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Parents as source of pertussis transmission in hospitalized young infants
Giorgio Fedele1, Maria Carollo2, Raffaella Palazzo2
1Department of Infectious, Parasitic, and Immune-Mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy. giorgio.fedele@iss.it.
Insights
Parents often unknowingly transmit pertussis (whooping cough) to infants. Over 40% of parents had recent pertussis, indicating a significant risk of household transmission to newborns.
Area of Science:
- Pediatric infectious diseases
- Immunology
- Public health
Background:
- Pertussis (whooping cough) poses a severe risk to infants younger than six months.
- Understanding familial transmission is crucial for effective pertussis control strategies.
Purpose of the Study:
- To investigate familial pertussis transmission to infants under six months.
- To identify parents as potential sources of pertussis infection in infants.
Main Methods:
- Seroprevalence of IgG antibodies to pertussis toxin (PT-IgG) and cough symptoms were assessed in parents of infants hospitalized with pertussis.
- Parents of infants with lower respiratory tract infection (LRTI) and healthy infants (hip examination - HE) served as controls.
Main Results:
- Parents of pertussis cases showed significantly higher PT-IgG levels compared to control groups.
- Over 40% of parents had PT-IgG levels indicative of recent pertussis infection.
- Serological data suggested parental infection in 49.1% of infant pertussis cases, rising to 56.4% when cough symptoms were considered.
Conclusions:
- Parents are often unaware of their role in transmitting pertussis to newborns.
- Advising parents on transmission risks and recognizing cough symptoms is essential.
- Serological screening of family members may be necessary due to asymptomatic infections.
Purpose:
This study was planned to collect evidences of familial pertussis transmission to infants younger than 6 months of age. Understanding the dynamics of transmission of pertussis in families is essential to plan effective prevention strategies that could be integrated in pertussis control.
Methods:
The seroprevalence of IgG antibodies to pertussis toxin (PT-IgG) and prolonged cough symptoms were evaluated in parents of 55 infants aged <6 months hospitalized for confirmed pertussis. Parents of 33 infants with lower respiratory tract infection (LRTI) and parents of 57 healthy infants admitted as outpatients for hip ultrasound examination (HE) were enrolled as controls.
Results:
Parents of pertussis cases had PT-IgG levels significantly higher as compared to LRTI and HE parents. More than 40 % were compatible as transmitters of pertussis to their babies, since they had a level of PT-IgG ≥ 100 IU/ml, which is considered diagnostic for a recent pertussis episode. Based on serology, the percentage of pertussis cases that had at least one parent as source of infection was 49.1 %. When cough symptoms were taken into account, the percentage of parents putative transmitters of the infection to their infants increased to 56.4 %.
Conclusions:
Parents are scarcely aware of the household transmission of pertussis to their newborns. Our study highlights the need to advise parents about the likelihood of transmission to the newborn and to be particularly aware of coughing symptoms in the household. Since infection can be asymptomatic, a serological survey of family members should also be considered.
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