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Risk factors for pertussis in young infants during an outbreak in Chicago in 1993
H S Izurieta1, T A Kenyon, P M Strebel
1Epidemiology and Surveillance Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia 30303-3186, USA.
Insights
Young infants are highly susceptible to severe pertussis (whooping cough). This study found that infants born to adolescent mothers or mothers with prolonged cough were at significantly higher risk for pertussis.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Young infants face the highest risk of severe pertussis and mortality.
- Infants under 7 months are too young to complete the primary diphtheria-tetanus-pertussis (DTP) vaccination series.
- Pertussis outbreaks pose a significant threat to unvaccinated or incompletely vaccinated infant populations.
Purpose of the Study:
- To identify risk factors for pertussis infection in young infants during a 1993 Chicago outbreak.
- To assess the role of maternal and infant characteristics in pertussis transmission.
- To inform public health strategies for protecting vulnerable infants.
Main Methods:
- A matched case-control study design was employed.
- 39 infants (<7 months) with pertussis (cases) and 96 age-matched controls were enrolled from a single teaching hospital.
- Conditional logistic regression was used to analyze demographic data, immunization status, and exposure history.
Main Results:
- Infant DTP vaccination rates were similar between cases (87%) and controls (89%).
- Infants of adolescent mothers had a significantly increased odds of pertussis (OR, 6.4).
- Maternal cough lasting >= 7 days during the infant's incubation period was strongly associated with infant pertussis (OR, 12.0).
Conclusions:
- Adolescent mothers and mothers experiencing prolonged cough represent significant sources of pertussis infection for their young infants.
- Targeted interventions for high-risk mothers may be crucial for preventing infant pertussis.
- The findings highlight the importance of maternal health and vaccination in protecting infants from pertussis.
Abstract:
Because young infants are at highest risk for severe pertussis and death and are also too young to have received the minimal protective series of three doses of diphtheria-tetanus-pertussis (DTP) vaccine, we conducted a matched case-control study to assess risk factors for pertussis among young infants during a pertussis outbreak in Chicago in 1993. We enrolled 39 cases < 7 months of age from a single teaching hospital and 96 controls, individually matched for age, from the well-child clinic at the same hospital. Demographic characteristics, immunization status, and opportunities for disease exposure were analyzed by means of conditional logistic regression. Cases and controls were similarly up to date with their DTP vaccinations (87% and 89%, respectively). Infants of adolescent mothers (matched odds ratio [OR], 6.4; 95% confidence interval [CI], 1.3-41.4) and infants of mothers who suffered > or = 7 days of cough during the child's incubation period (matched OR, 12.0; 95% CI, 1.4 to infinity) were significantly more likely to have pertussis. Young mothers and mothers with a cough lasting > or = 7 days may be an important source of pertussis infection for their young infants.