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Changing Patterns of Pertussis in a Children's Hospital in the Polymerase Chain Reaction Diagnostic Era

Sophie Hale1, Helen E Quinn1, Alison Kesson2

  • 1National Center for Immunization Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead, Westmead, New South Wales, Australia; Discipline of Pediatrics and Child Health, University of Sydney, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.

The Journal of Pediatrics
|December 22, 2015
PubMed

Insights

Changes in pertussis vaccine schedules led to more hospitalizations in older children. Fully immunized children over 6 months had increased culture-positive pertussis, highlighting the need for booster doses.

Area of Science:

  • Pediatric infectious diseases
  • Immunization practices
  • Epidemiology

Background:

  • Pertussis (whooping cough) diagnosis and management have evolved.
  • Vaccine schedules and types have changed, impacting disease epidemiology.
  • Understanding these changes is crucial for public health.

Purpose of the Study:

  • To compare pertussis cases before and after changes in vaccine schedules.
  • To assess the impact of diagnostic methods and clinical severity on pertussis case ascertainment.
  • To evaluate the role of comorbidities in hospitalized pertussis patients.

Main Methods:

  • Retrospective observational study comparing pertussis cases from 1997-1999 and 2007-2012.
  • Replicated case ascertainment methods, including culture confirmation and clinical severity assessment.
  • Analyzed hospitalizations, comorbidities, and diagnostic test availability (culture, PCR).

Main Results:

  • Hospitalizations for pertussis increased significantly, particularly in children over 6 months.
  • Culture-positive hospitalizations rose in children over 6 months but not in those under 6 months.
  • Comorbidities were common in hospitalized children, especially those aged 12 months and older.

Conclusions:

  • Increased culture-positive pertussis hospitalizations were observed in fully immunized children over 6 months, correlating with vaccine schedule changes.
  • The prevalence of significant comorbidities underscores the importance of timely pertussis booster vaccinations.
  • Diagnostic practices and vaccine schedules significantly influence pertussis epidemiology in pediatric populations.
Abstract

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