Infant Pertussis and Household Transmission in Korea

Abstract

A recent resurgence of pertussis has raised public health concerns even in developed countries with high vaccination coverage. The aim of this study was to describe the clinical characteristics of infant pertussis, and to determine the relative importance of household transmission in Korea. The multicenter study was prospectively conducted from January 2009 to September 2011. We identified the demographic and clinical data from these patients and performed the diagnostic tests for pertussis in their household contacts. Twenty-one patients with confirmed pertussis were included in the analysis. All infections occurred in infants younger than 6 months of age (mean age, 2.5 months) who had not completed the primary DTaP vaccination except for one patient. Infants without immunization history had a significant higher lymphocytosis and longer duration of hospital stay compared to those with immunization. All were diagnosed with PCR (100%), however, culture tests showed the lowest sensitivity (42.9%). Presumed source of infection in household contacts was documented in 85.7%, mainly parents (52.6%). Pertussis had a major morbidity in young infants who were not fully immunized. Household members were responsible for pertussis transmission of infants in whom a source could be identified. The control of pertussis through booster vaccination with Tdap in family who is taking care of young infants is necessary in Korea.

Características clínicas y epidemiológicas de niños con enfermedad por Bordetella pertussis en Santa Fe, Argentina

“…Nuestro estudio demuestra que la tos convulsiva es una enfermedad de un impacto considerable, principalmente en la población bajo 6 meses de edad -94% de los casos que fueron hospitalizados correspondían a ese grupo etario-siendo 63% menores de 2 meses, así como también se registró en otros estudios publicados de Argentina y otros países del mundo 17,18,[21][22][23][24][25][26][27][28][29] . Nieto Guevara J.…”

“…El 75% de los casos graves requirió asistencia respiratoria. Los pacientes graves tenían todos menos de 2 meses de edad y la neumonía fue una de las complicaciones más frecuentes, la cual asociada a falla respiratoria, como también a hipertensión pulmonar grave han conformado un cuadro clínico con elevada mortalidad, en consonancia con otros autores 17,20,23,27,29,31,32,34,36 . Los casos fatales representaron en nuestro estudio 4,9%, teniendo todos menos de 2 meses de edad, en línea con trabajos realizados en nuestro país y en España 17,24,25 .…”

Epidemiological Aspects of Pertussis among Adults and Adolescents in a Korean Outpatient Setting: A Multicenter, PCR-Based Study

“…However, the diagnosis of pertussis is challenging in adult patients, and the waning immunity following vaccination can contribute to the persistence of pertussis; household contacts can be the main source of pertussis transmission (4, 6). Therefore, the early detection and prevention of adolescent and adult pertussis is of great importance (1).…”

Pertussis: Microbiology, Disease, Treatment, and Prevention

“…Experts now recognize that household members were the primary source of pertussis infection for children (247,249,251,524,(539)(540)(541). Although the source of infection (SOI) has not been identified in more than 50% of infant cases, mothers were recognized as the main SOI for an estimated 35% of infections in the United States (247,250,540).…”

“…The observed increase in reported cases among adolescents and adults has been attributed, in part, to waning immunity that occurs several years after primary childhood immunization (216,(239)(240)(241)(242)(243)(244)(245)(246). Such waning immunity likely plays an important role in pertussis transmission among household contacts (218,(247)(248)(249)(250)(251)(252)(253).…”