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Pertussis seroprevalence in emergency department staff
S W Wright1, K M Edwards, M D Decker
1Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN.
Study Objective:
The purpose of this study was to look at the prevalence of pertussis immunity in emergency department employees.
Design:
Prospective, observational study conducted in September 1992.
Setting:
A university hospital ED.
Participants:
A convenience sample of 73 ED employees.
Interventions:
Blood was collected from ED staff and assayed for antibody to pertussis toxin and filamentous hemagglutinin.
Results:
Ninety-nine percent of the subjects reported childhood immunization. Geometric mean titers were 3.6 (geometric SD, 3.2) enzyme-linked immunosorbent assay (ELISA) units for pertussis toxin and 12.1 (geometric SD, 3.3) ELISA units for filamentous hemagglutinin. These titers are comparable to those previously reported in other adults not immunized since childhood and are substantially lower than the levels commonly seen in children or adults following immunization. Titers did not differ significantly between male and female subjects or between subjects with or without a recent prolonged cough, family members with a cough, or small children in the household.
Conclusion:
Most ED staff members have low levels of antibody to pertussis and may be at risk for acquiring the disease from infected children or adults, with subsequent risk of transmission to susceptible patients. Booster immunization with an acellular pertussis vaccine has been shown to be safe and immunogenic in adults and may be appropriate for adult ED personnel to reduce these risks.