Luo Feng, Zheng Shuhan, Zhou Yang, Zhu Yao, Su Ying, Dai Rongrong, Hua Chunzhen, Zhang Hangjie, He Hanqing
School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China.
Hangzhou Medical College, Hangzhou, China.
BMC Infect Dis. 2025 Feb 10;25(1):198. doi: 10.1186/s12879-025-10536-y.
While parents were traditionally the main reservoir for infant pertussis, transmission sources may have shifted with China's multi-child policy. Our study aimed to investigate the household transmission patterns and clinical characteristics of pertussis in infants.
We investigated infant pertussis patients (aged ≤ 6 months) diagnosed at a hospital (Children's Hospital of Zhejiang University School of Medicine) from 1 January to 1 May 2024. The laboratory diagnosis of pertussis was confirmed through bacterial culture. We collected basic and clinical information and conducted a telephone survey to investigate the transmission patterns within their households.
A total of 275 infant pertussis cases were identified, including 162 (58.9%) infants aged ≤ 3 months. A total of 188 households completed the transmission pattern survey, of which 121 households had two or more children. The clinical characteristic analysis indicated that infants aged ≤ 3 months had more severe disease, with higher proportion of paroxysmal cyanosis (12.4% vs. 3.5%), elevated leukocyte count (13.3 vs. 9.8 × 10/L), and prolonged hospital stay (10.0 vs. 5.5 days) (all P < 0.05). The household survey revealed significant differences in the distributions of first and source cases between single-child and multi-child households (P < 0.001). In multi-child households, the primary sources of pertussis transmission to infants were siblings aged 3-12 years, accounting for 46.4% of cases, while adults accounted for 32.1%.
This study highlights the growing involvement of older children in the spread of pertussis, with siblings emerging as the main sources of pertussis transmission to infants in multi-child households. Optimization of pertussis vaccination tactics is advised to protect infants better.
传统上，父母是婴儿百日咳的主要传染源，但随着中国二孩政策的实施，传染源可能已经发生了变化。我们的研究旨在调查婴儿百日咳的家庭传播模式和临床特征。
我们调查了2024年1月1日至5月1日在一家医院（浙江大学医学院附属儿童医院）确诊的婴儿百日咳患者（年龄≤6个月）。百日咳的实验室诊断通过细菌培养得以确认。我们收集了基本和临床信息，并进行了电话调查以研究其家庭内的传播模式。
共确定了275例婴儿百日咳病例，其中162例（58.9%）年龄≤3个月。共有188户家庭完成了传播模式调查，其中121户家庭有两个或更多孩子。临床特征分析表明，年龄≤3个月的婴儿病情更严重，阵发性发绀比例更高（12.4%对3.5%）、白细胞计数升高（13.3对9.8×10⁹/L）以及住院时间延长（10.0天对5.5天）（所有P<0.05）。家庭调查显示，独生子女家庭和多子女家庭中首例病例和传染源的分布存在显著差异（P<0.001）。在多子女家庭中，百日咳传播给婴儿的主要传染源是3至12岁的兄弟姐妹，占病例的46.4%，而成人占32.1%。
本研究强调了大龄儿童在百日咳传播中作用的增加，在多子女家庭中，兄弟姐妹已成为百日咳传播给婴儿的主要传染源。建议优化百日咳疫苗接种策略以更好地保护婴儿。
