Texas Healthcare Worker Gave Pertussis to Newborns

Eleven newborns acquired PCR-confirmed pertussis during the month of July 2004, from a healthcare worker in a Texas hospital nursery, according to the June 6 issue of MMWR. The healthcare worker, who had been fully vaccinated for pertussis during childhood, experienced symptoms consistent with the disease before the outbreak. She had provided direct care for 113 infants while symptomatic (attack rate, 9.7%). Her husband experienced similar symptoms after returning from California, 2-3 weeks prior. (The vaccination status of the husband was not reported.)

All 11 newborns were treated with erythromycin at a Texas children's hospital and recovered, according to the MMWR. Nine required hospital admission, and 5 received intensive care. During follow-up screening of infants who were in the nursery from May 31 to July 17, 18 of 110 exhibited cough; despite being PCR negative, they were treated with prophylactic erythromycin. Two infants were found to be symptomatic and PCR positive; one was admitted to the children's hospital. Another possible case of pertussis was identified in a 3-year-old sibling.

Children younger than 1 year of age are especially prone to complications of pertussis, including seizures, pneumonia, encephalopathy, and cardiovascular compromise. The pertussis case-fatality rate for infected infants younger than 2 months approaches 2%. The CDC's Advisory Committee on Immunization Practices recommends the Tdap vaccine for healthcare workers and others who are in direct contact with children younger than 1 year of age.

PCR = polymerase chain reaction.

Photo of symptomatic child with pertussis from pertussis.com.