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Evaluation of Pertussis Disease in Young Infants in India: A Hospital-Based Multicentric Observational Study

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Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objectives

To evaluate the incidence of laboratory-confirmed pertussis (LCP) among infants hospitalized with acute respiratory infections (ARIs) and meeting the Centers for Disease Control and Prevention (CDC)-recommended clinical case definition.

Methods

An investigator-initiated active surveillance for clinically suspected cases (CSCs) of pertussis screened infants aged ≤6 mo hospitalized with ARIs during January 2020-April 2022 at seven centers across India. Reverse transcription-polymerase chain reaction (RT-PCR) was used to detect Bordetella pertussis in nasopharyngeal swabs. Infants were classified as having ‘LCP’ or ‘probable pertussis’ (PP).

Results

Among 1102 screened infants, 400 participants met the CDC-2020 clinical case definition for pertussis. Of these, 34/400 (8.5%) had LCP and 46/400 (11.5%) had PP. The proportion of participants with LCP and PP was similar among infants aged 0-3 and 4-6 mo [LCP: 0-3 mo, 21/248 (~9%); 4-6 mo, 13/152 (~9%); PP: 0-3 mo, 30/248 (~12%); 4-6 mo, 16/152 (~11%)]. Cough illness lasted ≥2 wk in 3/34 (~9%) and 34/46 (~74%) participants with LCP and PP, respectively. Notably, 80% CSCs had neither LCP nor PP, and a respiratory pathogen apart from B. pertussis was detected in ~32%. Ventilation was required in 12 participants with LCP/PP.

Conclusions

In this first study from India based on revised CDC guidelines, the incidence of LCP was 8.5%; cough illness was not a predominant feature. Infants below the age appropriate for vaccination are prone to pertussis-related hospital admissions, ICU care, and ventilation. Maternal immunization may be evaluated for neonatal protection, in addition to other strategies, to decrease disease burden in this highly vulnerable group.

Clinical Trial Registration Number

CTRI/2019/12/022449.

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Acknowledgements

The authors would like to thank all study subjects and their parents for participating in this study. The authors would like to acknowledge support of Medclin Research in statistical analysis and manuscript development.

Funding

Funding for this study was provided by GSK. A preliminary version of the manuscript was reviewed by GSK for factual accuracy. The authors are solely responsible for the final content of the manuscript and interpretation of data.

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Authors and Affiliations

  1. Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India

    Varinder Singh, Priti Singh & Ravitanaya Sodani

  2. Department of Pediatrics, Kanchi Kamakoti Childs Trust Hospital, Chennai, India

    Balasubramanian S

  3. Department of Pediatrics, Bharathi Vidyapeeth Hospital, Pune, India

    Sanjay Lalwani

  4. Department of Pediatrics, Maulana Azad Medical College, New Delhi, India

    Raghvendra Singh

  5. Department of Pediatrics, Medical College & Hospital, Kolkata, India

    Kalpana Datta

  6. Department of Pediatrics, MGM Medical College, Mumbai, India

    Nimain Mohanty

  7. Department of Microbiology, Institute of Child Health, Kolkata, India

    Sumon Poddar

  8. Department of Medical Affairs, Medclin Research Private Limited, Kolkata, India

    Manipa Saha

  9. Department of Pediatrics, Institute of Child Health, 11 Biresh Guha Street, Kolkata, 700017, India

    Monjori Mitra

Authors
  1. Varinder Singh
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  2. Balasubramanian S
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  3. Sanjay Lalwani
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  4. Raghvendra Singh
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  5. Priti Singh
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  7. Nimain Mohanty
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  8. Sumon Poddar
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  9. Ravitanaya Sodani
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  10. Manipa Saha
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  11. Monjori Mitra
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Contributions

MM designed the study protocol, supervised the study, collected, and analyzed data, prepared the initial draft of the manuscript, and revised it critically for intellectual content; VS provided critical intellectual input during manuscript preparation; VS, PS, RS, BS, SL, NM, KD, and RS were involved in patient recruitment, study supervision, data collection, and critical revision of the manuscript for intellectual content; SP performed investigations using RT-PCR; MS participated in preparation and revision of the manuscript. MM will act as guarantor for this manuscript.

Corresponding author

Correspondence to Monjori Mitra.

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Singh, V., S, B., Lalwani, S. et al. Evaluation of Pertussis Disease in Young Infants in India: A Hospital-Based Multicentric Observational Study. Indian J Pediatr 91, 358–365 (2024). https://doi.org/10.1007/s12098-023-04700-y

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  • DOI: https://doi.org/10.1007/s12098-023-04700-y

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