OPP2 PROTECTING OUR YOUTH: PERTUSSIS IN SCHOOL AGED CHILDREN WITH ACUTE RESPIRATORY TRACT INFECTION

Introduction and Aim:

Pertussis in Malaysian school-going children is underreported. Post-COVID-19, pertussis cases rose from 0.3 per million in 2021 to 35.1% in 2023, likely due to reduced vaccination rates and waning immunity from immunization. The Malaysian immunization program excludes the pertussis booster dose for school-aged children despite it being recommended by the WHO. This study aimed to determine the prevalence of Bordetella pertussis and pertussis-susceptible children aged ≥ 4 years who presented with acute respiratory infections (ARTIs).

Methods:

This single-center, cross-sectional study was conducted at the Paediatric Emergency Department from October 1, 2022, to January 31, 2023, and included children aged four years and older with ARTI symptoms excluding COVID-19 positive children. B. pertussis was detected via quantitative Polymerase Chain Reaction (PCR) on nasopharyngeal swabs and pertussis toxin (PT) IgG enzyme-linked immunosorbent assay. 

Results:

Children (n=298) with a median (Interquartile range, [IQR]) age of 6.0 (5.0, 8.0) years old were recruited, and 98% were vaccinated adequately. Two cases of B. pertussis (n=2/298, 0.67%) were detected, and both were co-infected with Bordetella spp. The majority (83.1%) had low protective antibodies against pertussis (anti-PT IgG < 5 IU/ml), and children five years and older were more likely to have lower anti-PT Ig G levels of < 5 IU/ml (odds ratio 2.02 [95% CI 1.04,3.90]) compared to children four years old. 

Conclusion:

The prevalence of pertussis was low. However, there is significant waning immunity. This indicates a pressing need for booster pertussis vaccinations in school-aged children to prevent future infections.