Transmission of Bordetella pertussis to young infants

Aaron M. Wendelboe, Elisabeth Njamkepo, Antoine Bourillon, D. Daniel Floret, Joel Gaudelus, Michael Gerber, Emmanuel Grimprel, David Greenberg, Scott Halperin, Johannes Liese, Flor Muñoz-Rivas, Remy Teyssou, Nicole Guiso, Annelies Van Rie

Research output: Contribution to journalArticlepeer-review

398 Scopus citations


BACKGROUND: Pertussis vaccination has reduced the number of notified cases in industrialized countries from peak years by more than 95%. The effect of recently recommended adult and adolescent vaccination strategies on infant pertussis depends, in part, on the proportion of infants infected by adults and adolescents. This proportion, however, remains unclear, because studies have not been able to determine the source case for 47%-60% of infant cases. METHODS: A prospective international multicenter study was conducted of laboratory confirmed infant pertussis cases (aged ≤6 months) and their household and nonhousehold contacts. Comprehensive diagnostic evaluation (including PCR and serology) was performed on all participants independent of symptoms. Source cases were identified and described by relationship to the infant, age and household status. RESULTS: The study population comprised 95 index cases and 404 contacts. The source of pertussis was identified for 48% of infants in the primary analysis and up to 78% in sensitivity analyses. In the primary analysis, parents accounted for 55% of source cases, followed by siblings (16%), aunts/uncles (10%), friends/cousins (10%), grandparents (6%) and part-time caretakers (2%). The distribution of source cases was robust to sensitivity analyses. CONCLUSIONS: This study provides solid evidence that among infants for whom a source case was identified, household members were responsible for 76%-83% of transmission of Bordetella pertussis to this high-risk group. Vaccination of adolescents and adults in close contact with young infants may thus eliminate a substantial proportion of infant pertussis if high coverage rates can be achieved.

Original languageEnglish
Pages (from-to)293-299
Number of pages7
JournalPediatric Infectious Disease Journal
Issue number4
StatePublished - 1 Apr 2007
Externally publishedYes


  • Asymptomatic
  • Diagnosis
  • Sensitivity analysis
  • Source case
  • Transmission

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases


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