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IMAJ | volume 12
Journal 5, May 2010
pages: 283-286
A Pertussis Outbreak among Daycare Children in Northern Israel: Who Gets Sick?
Full article (PDF)
Summary
Background:
An outbreak of pertussis occurred in a daycare center with 87.5% vaccination coverage.
Objectives:
To assess the effectiveness of the acellular pertussis vaccine and prevention of pertussis after chemoprophylaxis with azithromycin.
Methods:
We studied 31 daycare children aged 3–5.5 years exposed to a child with pertussis. Nasopharyngeal swabs were obtained for
Bordetella pertussis
culture and polymerase chain reaction initially, and at days 21 and 60 of follow-up, in cases exhibiting symptoms.
Results:
Of the 31 daycare children 6 (19%) tested positive for
B. pertussis
by PCR[1], 4 of whom had not been vaccinated against the disease. Of the two vaccinated children who contracted pertussis, one had milder symptoms and the other was asymptomatic. The incidence of pertussis was significantly lower in the vaccinated group (2/27) than in the unvaccinated group (4/4) (
P
= 0.000), with efficacy of the vaccine calculated to be 92.5%. Azithromycin chemoprophylaxis was taken only by 14 of the 25 exposed children (56%). On day 21 follow-up, there was no further laboratory-diagnosed
B. pertussis
cases in any of the exposed children, regardless of whether or not chemoprophylaxis was taken.
Conclusions:
Based on the children’s clinical manifestations and PCR findings a pertussis outbreak had occurred in the daycare center studied. Our findings support the importance of pertussis vaccination since all the unvaccinated children in the daycare center contracted the infection.
[1] PCR = polymerase chain reaction
Keywords:
ori hochwald
ellen bamberger
lisa rubin
rosa gershtein
isaac srugo
hochwald
bamberger
rubin
gershtein
srugo
bordetella pertussis
polymerase chain reaction
outbreak
Full article (PDF)
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