Study identifies infants at highest risk of death from pertussis

A study released today from the upcoming issue of the Journal of the Pediatric Infectious Diseases Society (JPIDS) found that taking early and repeated white blood cell counts (WBC) is critical in determining whether infants have pertussis and which of those children are at highest risk of death from the disease.

In 2010, California reported its highest pertussis rates in 60 years. Murray, et al.'s used medical records from five Southern California Units between September 2009 and June 2011. Of the 31 infants studied, eight comprised a group considered to have more severe infections, which included suffering from and death from the pertussis.

The study showed that infants who had more severe disease had higher WBC counts and were more likely to show at least a 50% increase in WBC. Infants with more severe disease had median peak WBC counts of 74,100 compared to 24,200 among infants with less severe disease. All but one of those with more severe disease had at least a 50% increase in WBC within 48 hours, and none of those infants with less severe disease had more than a 50% increase in WBC.

Additionally, the group of infants with more severe infections had higher maximum heart and respiratory rates and was more likely to develop pneumonia. All of these conditions occurred earlier after illness onset among infants with more severe disease. This group was more likely to have seizures, hypotension/shock, , and was more likely to be intubated and receive exchange transfusions. Six of the infants received exchange transfusions, and four of those died. Those four were all in shock at the time of their transfusions; the two who survived were not in shock at the time of transfusion.

Also known as , pertussis is a highly contagious bacterial infection of the respiratory tract. Most children are vaccinated against pertussis at an early age, but infants are too young to complete the vaccination series. The U.S. Centers for Disease Control and Prevention reports that 2012 rates of the disease are at their highest level in 50 years and some states are reporting case counts not seen since the 1930s, which was prior to the vaccine era.

"Because very young infants have not yet been vaccinated and are at the highest risk for severe disease, we need to better manage and treat it," said Erin Murray, lead author of the study and epidemiologist at the California Department of Public Health. "This study shows the importance of aggressive pediatric intensive care and provides us additional metrics as we treat these very young patients."

Related Stories

Recommended for you

Niger battles deadly meningitis epidemic

date 6 hours ago

Parents cradling sick children in their arms streamed into a treatment centre in Niger's capital Niamey, the victims of a meningitis epidemic that has claimed over 100 lives and appears to be accelerating.

Long lasting anti-hemophilia factor safe in kids

date 11 hours ago

Children with hemophilia A require three to four infusions each week to prevent bleeding episodes, chronic pain and joint damage. The effect on quality of life can be significant, due to time and discomfort associated with ...

Missouri detective battles flesh-eating infection

date 15 hours ago

Friends and loved ones of Lee's Summit, Mo., Police Detective Joshua Ward are praying for the 34-year-old married father of three who, even after five surgeries in as many days, remained in critical condition Monday at St. ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.