Retrospective cohort study investigating extent of pertussis transmission during a boarding school outbreak, England, December 2017 to June 2018.

On 1 May 2018, a pertussis outbreak was declared and widespread vaccination recommended at an all-female secondary boarding school in southern England. We conducted a retrospective cohort study to determine the extent of pertussis transmission and identify risk factors in this semi-closed population. Of 504 students and staff assessed before post-exposure vaccination, 48% (n = 240) had evidence of pertussis. A sub-analysis of 409 students found that both residential dormitory (p = 0.05) and school year (p = 0.03) were associated with pertussis, with odds decreasing by 11% for each increase in school year (95% confidence interval: 0.7-20.2). Odds of pertussis were 1.7 times higher in those assumed to have received acellular vaccines for their primary course compared with those assumed to have received whole-cell vaccines (based on date of birth), although this difference was not significant (p = 0.12). Our findings support the need for timely, widespread vaccination following identification of cases among adolescents in a semi-closed United Kingdom (UK) setting and to review the evidence for the introduction of an adolescent pertussis booster to the UK routine vaccination programme.

Viral Genome Sequencing Proves Nosocomial Transmission of Fatal Varicella.

We report the first use of whole viral genome sequencing to identify nosocomial transmission of varicella-zoster virus with fatal outcome. The index case patient, nursed in source isolation, developed disseminated zoster with rash present for 1 day before being transferred to the intensive care unit (ICU). Two patients who had received renal transplants while inpatients in an adjacent ward developed chickenpox and 1 died; neither patient had direct contact with the index patient.

Who has chlamydia? The prevalence of genital tract Chlamydia trachomatis within Portsmouth and South East Hampshire, UK.

OBJECTIVE: To determine the prevalence of genital tract Chlamydia trachomatis infection in women and men attending different health care settings in Portsmouth and South East Hampshire. DESIGN: Prospective, opportunistic screening. SETTING: Multiple health care sites. PARTICIPANTS: Consenting sexually active women and men. INTERVENTION: A urine sample was tested for Chlamydia trachomatis and positive patients were offered treatment and partner notification. MAIN OUTCOME MEASURES: The presence or absence of chlamydia infection according to age, gender, health care setting and reason for attendance. RESULTS: A total of 14,756 samples were tested giving an overall prevalence of 9.6%. The prevalence was significantly higher in women attending for a termination of pregnancy, antenatal care, women and men attending genitourinary medicine and in those with genital tract symptoms. The prevalence was different for men and women at different ages. CONCLUSION: The prevalence of genital Chlamydia trachomatis infection was high but differed at various health care settings and by reason for attendance.