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Pertussis--a re-emerging infection?
K S C Fung1, W L Yeung, T W Wong
1Department of Microbiology, Prince of Wales Hospital, Hong Kong, SAR, People's Republic of China. kittyfung@cuhk.edu.hk
Insights
Infants under six months are at high risk for pertussis (whooping cough), even in vaccinated populations. Early diagnosis and prompt vaccination are crucial for protecting this vulnerable group.
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Background:
- Pertussis (whooping cough) poses a significant threat to infants.
- Herd immunity may not adequately protect vulnerable infants in highly vaccinated communities.
Purpose of the Study:
- To report on pertussis cases in infants aged 1-6 months.
- To highlight clinical indicators and emphasize vaccination strategies.
Main Methods:
- Retrospective case series analysis of seven infants diagnosed with pertussis over three months.
- Clinical data collection including symptoms, laboratory results (leukocyte and lymphocyte counts), and microbiological confirmation (Bordetella pertussis isolation).
Main Results:
- Common symptoms included paroxysmal cough, post-tussive vomiting, and poor feeding.
- Bordetella pertussis was confirmed in six out of seven cases.
- Elevated lymphocyte counts (59-73%) were observed and suggested as potential diagnostic indicators.
Conclusions:
- Infants aged 1-6 months are a vulnerable group for pertussis, requiring heightened clinical suspicion.
- Maintaining high vaccination coverage and early infant vaccination are essential.
- Prompt case identification, contact tracing, and timely treatment are critical for managing pertussis outbreaks.
Abstract:
Seven cases of pertussis in patients aged between 1 and 6 months detected over 3 months were reported. Paroxysmal cough (six cases), post-tussive vomiting (three cases) and poor feeding (three cases) were the most common presenting symptoms. Bordetella pertussis was isolated from six patients. The total leucocyte counts were mildly increased (10.8-15.6x10(9)/L). The lymphocyte counts were markly raised (59-73%) and appear to be useful indicators of pertussis. It appears that herd immunity does not offer adequate protection to the vulnerable group even in well-vaccinated populations. High vaccination coverage should be maintained, and vaccination should be given as early an age as possible. Aggressive efforts to identify cases and contacts are essential. Health care workers should have a high index of suspicion for pertussis, in particular for those with paroxysmal cough and high lymphocyte counts so as to give timely diagnosis and treatment.
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