Evaluation of the impact of a pertussis cocooning program on infant pertussis infection

Area of Science:

• Pediatrics
• Immunology
• Public Health

Background:

• Infant pertussis poses a significant health risk.
• The Centers for Disease Control and Prevention recommends cocooning (immunizing infant contacts) to prevent pertussis.
• The effectiveness of cocooning programs in reducing severe infant pertussis needed evaluation.

Purpose of the Study:

• To determine if implementing a cocooning program at Ben Taub General Hospital reduced severe pertussis in infants.
• To assess the impact of postpartum and cocooning immunization strategies on infant pertussis.

Main Methods:

• A comparative study design was used, comparing infants diagnosed with pertussis before and after the implementation of cocooning.
• Infants ≤6 months diagnosed with pertussis were identified using ICD-9 codes and microbiology records.
• Data were collected from four hospitals, comparing infants born during preintervention, postpartum (PP), and cocooning (C) periods.

Main Results:

• A total of 196 infants were diagnosed preintervention, 140 during PP, and 64 during C.
• Infant demographics, age at diagnosis, hospitalization rates, and outcomes were similar across periods, except for a significant increase in intensive care unit admissions during the cocooning period (68%).
• No significant reduction in pertussis illness or mortality was observed with postpartum or cocooning immunization strategies.

Conclusions:

• Postpartum immunization and cocooning strategies did not effectively reduce pertussis illness in infants ≤6 months.
• Increased tetanus, diphtheria, and acellular pertussis (Tdap) immunization during pregnancy, combined with cocooning, is suggested to better prevent severe infant pertussis.
• Further research and implementation strategies are needed to enhance Tdap coverage in pregnant women.