Risk Factors Associated with Bordetella pertussis Among Infants ≤4 Months of Age in the Pre-Tdap Era

Details

• Alternative Title:
  Pediatr Infect Dis J
• Personal Author:
  Curtis, Christine Robinette ; Baughman, Andrew L. ; DeBolt, Chas ; Goodykoontz, Susan ; Kenyon, Cynthia ; Watson, Barbara ; Cassiday, Pamela K. ; Miller, Claudia ; Pawloski, Lucia C. ; Tondella, Maria-Lucia C. ; Bisgard, Kristine M.
• Description:
  Background:
  
  In the United States, infants have the highest reported pertussis incidence and death rates. Improved understanding of infant risk factors is needed to optimize prevention strategies.
  
  Methods:
  
  We prospectively enrolled infants ≤4 months of age with incident-confirmed pertussis from 4 sites during 2002–2005 (preceding pertussis antigen-containing vaccination recommendations for adolescents/adults); each case-patient was age and site matched with 2 control subjects. Caregivers completed structured interviews. Infants and their contacts ≥11 years of age were offered serologic testing for IgG; being seropositive was defined as ≥94 antipertussis toxin IgG enzyme-linked immunosorbent assay units per milliliter.
  
  Results:
  
  Enrolled subjects (115 case-patients; 230 control subjects) had 4396 contacts during incubation periods; 83 (72%) case-patients had ≥1 contact with prolonged (≥5 days) new cough in primary or secondary households. In multivariable analysis, the odds for pertussis were higher for infants with primary/secondary household contacts who had a prolonged new cough, compared with infants who did not. These contacts included mother [adjusted matched odds ratio (aMOR), 43.8; 95% confidence interval (CI), 6.45–298.0] and ≥1 nonmother contact (aMOR, 20.1; 95% CI, 6.48–62.7). Infants receiving breast milk with 0–1 formula feedings daily had decreased pertussis odds (aMOR, 0.27; 95% CI, 0.08–0.89), compared with those receiving more formula. Of 41 tested case-patients, 37 (90%) were seropositive.
  
  Conclusions:
  
  Pertussis in infants was associated with prolonged new cough (≥5 days) in infants’ household contacts. Findings suggest that breastfeeding protects against pertussis and warrants recommendation with pertussis prevention strategies, which currently include pertussis vaccination of pregnant mothers and infants’ close contacts.
  
  
• Subjects:
  Bordetella Pertussis Breast Feeding Diphtheria-Tetanus-Pertussis Vaccines Female Humans Immunization Schedule Infant Infant, Newborn Male Prospective Studies Risk Factors Whooping Cough

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• Keywords:
  Breastfeeding Infants Risk Factors Serology Whooping Cough
• Source:
  Pediatr Infect Dis J. 36(8):726-735
• Pubmed ID:
  28033240
• Pubmed Central ID:
  PMC8508157
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  36
• Issue:
  8
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:2efd08d2446763aeddabe1c46f2548d36dd328303a7244dcdbf11d872f8ff9a4833ad213f7133e2f833e4f90977b800d3e65d2aa8212495c8bc50202b870dd99
• Download URL:
  https://stacks.cdc.gov/view/cdc/110743/cdc_110743_DS1.pdf
• File Type:
  [PDF - 404.12 KB ]