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Pertussis, or whooping cough, can present with atypical symptoms, complicating diagnosis. Early recognition in infants and prompt contact tracing are vital to prevent infant deaths from Bordetella pertussis.
Area of Science:
- Pediatric Infectious Diseases
- Bacteriology
- Public Health
Background:
- Pertussis (whooping cough) is a highly contagious respiratory infection caused by Bordetella pertussis.
- Typical symptoms include inspiratory "whoop," paroxysmal cough, and posttussive vomiting.
- Infants under 6 months and unvaccinated infants are particularly susceptible to severe B. pertussis infection.
Observation:
- Atypical presentations of pertussis can hinder prompt clinical recognition.
- Two infant deaths due to pertussis in 2000 highlight diagnostic challenges.
- Vulnerable infants presenting with cough, respiratory distress, or apnea may have pertussis.
Findings:
- Bordetella pertussis infection can manifest with non-classic symptoms.
- Delayed diagnosis increases the risk of transmission and adverse outcomes.
- Prompt identification of pertussis in infants and their contacts is crucial.
Implications:
- Clinicians must maintain a high index of suspicion for pertussis in infants with respiratory symptoms.
- Effective diagnosis and management of pertussis in contacts can prevent infant fatalities.
- Public health strategies should emphasize vaccination and early detection to protect vulnerable populations.
Abstract:
Pertussis (i.e., whooping cough) is associated typically with an inspiratory "whoop," prolonged paroxysmal cough, and posttussive vomiting; however, persons infected with Bordetella pertussis sometimes experience atypical symptoms, making prompt recognition difficult and probably increasing infection transmission. All infants aged <6 months and any infants who have not yet received 3 doses of diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine are especially vulnerable to B. pertussis infection. This report summarizes the investigations of two pertussis deaths that occurred in 2000. Clinicians should consider pertussis as a cause of illness, especially among vulnerable infants who present with cough illness, respiratory distress, or apnea. Timely diagnosis of pertussis in caregivers and other contacts of infants could prevent infant pertussis fatalities.