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Pertussis manifesting as recurrent cough and wheezing in an incompletely vaccinated 8-month-old infant
Dimitri Poddighe1,2, Marco Giuseppe Nedbal1, Nunzia Mastricci1
1Department of Pediatrics, ASST Melegnano e Martesana, Vizzolo Predabissi, Italy.
Insights
Pertussis, a respiratory illness caused by Bordetella pertussis, is re-emerging. This case highlights the need for early diagnosis in vaccinated infants and potential vaccine strategy adjustments.
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Background:
- Pertussis (whooping cough) caused by Bordetella pertussis is re-emerging in developed nations.
- The disease is often under-recognized, leading to an underestimation of its public health burden.
- Current vaccination schedules may require re-evaluation in light of changing epidemiological factors.
Observation:
- A clinical case of pertussis is presented in an infant who received routine vaccinations.
- Diagnosis was achieved through meticulous clinical assessment, including detailed patient and family history.
- The infant presented with atypical pertussis symptoms, underscoring diagnostic challenges.
Findings:
- Early and accurate diagnosis of pertussis is crucial, even in vaccinated individuals.
- Atypical presentations can occur, necessitating a high index of suspicion.
- Clinical vigilance is key to identifying under-recognized cases of Bordetella pertussis.
Implications:
- This case emphasizes the importance of considering pertussis in infants with respiratory symptoms, irrespective of vaccination status.
- Findings suggest a potential need to modify or enhance immunization strategies in Europe.
- Adapting vaccination policies to evolving social and health landscapes, including vaccine coverage rates, is critical.
Abstract:
Pertussis is an acute respiratory illness caused by Bordetella pertussis, showing a re-emergence in developed countries. However, it is probably under-recognised and, as a consequence, its burden is underestimated. Here, we report the clinical case of an infant diagnosed with pertussis, despite a regular schedule of vaccination, thanks to a careful clinical evaluation, including personal and family history. In addition to pointing the attention on a precocious diagnosis of atypical cases of pertussis, this case report further raised the issue of modifying and/or implementing the immunisation strategy, considering the ongoing changes of social (eg, immigration) and sanitary (eg, vaccine coverage) background in Italy and all over the Europe.