Related Experiment Video
Updated: May 2, 2026
Evaluation of Host-Pathogen Responses and Vaccine Efficacy in Mice
Published on: February 22, 2019
Epidemiology of Bordetella pertussis in a children's hospital
Angela Gentile1, Viviana S Romanin1, María Del Valle Juárez1
1División Promoción y Protección de la Salud, Hospital de Niños Ricardo Gutiérrez.
Insights
Pertussis (whooping cough) disproportionately affects unvaccinated infants. Paroxysmal cough and high white blood cell counts predict pertussis diagnosis, while elevated white blood cells indicate a higher risk of fatality.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Pertussis (whooping cough) remains a significant cause of illness and death in infants under one year old.
- Understanding Bordetella pertussis clinical and epidemiological patterns is crucial for effective management.
Purpose of the Study:
- To detail the clinical and epidemiological profile of Bordetella pertussis infections.
- To identify factors associated with positive PCR confirmation and case fatality rates.
Main Methods:
- A prospective cohort study was conducted from December 2003 to December 2011.
- Included were children suspected of pertussis at a pediatric hospital, analyzing PCR confirmation and case fatality using relative risk.
Main Results:
- Of 620 patients, 38% had confirmed pertussis, primarily infants under 1 year with incomplete vaccination.
- Paroxysmal cough and leukocytosis (>20,000 cells/mm³) predicted PCR confirmation.
- Leukocytosis (>30,000 cells/mm³) was a significant predictor of mortality (RR 6.7), with a 6.8% case fatality rate among hospitalized patients.
Conclusions:
- Infants under one year with incomplete immunization are most affected by pertussis.
- Paroxysmal cough and leukocytosis are key indicators for PCR diagnosis.
- Leukocytosis is a critical predictor of mortality in pertussis cases.
Introduction:
Pertussis or whooping cough continues to be a major cause of morbidity and mortality in infants younger than 1 year old.
Objectives:
To describe the clinical and epidemiological profile of Bordetella pertussis and to analyze the factors associated with confirmation by PCR and case fatality rate.
Material And Methods:
Prospective, cohort study conducted between December 2003 and December 2011. The study included children seen at the Hospital de Niños Ricardo Gutiérrez suspected of pertussis. The factors associated with confirmation by PCR and the case fatality rate by relative risk (RR) with a 95% confidence interval were studied.
Results:
Six hundred and twenty patients with a 38% of positive cases (236/620) were included, 3 cases were confirmed by epidemiological link. Confirmed cases (239) showed a seasonal pattern from September through February, a median age of 3 months old, and 89% had received less than three vaccine doses. Eighty six percent of patients were hospitalized: their median length of stay was 7 days. A total of 99% of patients were eu-trophic, 98% were immunocompetent and 17.5% required intensive care. The clinical presentation was analyzed in 480 patients. Of them, 38% (184) had a positive PCR result and their symptoms were: 96.2%, cough; 76.5%, paroxysmal cough; 57.9% cyanosis; 55.7%, respiratory distress; 29%, fever; 22.4%, apnea; 21.9%, vomiting after coughing. A multivariate analysis identified the following as independent predictors associated with confirmation of pertussis by PCR: paroxysmal cough (OR 2.52: 1.50-4.22; p= 0.000) and leukocytosis upon admission >20 000 white blood cells/mm3 (OR 7.96: 4.82-13.17; p= 0.000); having developed fever reduced the chance of having a positive PCR result (OR 0.47: 0.29-0.77; p= 0.003). The case fatality rate for hospitalized patients was 6.8%. Leukocytosis >30 000 white blood cells/mm3 was a predictor of fatality (RR 6.7: 1.88-23.9; p= 0.001).
Conclusions:
Confirmed cases were mostly infants younger than 1 year old who were healthy before and who had not completed their primary immunization schedule. Paroxysmal cough and leukocytosis were associated with PCR diagnosis, while leukocytosis was a predictor of mortality.
More Related Videos
Related Concept Videos
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
01:25Transmission-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...
01:28Diphtheria
01:29Microbiota of the Respiratory Tract
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...