Infectious diseases

Pertussis Infection in Children QIP: Raising Awareness Amongst Clinicians (2025)

Posted on by

Type of publication:

Conference abstract

Author(s):

*Khallaf L.; *Muniu S.; *Sakremath R.; *Lee S.

Citation:

Archives of Disease in Childhood. Conference: Royal College of Paediatrics and Child Health Conference, RCPCH 2025. Glasgow United Kingdom. 110(Supplement 1) (pp A301-A302), 2025. Date of Publication: 01 Jun 2025.

Abstract:

Why did you do this work? Pertussis is a highly infectious preventable disease caused by Bordetella pertussis. Young infants under 3 months of age remain at the highest risk of severe disease with 9 reported infant deaths this year in the United Kingdom.1 We aim to raise awareness about pertussis infection among clinicians in our Paediatric Department through education. What did you do? Educational sessions were delivered from February to March 2024. Data was collected using pre- and post-session questionnaires to assess clinician's knowledge. The questionnaire included symptoms, signs, management and complications of pertussis infection. A teaching presentation was given in the first cycle. In the second cycle, an informative poster was displayed throughout our department. Data was collected and analysed using Microsoft Excel. The effectiveness of the education tool delivered was evaluated. What did you find? There were 11 participants in the first cycle and 9 in the second cycle. All participants in cycle 1 understood pertussis infection and its complications and recognised the importance of exclusion from nursery/school. In cycle 2, all demonstrated knowledge of pertussis symptoms and knew it was a notifiable disease. In the first cycle, many participants, 63% (7 out of 11 participants), were unaware of the process for requesting a pertussis test in our department, which improved slightly to 55% (5 out of 9 participants) in the second cycle. Additionally, the rate of incorrect responses decreased between cycles for several topics: the incubation period of pertussis (54.5% in cycle 1 versus 33% in cycle 2), the appropriate timing for requesting the test (18% versus 11%), and knowledge of first-line antibiotics (36% versus 22%). The rate of incorrect responses increased between cycle 1 and cycle 2, rising from 27% to 33% for the need of prophylaxis treatment and 27% to 44% for the exclusion of asymptomatic contacts. Despite interventions, knowledge of the latter showed no improvement between the two cycles. Following cycle 1, significant improvements were noted, with 100% correct responses for how to request a pertussis test, appropriate timing for ordering the tests, and the incubation period. Both cycles demonstrated improvement as all participants knew the first-line antibiotic treatment for pertussis. What does it mean? Although our sample size was small, our project showed that the overall knowledge of our clinicians improved in the 2 cycles. Ongoing education is needed to improve awareness of pertussis infection, especially during the winter months.

DOI: 10.1136/archdischild-2025-rcpch.413

Link to full-text [NHS OpenAthens account required]

Viral Haemorrhagic Fevers: Preparation for the Next Pandemic? (2025)

Posted on by

Type of publication:

Conference abstract

Author(s):

*Moumneh R.; McMonnies K.; Johnston V.; Eisen S.

Citation:

Archives of Disease in Childhood. Conference: Royal College of Paediatrics and Child Health Conference, RCPCH 2025. Glasgow United Kingdom. 110(Supplement 1) (pp A123-A124), 2025. Date of Publication: 01 Jun 2025.

Abstract:

Why did you do this work? Multiple viral haemorrhagic fevers (VHFs) are classified as high consequence infections due to high mortality and potential for human-to-human transmission. 1 To aid early identification and prevent outbreaks, our hospital has designed an electronic screening tool to be used at triage in our emergency department (ED) to identify patients presenting with fever within 21days of travel to a VHF endemic country. This study aimed to evaluate if this electronic triage tool was being used appropriately in our Paediatric ED to support early identification and appropriate management of children at risk of VHF. What did you do? A random sample of 50 children (<18 years) presenting to our central London acute hospital with current or recent history of fever (>37.5oC) between March – May 2024 had their electronic health care records reviewed (EPIC ©) to evaluate if the electronic triage tool was being used. A data extract of where the triage tool had been used in EPIC between January – March 2024 was used to identify children at risk of VHF; case notes were then reviewed for evidence of appropriate isolation and escalation. All data were anonymised and analysed using Microsoft ExcelTM. What did you find? The triage tool was used correctly in 32/ 50 febrile children (64%). The triage tool was not used in 6 cases (12%) and used incorrectly (not fully completed or incorrect information included) in 12 cases (24%). 47 children were identified in the triage tool as at risk of VHF (fever within 21days of travel to VHF endemic country). There was no evidence of consideration of VHF, isolation or escalation in any of these cases. What does this mean? Early identification of cases is key to preventing healthcare associated outbreaks, protecting both staff and patients. The current implementation of the VHF triage tool in our Paediatric ED has not been shown to assist with this early identification. The VHF triage tool was frequently not used or incorrectly completed. Even when used, identification of VHF risk did not result in appropriate isolation or escalation of children at risk of VHF. One explanation for this might be the increased number of presentations of 'fever in the returning traveller' in the paediatric population therefore the triage tool is seen as unnecessary additional workload, or the significance of high consequence infections is not considered. Following this study, we developed a paediatric specific quick reference guide for conducting VHF risk assessments and to guide early management of children 'at risk' of VHF. Multidisciplinary departmental teaching has resulted in a positive impact on staff confidence in use of the tool and in responding to identification of VHF risk (evaluation in full write-up). We plan to re-audit the use of the triage tool and subsequent management once established.

DOI: 10.1136/archdischild-2025-rcpch.166

Link to full-text [NHS OpenAthens account required]

Cost of Tuberculosis (TB) screening and contact tracing an Eastern European immigrant population seasonally employed at an agricultural farm in the United Kingdom (2024)

Posted on by

Type of publication:

Conference abstract

Author(s):

*George S.; *Moudgil H.;

Citation:

European Respiratory Journal. Conference: European Respiratory Society International Congress, ERS 2024. Vienna Austria. 64(Supplement 68) (pp PA1475), 2024. Date of Publication: 01 Sep 2024.

Abstract:

Background: Economic data inform public health measures; a co-ordinated approach to TB contact tracing, guided by Public Health England (PHE), was undertaken assessing a non English speaking Eastern European immigrant population seasonally employed at an agricultural farm and we (1) report direct costs, (2) identify cultural issues and risks employing such a population Methods: After an initial pilot study of work-based contacts of an index case, contact lists incorporating workforce in every shift pattern back-dated two years to his UK entry were identified. Direct costs included T-spot testing (Oxford Immunotec) and translators (Romanian, Polish, Lithuanian, Italian) along with secondary care charges at tariff with uniform cross-charge among providers. TB drug costs (managing latent or disease) were from the British National Formulary.
Result(s): 258/331 (78%) workers took up testing. 80 (31%) were then referred for contact screening; of these, 47 had latent and 3 active disease. 16 defaulted, 5 declined, 4 were pregnant, and 5 lost moved elsewhere. Most had no registered General Practitioner and no pre-employment health check, BCG or radiology. Anecdotally, several returned to their parent countries for healthcare advice despite measures to overcome language barriers. Main direct costs (51,497-52) equated to 199-60/person screening and 1029-95/person treated for either latent or TB disease.
Conclusion(s): Language and cultural barriers are challenges to TB screening/contact tracing. Direct costs are 200 (UK pound sterling = 1.17 Euro) per patient screened and five times this amount treating latent or active disease.

Link to full-text [no password required]

Is the MMR vaccination programme failing to protect women against rubella infection? (2014)

Posted on by

Type of publication:
Journal article

Author(s):
*Skidmore S., Boxall E., Lord S.

Citation:
Epidemiology and Infection, 2014, vol./is. 142/5(1114-1117), 0950-2688;1469-4409 (2014)

Abstract:
In recent years the number of pregnant women susceptible to rubella has increased markedly. In the West Midlands the proportion has risen from 1.4% in 2004 to 6.9% in 2011. Locally, the proportion of non-immune women ranges from 1.6% in those born prior to 1976 to 17.8% in those born since 1986. The latter group comprises those given MMR in their second year with no further booster doses. The number of non-immune women will continue to rise as a consequence of low MMR uptake in the late 1990s. Repeat testing of samples with values

Link to more details or full-text: http://www.ncbi.nlm.nih.gov/pubmed/23953764