Seroprevalence study of B. pertussis infection in health care workers in Catalonia, Spain

Abstract

Pertussis is a re-emerging infection in countries with high infant immunization coverage. Healthcare workers (HCW) are exposed and can transmit the infection to especially-vulnerable patients. Therefore, pertussis vaccination of HCW is recommended.

Between June 2008 and December 2010, 460 HCW from hospital and primary healthcare centers were recruited to determine susceptibility to pertussis. IgG antibodies against pertussis (anti-pertussis ab) were measured, using a routine technique that detects antibodies against pertussis including pertussis toxin (PT) and filamentous hemagglutinin (FHA). Positive results were confirmed with a more-specific technique that only assesses anti-PT IgG antibodies.

The median age was 42 years (range, 21–65), 77.3% were female. 172 were nurses, 133 physicians, 60 other clinical workers and 95 non-clinical workers. None had received pertussis vaccination since childhood. The overall prevalence of anti-pertussis antibodies was 51.7%, (95% CI 47.1–56.4).

Anti-PT antibodies were determined in the 220 HCW with positive anti-pertussis antibodies: 4 (1.8%) were negative and 33 (15%) had a high titer (≥ 45 IU/mL).

No significant differences between the prevalence of anti-pertussis antibodies or anti-TP antibodies were found according to age, type of occupation or type of center.

Our study confirms the need for vaccination of HCW because at least half are susceptible to pertussis. High anti-PT titers found in 15% of seropositive HCW showed that they had had recent contact with B. pertussis.

Keywords: :

• Pertussis
• whooping cough
• pertussis antibodies
• anti-pertussis toxin antibodies
• health care workers
• nosocomial pertussis outbreaks

Disclosure of Potential Conflicts of Interest

No potential conflicts of interest were disclosed.

Acknowledgements

We thank the workers of the Basic Preventive Units of the Catalan Health Institute and the hospitals that participated in the study.

The members of the Working Group for the Study of the Immune Status in Healthcare Workers in Catalonia are: J Amores, T Catalán, A Company, M Cortés, C Diez, E Domenech, X Esteva, J Funes, R Llobet, A Marinetto, M Plana, J Sol, A Tarragó, M Vendrell (Unitats Bàsiques de Prevenció de Riscos Laborals d’Atenció Primària del Institut Català de la Salut); E Barbé, J Peña, M L Villarte (Hospital Arnau de Vilanova, Unitat Bàsica de Prevenció Lleida Alt Pirineu); MT Mestre, P Carbajo (Hospital U. de Tarragona Joan XXIII); I Casas, R Guerola (Hospital Germans Trias, Badalona); A Gascó (H. Viladecans); A Ayora, I Bravo (Hospital Vall d’Hebron, Barcelona); RM Labarta, J Matllo (Servei Propi Mancomunat de Prevenció de Riscos Laborals, Barcelona); P Varela (Hospital Clínic, Barcelona); J Espuñes, R Moreno, M Martínez (Public Health Agency of Catalonia).

Funding

This study was supported by the Direcció General de Salut Pública, Generalitat of Catalonia, Fundación Bosch i Gimpera (Project 305232), AGAUR (Project 2009 SGR42) and CIBERESP.