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Predicting pertussis in infants.

Hazel Guinto-Ocampo1, Jonathan E Bennett, Magdy W Attia

  • 1Division of Emergency Medicine, Thomas Jefferson University Medical College, A.I. duPont Hospital for Children, Nemours Children's Clinic, Wilmington, DE 19899, USA. hguinto@nemours.org

Pediatric Emergency Care
|January 1, 2008
PubMed
Summary
This summary is machine-generated.

Rising pertussis cases in infants are concerning. Younger infants, specific seasonal evaluation, and higher absolute lymphocyte counts (ALC) are key predictors of pertussis, with an ALC below 9400/microL effectively ruling out the disease.

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Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Clinical Laboratory Science

Background:

  • Pertussis (whooping cough) incidence is increasing globally, posing significant risks to infants.
  • Infants face the highest burden of pertussis-related complications and mortality.
  • Timely and accurate diagnostic tests for pertussis in infants are limited, delaying crucial interventions.

Purpose of the Study:

  • To identify clinical and laboratory predictors for diagnosing pertussis in infants.
  • To improve early identification of pertussis in the pediatric population.

Main Methods:

  • Retrospective analysis of medical records for 141 infants under 12 months tested for Bordetella pertussis.
  • Data collected included demographics, clinical symptoms, and laboratory results.
  • Statistical analysis, including univariate, multivariate, and receiver operating characteristic (ROC) analyses, was performed.

Main Results:

  • Younger infants, those evaluated between July-October, and infants with lower respiratory rates were more likely to test positive for pertussis.
  • Higher white blood cell counts and elevated absolute lymphocyte counts (ALC) were significantly associated with positive pertussis tests.
  • An ALC cutoff of 9400/microL demonstrated 89% sensitivity and 75% specificity for pertussis detection.

Conclusions:

  • Younger age, seasonal factors (July-October), reduced tachypnea, elevated white blood cell count, and higher ALC are significant predictors of pertussis in infants.
  • Absolute lymphocyte count (ALC) emerged as the strongest laboratory predictor for pertussis.
  • An ALC below 9400/microL demonstrated a high negative predictive value (97%), effectively excluding pertussis in most infants.