Wednesday, September 9, 2015

The Mystery of Who’s Giving Babies Pertussis? A New Suspect Emerges!

By: Lewis First, MD, MS; Editor-in-Chief 
  
Mamma Loves
          While no one wants to contract pertussis, we worry the most about infants coming down with this disease.  They tend to have the least reserve and highest morbidity and mortality from this illness—and sadly even in the setting of high infant pertussis vaccination coverage, the incidence of this disease in babies has been increasing.  This raises the question of who is spreading the disease to our youngest patients.   
     Prior to a study by Skoff et al. (doi: 10.1542/peds.2015-1120) being released this week, we certainly worried about mothers being the most common source of spreading this infection, but with the aggressive campaign to vaccinate pregnant mothers with Tdap vaccine, are there other “suspects?”  The authors reviewed cases of pertussis in infants less than 1 year old and interviewed parents regarding potential sources of infection in contact with a baby within 7 to 20 days before the onset of their cough.   
     Of more than 1300 cases identified, a source was found for almost half with that source being other family members—and most commonly siblings—with parents following behind. In fact siblings have taken over from mothers as the most common source of pertussis infection to the new babies in their families.  So how old were the siblings who tended to spread this infection, and what was their vaccination status in terms of needing or receiving a Tdap booster?  Inject some time into reading this interesting study and learn more, and in turn share the import of getting booster pertussis vaccine where warranted in older sibs and parents especially if a new baby is expected or has arrived into a family.  
    Have you seen siblings as the source of pertussis cases in your practice?  What if anything did you do about the spread of pertussis if you live in an area that has recently seen an uptick in cases?  Share your thoughts on preventive measures via a response to this blog, an e-letter, or posting on Facebook or Twitter.

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