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Bordetella pertussis infection in children with severe pneumonia, Philippines, 2012-2015

Alexander Sadiasa1, Mariko Saito-Obata2, Clyde Dapat3

  • 1Research Institute for Tropical Medicine 17, Muntinlupa City, Metro Manila, Philippines.

Vaccine
|January 23, 2017
PubMed

Insights

Severe pneumonia in Philippine children can be caused by Bordetella pertussis (whooping cough). Infants under 6 months with pertussis had the highest fatality rates, highlighting the need for infant protection.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Severe pneumonia is a significant cause of hospitalization in children.
  • Bordetella pertussis (whooping cough) is a vaccine-preventable disease that can cause severe respiratory illness in infants and children.
  • The prevalence and clinical characteristics of pertussis-associated severe pneumonia in the Philippines are not well-defined.

Purpose of the Study:

  • To investigate the association between Bordetella pertussis infection and severe pneumonia in hospitalized children in the Philippines.
  • To describe the clinical features, risk factors, and outcomes of pertussis-positive severe pneumonia cases.

Main Methods:

  • A case-comparison study was conducted using data from an observational study of hospitalized children aged 8 days to 13 years with severe or very severe pneumonia.
  • Nasopharyngeal swabs were collected from 1152 children between August 2012 and February 2015.
  • Polymerase chain reaction (PCR) was used to detect Bordetella pertussis.

Main Results:

  • Bordetella pertussis was detected in 34 (3.0%) of the 1152 severe pneumonia cases.
  • Pertussis-positive cases were more likely to present with prolonged coughing (over one week), breathing difficulty, decreased breathing sounds, and central cyanosis, and were less likely to have fever.
  • A significantly higher percentage of underweight children were found in the pertussis-positive group.
  • The fatality rate was remarkably higher in pertussis-positive cases compared to pertussis-negative cases.
  • All fatal cases among pertussis-positive children were less than 6 months old.

Conclusions:

  • Bordetella pertussis is an important cause of severe pneumonia in hospitalized children in the Philippines, particularly in young infants.
  • Clinical presentation of pertussis-associated pneumonia may differ from typical bacterial pneumonia, often lacking fever but presenting with prolonged cough and respiratory distress.
  • Young infants (<6 months) with pertussis pneumonia face a substantially higher risk of mortality, underscoring the critical need for timely vaccination and protection strategies for this vulnerable group.

Keywords:
Bordetella pertussisPhilippines

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