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Looking beyond Pertussis in Prolonged Cough Illness of Young Children
Rajlakshmi Viswanathan1, Sanjay Bafna2, Manohar Lal Choudhary3
1Bacteriology Group, ICMR-National Institute of Virology, 130/1, Sus Road, Pashan, Pune 411021, India.
Insights
Whooping cough (pertussis) is a poorly controlled vaccine-preventable disease. In India, molecular methods identified Bordetella pertussis and other bacteria, alongside common viruses, in young children with prolonged coughs.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Pertussis (whooping cough) is a significant global health concern and a poorly controlled vaccine-preventable illness.
- Childhood pertussis burden is high in South-East Asia, yet remains understudied in India.
- Clinical diagnosis of pertussis in young children is challenging due to atypical presentations and overlap with other respiratory infections.
Purpose of the Study:
- To investigate the prevalence of pertussis and common viral respiratory infections in young children with prolonged cough in western India.
- To evaluate the utility of molecular diagnostic methods for identifying causative agents of prolonged cough illness in pediatric patients.
Main Methods:
- Molecular methods were employed to detect *Bordetella pertussis*, *Bordetella holmesii*, and common respiratory viruses.
- The study included children under two years of age presenting with prolonged cough illness at an urban pediatric center in western India.
Main Results:
- *Bordetella pertussis* and *Bordetella holmesii* were each detected in 3 out of 45 suspected cases.
- Respiratory Syncytial Virus-A (RSV-A) and human Metapneumovirus (hMPV) were the most frequently identified viral pathogens.
- These detected pathogens can present with symptoms mimicking mild pertussis.
Conclusions:
- Bacterial and viral pathogens, including *B. pertussis*, *B. holmesii*, RSV-A, and hMPV, are important causes of prolonged cough illness in young children in India.
- Accurate etiological diagnosis is crucial for appropriate clinical management and reliable disease burden estimation.
- These findings highlight the need to consider pertussis and viral infections in the differential diagnosis of persistent cough in pediatric populations.
Abstract:
Pertussis, commonly known as whooping cough, is one of the most poorly controlled vaccine-preventable diseases in the world. South-East Asia is estimated to contribute the most to childhood disease burden while this remains largely unexplored in India. The clinical diagnosis of pertussis in young children is a challenge as the classical four-stage presentation with paroxysmal cough or whoop may be absent. It is also difficult to differentiate from other respiratory infections which can cause pertussis-like illness. Children below two years with prolonged cough illness attending an urban pediatric center in western India, were evaluated for pertussis and viral infections by molecular methods. Bordetella pertussis and B. holmesii were confirmed in three each of 45 suspected cases, and RSV-A and hMPV were the most common viruses that were detected. These organisms can mimic mild cases of pertussis and need to be considered in differential diagnosis of prolonged cough illness in young children. The accurate etiology of prolonged cough illness needs to be detected and documented to ensure appropriate management and accurate estimates of disease burden.
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