Abstract/Details

Impact of maternal Tdap vaccination on pertussis infection in young infants


2010 2010

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Abstract (summary)

Undiagnosed infected mothers often are the source of pertussis illness in young infants. The Centers for Disease Control and Prevention (CDC) recommends Tdap vaccine for post-partum women before hospital discharge. This intervention has been implemented at Ben Taub General Hospital (BTGH) in Houston, TX since January 2008. Our objective was to compare the proportion of infants born at BTGH and developing pertussis to the total number of pertussis cases before and after the intervention. Methods. We conducted a cross-sectional comparative study between the pre-intervention (7/2000 to 12/2007) and post-intervention (1/2008 to 5/2009) periods. Information on pertussis diagnosis was determined using ICD-9 codes, infection control records, and molecular microbiology reports from Texas Children's Hospital (TCH) and BTGH. Only patients ≤ 6 months of age with laboratory-confirmed B. pertussis infection were included in the study. Results. 481 infants had pertussis illness; 353 (73.3%) during pre-intervention and 128 (26.6%) during post-intervention years. The groups were comparable in all measures including age (median 73 vs. 62.5 days; p=0.08), gender (males 54.2%; p=0.47), length of hospitalization (median 9.8 vs. 4 9.5 days; p=0.5), outcomes (2 deaths in each period; p=0.28) and pertussis illness at TCH (95.2% vs. 95.3%; p=0.9). The proportion of pertussis patients born at BTGH, and thus amenable to protection by the intervention, was not statically different between the two periods after adjusting for age, gender and ethnicity (7.3% vs. 9.3%; an OR=1.05, 95% CI 0.5-2.1, p=0.88). Conclusions. Vaccinating only mothers with Tdap in the post-partum period does not reduce the proportion of pertussis in infants age ≤ 6 months. Efforts should be directed at Tdap immunization of not only mothers, but also all household and key contacts of newborns to protect them against pertussis illness before the primary DTaP series is completed.

Indexing (details)


Subject
Medicine;
Epidemiology
Classification
0564: Medicine
0766: Epidemiology
Identifier / keyword
Health and environmental sciences, Cocoon, Infant, Maternal, Pediatrics, Pertussis, Tdap
Title
Impact of maternal Tdap vaccination on pertussis infection in young infants
Author
Castagnini Castro, Luis Antonio
Number of pages
22
Publication year
2010
Degree date
2010
School code
0219
Source
MAI 49/01M, Masters Abstracts International
Place of publication
Ann Arbor
Country of publication
United States
ISBN
9781124136486
Advisor
Ross, Michael W.
Committee member
Baker, Carol J.; Quill, Beth
University/institution
The University of Texas School of Public Health
Department
Epidemiology & Disease Control
University location
United States -- Texas
Degree
M.P.H.
Source type
Dissertations & Theses
Language
English
Document type
Dissertation/Thesis
Dissertation/thesis number
1479476
ProQuest document ID
748217180
Copyright
Database copyright ProQuest LLC; ProQuest does not claim copyright in the individual underlying works.
Document URL
http://search.proquest.com/docview/748217180
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