Due to a significant surge in the cases of whooping cough (also known as pertussis), questions surrounding enduring immunity have surfaced. This highly contagious respiratory disease, caused by the bacterium Bordetella pertussis, has led to an upshot in queries on the adequacy of antibody levels, commonly assessed using a titer test before the receipt of a booster shot. However, practicing caution against over-reliance on titer tests is essential as per pediatric infectious disease expert Michael Glazier, MD, co-founder and Chief Medical Officer of Bluebird Kids Health, as conveyed during a discussion with Infection Control Today® (ICT®). This recommendation stems from the belief that boosters offer a more solid defense strategy, especially for adults who can unknowingly be carriers of the disease to vulnerable populations, such as infants.
This comes in the context of the Tdap vaccine, which guards against tetanus, diphtheria, and pertussis – despite the recommendation for adults to receive Tdap vaccination every decade, many are oblivious about their waning immunity. In light of the mounting cases, should one get tested or opt for a booster shot without delay? Dr. Glazier strongly recommends the latter, identifying booster shots as an absolute requirement to prevent severe disease, slow transmission, and protect those most susceptible to the disease.
Delving into more details, Dr. Glazier argues that the benefits derived from a titer test may not correspondingly outweigh the burdens. The test involves a blood draw, an experience often avoided, to provide a numerical value denoting one’s immunity- often indicating a necessity for a booster shot, theoretically resulting in the usage of two needles instead of one. This process becomes even more convoluted as it can be heavily influenced by one’s age.
The pertussis vaccine forms a part of the Tdap vaccine, along with that of tetanus and diphtheria, with the tetanus shot recommended at a minimum interval of every ten years. This becomes essential, even more so in adults who might interact with children, to prevent inadvertently transferring the disease. In current times, where the trauma induced by COVID-19 has overlapped with an increased incidence of respiratory diseases, such measures help control disease spread by limiting air droplet transmission. Easier diagnosis procedures facilitated today by PCR tests also contribute to the identification and management of pertussis.
For infection preventionists (IPs) and other health care workers, the primary step ought to be the recognition of the high case numbers. High-risk individuals and those who live with them, particularly neonates or those with pre-existing conditions like congenital heart disease or severe asthma, should be prioritized for testing. In case of a positive diagnosis, early treatment can mitigate symptoms and curb the spread. The awareness of escalating pertussis prevalence should be met with precautionary measures including prompt visits to the doctor. The inclusion of mask usage as a strategy to prevent pertussis transmission can complement the overall prevention approach, empowering vaccination efforts, improving health outcomes, and upholding public safety.