Prevalence and characteristics of pertussis co-infections in infants living in England. Prevalence and characteristics of co-infections in infants diagnosed with pertussis in England 2011-2019.

Abstract

Background and aim: Bordetella pertussis is a highly infectious bacterial respiratory disease that affects all age groups with infants being the most at risk of detrimental outcomes. B.Pertussis is still a public health concern, with outbreaks that occur every 2-5 years on average. Viral and bacterial infections are commonly diagnosed with pertussis with no clear understanding if there is a possible association between them and between the severity of outcomes in infants. The study aims to compare the characteristics of infants positive for pertussis with and without coinfections, and to compare the clinical severity between the two groups. Also, assessing the prevalence of these coinfections and whether their profile has changed over the study period. Method: A secondary data analysis was conducted using a national dataset collected from UKHSA surveillance systems from 2011-2019. The dataset includes 1646 infants < 1 year old living in England diagnosed with pertussis. A descriptive analysis was performed to summarize the main clinical and demographic characteristics. Additionally, to examine the key outcomes, complications, death, hospitalization with coinfection status, univariate and multivariate regression analyses using STATA software were conducted. Results: The total number of the pertussis-only group was 1475 cases, and 171 was the total number of pertussis with coinfection(s) cases where the majority of infants in both groups were 0-2 months old. 39.77% developed complications in the pertussis coinfection(s) group compared to 34.78% in the pertussis-only group [32.37 – 47.52; 32.35 - 37.27]. Death was high in both groups, with pertussis with coinfection(s) being higher (1.97, 5.85), respectively, hospitalization was also high in both groups, 74.44% in the pertussis-only group and 82.46% in the other group. Conclusion: No significant association between complications and coinfection status, yet complications are statistically associated with age and sex. Death and hospitalization were statistically significant with coinfection status with p-values <0.05. These results need to be considered for prevention and control strategies by increasing the awareness of vaccination and the importance of early diagnosis to decrease economic and social burden.