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Sources and clinical characteristics of infant pertussis in China: increasing contribution of siblings

Feng Luo1, Shuhan Zheng2, Yang Zhou3

  • 1School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China.

BMC Infectious Diseases
|February 10, 2025
PubMed

Insights

In multi-child households, older siblings are now the primary source of infant pertussis (whooping cough). This shift necessitates updated pertussis vaccination strategies to better protect vulnerable infants.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Epidemiology

Background:

  • Infant pertussis (whooping cough) transmission traditionally involved parents.
  • China's multi-child policy may have altered pertussis transmission dynamics.
  • Investigating current household transmission patterns and infant clinical features is crucial.

Purpose of the Study:

  • To determine household pertussis transmission patterns in infants.
  • To analyze the clinical characteristics of pertussis in infants.
  • To assess the impact of household structure (single-child vs. multi-child) on transmission.

Main Methods:

  • Retrospective study of infant pertussis patients (≤6 months) from January to May 2024.
  • Laboratory confirmation of pertussis via bacterial culture.
  • Household telephone surveys to investigate transmission sources and patterns.

Main Results:

  • 275 infant cases identified; 58.9% were ≤3 months old.
  • In multi-child households, siblings (3-12 years) were the main source (46.4%), followed by adults (32.1%).
  • Infants ≤3 months experienced more severe disease, including higher rates of cyanosis, elevated leukocytes, and longer hospital stays.

Conclusions:

  • Older children, particularly siblings, are increasingly significant sources of pertussis for infants in multi-child families.
  • Current pertussis vaccination strategies may require optimization to address this changing transmission landscape.
  • Enhanced protection for infants against pertussis is needed, considering evolving household dynamics.
Abstract

Keywords:
Clinical characteristicsEpidemiologyInfantPertussisSiblingsTransmission

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