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Predicting pertussis in a pediatric emergency department population
Jennifer E Mackey1, Susan Wojcik, Ray Long
1The Department of Emergency Medicine, University of New York Upstate Medical University, Syracuse, NY 13210, USA. mackeyj@upstate.edu
Clinical Pediatrics
|June 9, 2007
Summary
Pertussis (whooping cough) is surging in infants. Infants under 2 months with specific cough, choking, cyanosis, and rhonchi symptoms are highly likely to have pertussis.
Area of Science:
- Pediatric Emergency Medicine
- Infectious Diseases
- Public Health
Background:
- Pertussis (whooping cough) is a serious respiratory illness with cases at a 40-year high, particularly affecting infants.
- Pediatric emergency departments are common sites for initial pertussis evaluation.
- Early recognition is crucial for rapid triage, isolation, and preventing hospital-acquired (nosocomial) transmission.
Purpose of the Study:
- To identify key clinical predictors of pertussis in pediatric emergency department patients.
- To enable prompt identification and isolation of infants with pertussis to prevent transmission.
Main Methods:
- Retrospective, case-control chart review of pediatric patients (0-18 years) presenting to the emergency department.
- Analysis of medical history and physical examination variables to predict pertussis, confirmed by laboratory testing.
Main Results:
- Infants younger than 2 months presenting with cough or choking, cyanosis, and rhonchi on examination showed a high likelihood of pertussis.
- These specific clinical signs are strong predictors for pertussis in young infants.
Conclusions:
- Prompt identification of pertussis in infants under 2 months presenting with specific symptoms is critical in the emergency department.
- Immediate isolation and testing of these infants can lead to timely treatment and reduce nosocomial transmission within the department.
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