Pertussis (whooping cough): Adults are a source of infection in babies
A study of a hospital special care nursery has shown that adults with unsuspected infection can transmit pertussis (whooping cough) to babies and other adults.
In the latest edition of the Medical Journal of Australia, Natalie Spearing, Clinical Nurse Consultant, Infection Control, and colleagues, Robert Horvath, Infectious Diseases Registrar, and Joseph McCormack, Director of Infectious Diseases, at Mater Misericordiae Health Services, Brisbane, document the case of a woman with a two to three-week history of cough who gave birth at the hospital. She then spent several hours each day in the special care nursery with her premature baby.
On Day 15 after the woman's admission, the baby in the cot adjacent to her baby developed a cough and respiratory distress. Three days later, a nurse who cared for her baby also developed a cough.
Serum later collected from the mother was positive for antibodies to Bordetella pertussis, the cause of pertussis, despite an earlier test proving negative.
Several weeks later, the index patient's baby and another baby in the nursery also tested positive for the organism.
Screening of all other babies and parents and staff who had been in contact with the woman over the period showed no further infections.
It was concluded that the woman was the source of the infection.
The authors make recommendations to prevent similar infections:
Limit access of staff and visitors to nurseries;
Provide adequate space between open cots (at least one metre);
Discourage parents from contacts with infants other than their own; and
Perform hand antisepsis before entering the nursery and before and after patient contact.
There were 10,339 notifications of pertussis in 1999-2000 in Australia. People aged
15 years and over comprised 62 percent of these notifications.
Studies indicate that 12 to 32 percent of cases of prolonged cough (more than two weeks) in adolescents and adults are due to Bordetella pertussis.
Although adolescents and adults are the primary reservoir of the diseases and the main source of infection in infants and unvaccinated children, pertussis often goes unsuspected in these age groups.
The Medical Journal of Australia is a publication of the Australian Medical Association.
CONTACT: Associate Professor Joseph G McCormack
(07) 3840 8518/81 / (07) 3840 8111 (Pager service) (A/H)
Judith Tokley (AMA) (02) 6270 5472 / (0408) 824 306