A booster vaccination for parents of new babies and other household members may be the most effective way of preventing the fatal form of whooping cough in young infants, say a group of pediatric intensive care doctors on www.bmj.com today.
Whooping cough (pertussis) is a distressing infectious disease which affects infants and young children. Vaccination is effective and is usually given to infants at two to four months of age, with a further booster after three years. But evidence is growing that the incidence of pertussis is rising in adolescents and adults. Infectious adults within a family are the main source of infection for unimmunized infants.
Doctors at the
In the second case, a six-week old girl presented to hospital with a five-day history of cough and breathlessness. Her mother had a persistent cough for more than two weeks. The mother had received all her childhood immunizations including pertussis, there was no record of the father's pertussis immunization status. The child died within 30 hours despite maximum therapy. The patient's mother subsequently tested positive for pertussis infection.
This report demonstrates the devastating course of invasive pertussis in young infants, say the authors.
Pre-vaccination infants now account for the majority of pertussis-related complications, hospitalizations and deaths and most infants catch the disease from affected household members, with parents accounting for more than half of the cases.
As a result, several countries, including the U.S. and Australia, have introduced booster doses for adolescents and adults.
Mortality remains high for young infants developing invasive pertussis despite modern pediatric intensive care, say the authors. The best solution is to prevent infection. The introduction of an adult booster or more targeted vaccination of household contacts of young infants should be considered, they conclude.