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Burden and Outcomes of Severe Pertussis Infection in Critically Ill Infants

Lahn Straney1, Andreas Schibler, Anusha Ganeshalingham

  • 11Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia. 2Paediatric Critical Care Research Group, Mater Research Institute, University of Queensland, Brisbane, QLD, Australia. 3Paediatric Intensive Care Unit, Lady Cilento Children's Hospital, Brisbane, QLD, Australia. 4Paediatric Intensive Care Unit, Starship Children's Hospital, Auckland, New Zealand. 5Australian and New Zealand Paediatric Intensive Care Registry, CORE, Royal Children's Hospital Brisbane, Herston, QLD, Australia. 6Paediatric Intensive Care Unit, Children's Hospital Westmead, Sydney, NSW, Australia. 7Paediatric Intensive Care Unit, The Royal Children's Hospital, Melbourne, VIC, Australia. 8Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia. 9Cardiothoracic Intensive Care Unit, National University Health System, Singapore, Singapore. 10Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|July 1, 2016
PubMed

Insights

Severe pertussis (whooping cough) significantly impacts infants, especially newborns, leading to high ICU admission rates and mortality. This vaccine-preventable disease incurs substantial healthcare costs, necessitating improved prevention strategies.

Area of Science:

  • Pediatric Infectious Diseases
  • Intensive Care Medicine
  • Public Health and Epidemiology

Background:

  • Despite widespread vaccination, Bordetella pertussis (whooping cough) remains a significant cause of severe illness and mortality in infants.
  • There is a critical need for data on the incidence, clinical course, and economic impact of pertussis in critically ill infants requiring intensive care.

Purpose of the Study:

  • To determine the admission rates, clinical severity, mortality, and associated healthcare costs of pertussis infections in infants admitted to intensive care units (ICUs).
  • To analyze factors associated with mortality in critically ill infants with pertussis.

Main Methods:

  • A binational observational multicenter study was conducted.
  • Data were collected from 10 Pediatric Intensive Care Units (PICUs) and 19 general ICUs in Australia and New Zealand between 2002 and 2014.
  • Infants under one year of age admitted to the ICU with a pertussis diagnosis were included.

Main Results:

  • Pertussis accounted for 1.0% of infant ICU admissions (416/42,958), with rates varying from 2.1 to 18.6 per 100,000 infants.
  • Infants under 60 days old had the highest admission rates. Nearly half (49.5%) required mechanical ventilation, and 4.8% of all infants died.
  • Mechanical ventilation, high-frequency oscillatory ventilation, inhaled nitric oxide, and extracorporeal membrane oxygenation were linked to increased mortality. Annual direct hospitalization costs exceeded USD$1,000,000.

Conclusions:

  • Pertussis infection poses a substantial burden of morbidity and mortality in infants, particularly in the first few months of life.
  • Enhanced strategies are crucial to mitigate the impact of this vaccine-preventable disease and reduce associated healthcare expenditures.
Abstract

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