Related Experiment Video
Updated: Jul 14, 2026
Evaluation of Host-Pathogen Responses and Vaccine Efficacy in Mice
Published on: February 22, 2019
Increasing rates of infants hospitalized with pertussis
1Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
Insights
Pertussis hospitalizations in infants significantly increased over 14 years, with most unvaccinated infants under six months experiencing severe symptoms. Mortality was linked to pulmonary hypertension and high lymphocyte counts in infants under three months.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Pertussis (whooping cough) poses a significant threat to infants.
- Four infant deaths from pertussis in one year prompted this study.
Purpose of the Study:
- To determine trends in pertussis hospitalizations in infants under one year of age.
- To identify risk factors and outcomes associated with severe pertussis in this age group.
Main Methods:
- Retrospective chart review of medical records from July 1988 to June 2002.
- Inclusion criteria: infants < one year with positive pertussis tests, epidemiological link, or characteristic symptoms.
- Data collected: demographics, clinical presentation, laboratory results, and hospital course.
Main Results:
- A significant increase in pertussis hospitalizations was observed over the study period (2 in 1988-92, 22 in 1993-97, 45 in 1998-2002).
- Most hospitalized infants (94%) were under six months old, and 77% were unvaccinated.
- Common symptoms included paroxysmal cough (85%), cyanosis (68%), and apnea (52%). Mortality was associated with pulmonary hypertension, pneumonia, and elevated lymphocyte counts.
Conclusions:
- The incidence of infant pertussis hospitalizations has risen.
- Infants under three months with specific clinical and laboratory findings faced higher mortality risks.
- New immunization strategies are crucial to protect infants too young to be vaccinated.
Introduction:
Four infant deaths in one year due to pertussis at our hospital prompted a retrospective chart review to determine the trends in pertussis hospitalizations in children < one year of age over the past 14 years.
Methods:
All medical records from July 1988-June 2002 with pertussis-specific ICD-9 codes were reviewed. Subjects were included in the analysis if they were < one year of age, had positive pertussis tests, an epidemiological link to a laboratory-confirmed case; or if they had cough > two weeks with paroxysms, inspiratory whoops or post-tussive vomiting. Demographic, clinical, laboratory, and hospital course data were collected.
Results:
Of the 85 patients identified, 69 subjects met the inclusion criteria. Cases increased over the years with two cases detected from 1988-92, 22 from 1993-97, and 45 from 1998-2002 (p < 0.001). Mean age at admission was 71 days; 94 percent were < six mos. compared to children between six mos.-one yr. (p < 0.001). Mean birth weight was 3027g, with 17 percent preterm. Most subjects (77 percent) had no pertussis immunizations. Presenting symptoms were paroxysmal cough 85 percent, cyanosis 68 percent, and apnea 52 percent. Oxygen was required in 35 percent, mechanical ventilation in 12 percent, and extracorporeal membrane oxygenation (ECMO) in four percent because of uncontrolled pulmonary hypertension. All three subjects on ECMO died. Mean lymphocyte count was 46.3 thou/uL in survivors and 61.1 thou/uL in those who died (p = 0.001).
Conclusions:
The number of patients hospitalized with pertussis has significantly increased. Mortality was seen in infants < 3 mos. with pulmonary hypertension, pneumonia, and elevated lymphocyte counts. These data support the need for new immunization strategies to prevent pertussis disease in infants too young to have been immunized.
Related Concept Videos
01:29Respiratory Syncytial Virus Disease
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:29Pneumonia I: Introduction
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.
01:30Pneumonia III: Complications and Assessment
01:25Transmission-based Precautions II: Airborne and Protective Environment
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...