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Parents as source of pertussis transmission in hospitalized young infants

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Abstract

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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Acknowledgments

This work was supported by Grants from the Italian Ministry of Health, RF-2010-2317709.

The Pertussis Study Group Pasqualina Leone, Ilaria Schiavoni, Gabriele Buttinelli (Department of Infectious, Parasitic and Immuno-mediated Disease, Istituto Superiore di Sanità, Rome, Italy); Michaela Veronika Gonfiantini, Eleonora Agricola, Luisa Russo, Beatrice Ferretti, Ilaria Campagna (Multifactorial Disease and Complex Phenotype Research Area, Bambino Gesù Children’s Hospital, Rome, Italy); Valentina Marcellini (Immunology Area, B-cell physiopathology Unit, Bambino Gesù Children Hospital, Rome, Italy); Carlo Concato (Virology Unit, Bambino Gesù Children’s Hospital, Rome, Italy); Antonella Frassanito, Raffaella Nenna, Greta Di Mattia (Department of Pediatrics, Sapienza University of Rome, Rome, Italy); Caterina Rizzo (National Centre for Epidemiology Surveillance and Health Promotion, Istituto Superiore di Sanità, Rome, Italy).

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Authors and Affiliations

  1. Department of Infectious, Parasitic, and Immune-Mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy

    Giorgio Fedele, Maria Carollo, Raffaella Palazzo, Paola Stefanelli & Clara Maria Ausiello

  2. Multifactorial Disease and Complex Phenotype Research Area, Bambino Gesù Children’s Hospital, Rome, Italy

    Elisabetta Pandolfi, Francesco Gesualdo & Alberto Eugenio Tozzi

  3. Immunology Area, B Cell Physiopathology Unit, Immune Diagnosis Unit, Department of Laboratories, Bambino Gesù Children Hospital, Rome, Italy

    Rita Carsetti

  4. Department of Pediatrics, Bambino Gesù Children’s Hospital, Rome, Italy

    Alberto Villani

  5. Department of Pediatrics, Sapienza University of Rome, Rome, Italy

    Ambra Nicolai & Fabio Midulla

Authors
  1. Giorgio Fedele
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  2. Maria Carollo
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  3. Raffaella Palazzo
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  4. Paola Stefanelli
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  5. Elisabetta Pandolfi
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  6. Francesco Gesualdo
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  7. Alberto Eugenio Tozzi
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  8. Rita Carsetti
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  9. Alberto Villani
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  10. Ambra Nicolai
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  11. Fabio Midulla
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  12. Clara Maria Ausiello
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Consortia

The Pertussis Study Group

  • Pasqualina Leone
  • , Ilaria Schiavoni
  • , Gabriele Buttinelli
  • , Michaela Veronika Gonfiantini
  • , Eleonora Agricola
  • , Luisa Russo
  • , Beatrice Ferretti
  • , Ilaria Campagna
  • , Valentina Marcellini
  • , Carlo Concato
  • , Antonella Frassanito
  • , Raffaella Nenna
  • , Greta Di Mattia
  •  & Caterina Rizzo

Corresponding author

Correspondence to Giorgio Fedele.

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The authors declare no competing financial interests.

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Fedele, G., Carollo, M., Palazzo, R. et al. Parents as source of pertussis transmission in hospitalized young infants. Infection 45, 171–178 (2017). https://doi.org/10.1007/s15010-016-0943-6

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  • DOI: https://doi.org/10.1007/s15010-016-0943-6

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