high risk due to incomplete vaccination and immature immune systems.
Purpose of the Study:
- To review the epidemiology of nosocomial pertussis in neonates and infants.
- To highlight the critical role of healthcare workers (HCWs) in transmitting pertussis within neonatal settings.
- To emphasize the need for enhanced surveillance and control measures.
Main Methods:
- Literature review of nosocomial pertussis outbreaks in neonatal units.
- Analysis of transmission dynamics, focusing on HCW involvement.
- Review of diagnostic and management strategies, including post-exposure prophylaxis.
Main Results:
- Nosocomial pertussis outbreaks in NICUs are frequently linked to HCWs.
- Transmission by HCWs can lead to severe illness or death in susceptible infants.
- Current pertussis vaccines may not confer lifelong immunity, necessitating ongoing vigilance.
Conclusions:
- A high index of suspicion for pertussis in both patients and HCWs is essential for early detection and isolation.
- Contact investigations and post-exposure prophylaxis are vital for outbreak control.
- Booster vaccinations for HCWs are recommended, but current vaccines may not ensure lifelong protection against pertussis transmission.
Abstract:
Pertussis remains a public health concern in many countries despite high vaccination coverage rates. Nosocomial outbreaks of pertussis continue to occur in neonatal units. Neonates and young infants admitted to neonatal intensive care units constitute a pool of susceptible high-risk patients given their prematurity, inadequate immune response and the fact that they are too young to have completed their primary vaccination series against pertussis. This article reviews nosocomial pertussis in neonates and infants, focusing on the role of healthcare workers (HCWs). Outbreaks in neonatal units are often traced to HCWs and are associated with serious morbidity or even a fatal outcome among susceptible young infants. A high index of suspicion is required for early recognition and isolation of patients admitted with suspected or proven pertussis, as well as for HCWs with a compatible clinical syndrome, regardless of vaccination status. Contact investigation is also essential in order to guide administration of post-exposure prophylaxis. Recommendations for a booster vaccination for HCWs are in place in several countries; however, the need of HCWs for lifelong immunity against pertussis cannot be fulfilled by the current vaccine.
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