Pertussis immunisation program for new mums

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Pertussis immunisation program for new mums

• What it is all about

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Pertussis (whooping cough)

• Pertussis is a highly contagious respiratory
  infection caused by the bacteria bordetella
  pertussis
• Spread through respiratory droplets
• Causes inflammation of the respiratory tract,
  interfering with clearing of the pulmonary
  secretions.
• Characterised by paroxysmal cough, inspiratory
  whoop and post-tussive vomiting

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Symptoms

• Stage 1 Catarrahal (1-2 weeks)
• Cough, Sneezing, watery nasal discharge
• Stage 2 Paroxysmal (1-6 weeks)
• Coughing fits, choking, post-tussive vomiting
  inspiratory whoop
• Stage 3 Convalescent (weeks to months)

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Clinical Features

• 11

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Case definition

• An acute cough lasting gt14 days with at least one
  of post-tussive vomiting, apnoea or whoop
• Or
• A cough of any duration in a person linked to a
  laboratory confirmed case.
• Laboratory tests
• Culture
• PCR - Nasal swab or nasopharyngeal aspirate
• Serology detection of IgG antibodies to B
  pertussis antigens.

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Morbidity

• In Australia between 1993 and 2005, there were 18
  deaths. 16 were infants. 2 were adults.
• Most common cause of death from pertussis is
  pneumonia.
• Other complications include apnoea, seizures and
  encephalopathy.

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Pertussis in the NT
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Source

• Adults are the primary reservoir for the
  bacteria, and are the major source of infection
  in infants under 6 months.
• Last year there were 22 children under 12 months
  diagnosed with Pertussis in the Northern
  Territory.
• Source was known in 54 (14). 7 were mothers, 2
  fathers, 3 siblings,1 grandmother and 1 health
  worker.
• Modelling estimated that pertussis vaccination of
  household contacts may prevent 70 of Pertussis
  cases in the 0-3 months old age groups. (Van Rie.
  A et al. Adolescent and adult pertussis
  vaccination computer simulations of five new
  strategies. Vaccine.2004 Vol.22. Pp.2953-2964).

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Vaccination

• Childhood vaccination schedule includes a
  combination vaccine containing pertussis.
• given at 2,4 and 6 months (InfanrixPenta)
• 4th dose is given at 4 years of age (InfanrixIPV)
• booster dose at 13 (Boostrix)

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Recommendations

• dTpa is recommended for
• Adults planning a pregnancy
• Adults working with young people
• All health care workers
• Any adult wishing to be immunised should be
  encouraged to do so.
• NT government have funded adult
  diptheria-tetnus-pertussis vaccine (dTpa) for all
  new mothers who birthed after october 1, 2008.

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Implementing The program

• Antenatal and postnatal education
• Pamphlets and cards
• Gain informed consent antenatally
• Check the mothers immunisation status antenatally
  
• If she is born after 1986 (younger than 23 y.o)
• Vacccines are requested on the medical chart and
  are now an imprest item on the maternity ward.
• Administer vaccine with informed consent
• Document
• On the adult vaccination record form
• In the patients file/ information system
• If there is no documentation of immunisations on
  the d/c letter please call 89517557.
• Promote vaccine to other carers and ensure other
  children in the family are vaccinated.
• DHF cards Protect your baby from whooping cough.

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Thankyou
Kristen Winton Pertussis Immunisation
Officer CDC, Alice Springs Ph. 08 89517557