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Pertussis in Hospitalized Children

Pertussis in Hospitalized Children Abstract • Before the whole-cell pertussis vaccine was available, Bordetella pertussis infections were an important cause of morbidity and mortality in infants. To determine the extent of continuing morbidity in an era of vaccination, a retrospective review was conducted of the records of neonates and infants hospitalized with pertussis infection at Parkland Memorial Hospital and Children's Medical Center, Dallas, Tex. During the 20 years from 1967 through 1986, 182 patients were younger than 24 months. Among 176 patients whose immunization history was recorded, 89% had received fewer than two doses of pertussis vaccine. The mean hospital stay was 7.4 days (range, 1 to 69 days). A convulsion occurred in 11 patients (6%). Apnea was reported in 45 patients (25%) and observed in the hospital in 26 (14%). Nine patients (5%) received mechanical ventilatory therapy. Intensive care monitoring was required in 18 patients (10%). Three (1.6%) died, all with secondary bacterial pneumonia. This hospital-based population indicates that pertussis continues to be a cause of serious morbidity and mortality in infants. (AJDC. 1990;144:1130-1134) References 1. Barkin RM, Samuelson JS. DPT vaccine . JAMA . 1986;255:2026-2027. Letters.Crossref 2. Centers for Disease Control. Pertussis surveillance: United States, 1984 and 1985 . MMWR . 1987;36:168-171. 3. Lapin JH. Whooping Cough . Springfield, Ill: Charles C Thomas Publisher; 1943. 4. Fulginiti VA. The current state of pertussis and pertussis vaccines . AJDC . 1989;143:532-533. 5. Kaufman S, Bruyn HB. Pertussis: a clinical study . AJDC . 1960;99:417-422. 6. Brooksaler F, Nelson JD. Pertussis: a reappraisal and report of 190 confirmed cases . AJDC . 1967;114:389-896. 7. Johnston IDA, Anderson HR, Lambert HP. The severity of whooping cough in hospitalized children: is it declining? J Hyg Camb . 1985;94:151-161.Crossref 8. Malleson PN, Bennett JC. Whooping-cough admissions to a paediatric hospital over ten years . Lancet . 1977;1:237-239.Crossref 9. Robinson DA, Mandal BK, Ironside AG, Dunbar EM. Whooping cough: study of severity in hospital cases . Arch Dis Child . 1981;56:687-691.Crossref 10. Pollock TM, Miller E, Lobb J. Severity of whooping cough in England before and after the decline in pertussis immunization . Arch Dis Child . 1984;59:162-165.Crossref 11. Romanus V, Jonsell R, Bergquist SO. Pertussis in Sweden after the cessation of general immunization in 1979 . Pediatr Infect Dis J . 1987;6:364-371.Crossref 12. Phillips E, Nash P. Culture media . In: Lennette EH, Balows A, Hausler WJ Jr, Shadomy HJ, eds. Manual of Clinical Microbiology . Washington, DC: American Society for Microbiology; 1985:1051-1092. 13. Nelson JD. The changing epidemiology of pertussis in young infants . AJDC . 1978;132:371-373. 14. Whitaker JA, Donalson P, Nelson JD. Diagnosis of pertussis by the fluorescent-antibody method . N Engl J Med . 1960;263:850-851.Crossref 15. Onorato IM, Wassilak SGF. Laboratory diagnosis of pertussis: the state of art . Pediatr Infect Dis J . 1987;6:145-151.Crossref 16. Patriaca PA, Biellik RJ, Sanden G, et al. Sensitivity and specificity of clinical case definitions for pertussis . Am J Public Health . 1988;78:833-836.Crossref 17. Steketee RW, Burstyn DG, Wassilak SGF, et al. A comparison of laboratory and clinical methods for diagnosing pertussis in an outbreak in a facility for the developmentally disabled . J Infect Dis . 1988;157:441-449.Crossref 18. Nelson KE, Gavitt F, Batt MD, Kallick CA, Reddi KT, Levin S. The role of adenoviruses in the pertussis syndrome . J Pediatr . 1975;86:335-341.Crossref 19. Keller MA, Aftandelians R, Connor JD. Etiology of pertussis syndrome . Pediatrics . 1980; 66:50-55. 20. Zellweger H. Pertussis encephalopathy . Arch Pediatr . 1959;76:381-386. 21. Bellamy EA, Johnston IDA, Wilson AG. The chest radiograph in whooping cough . Clin Radiol . 1987;38:39-43.Crossref 22. Fine PEM, Clarkson JA. Reflections on the efficacy of pertussis vaccines . Rev Infect Dis . 1987;9:866-883.Crossref 23. Nelson A. The pediatric vaccine controversy: what should the doctor do? JAMA . 1984;252: 3013-3014.Crossref 24. Cherry JD. The epidemiology of pertussis and pertussis immunization in the United Kingdom and the United States: a comparative study . Curr Probi Pediatr . 1984;14:1-78. 25. Centers for Disease Control. International notes: pertussis—England and Wales . MMWR . 1982;31:629-632. 26. Kanai K. Japan's experience in pertussis epidemiology and vaccination in the past thirty years . Jpn J Med Sci Biol . 1980;33:107-143.Crossref 27. Hinman AR, Koplan JP. Pertussis and pertussis vaccine: reanalysis of benefits, risks and costs . JAMA . 1984;251:3109-3113.Crossref 28. Koplan JP, Schoenbaun SC, Weinstein MC, Fraser DW. Pertussis vaccine: an analysis of benefits, risks and costs . N Engl J Med . 1979;301:906-911.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1990 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1990.02150340076027
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Abstract

Abstract • Before the whole-cell pertussis vaccine was available, Bordetella pertussis infections were an important cause of morbidity and mortality in infants. To determine the extent of continuing morbidity in an era of vaccination, a retrospective review was conducted of the records of neonates and infants hospitalized with pertussis infection at Parkland Memorial Hospital and Children's Medical Center, Dallas, Tex. During the 20 years from 1967 through 1986, 182 patients were younger than 24 months. Among 176 patients whose immunization history was recorded, 89% had received fewer than two doses of pertussis vaccine. The mean hospital stay was 7.4 days (range, 1 to 69 days). A convulsion occurred in 11 patients (6%). Apnea was reported in 45 patients (25%) and observed in the hospital in 26 (14%). Nine patients (5%) received mechanical ventilatory therapy. Intensive care monitoring was required in 18 patients (10%). Three (1.6%) died, all with secondary bacterial pneumonia. This hospital-based population indicates that pertussis continues to be a cause of serious morbidity and mortality in infants. (AJDC. 1990;144:1130-1134) References 1. Barkin RM, Samuelson JS. DPT vaccine . JAMA . 1986;255:2026-2027. Letters.Crossref 2. Centers for Disease Control. Pertussis surveillance: United States, 1984 and 1985 . MMWR . 1987;36:168-171. 3. Lapin JH. Whooping Cough . Springfield, Ill: Charles C Thomas Publisher; 1943. 4. Fulginiti VA. The current state of pertussis and pertussis vaccines . AJDC . 1989;143:532-533. 5. Kaufman S, Bruyn HB. Pertussis: a clinical study . AJDC . 1960;99:417-422. 6. Brooksaler F, Nelson JD. Pertussis: a reappraisal and report of 190 confirmed cases . AJDC . 1967;114:389-896. 7. Johnston IDA, Anderson HR, Lambert HP. The severity of whooping cough in hospitalized children: is it declining? J Hyg Camb . 1985;94:151-161.Crossref 8. Malleson PN, Bennett JC. Whooping-cough admissions to a paediatric hospital over ten years . Lancet . 1977;1:237-239.Crossref 9. Robinson DA, Mandal BK, Ironside AG, Dunbar EM. Whooping cough: study of severity in hospital cases . Arch Dis Child . 1981;56:687-691.Crossref 10. Pollock TM, Miller E, Lobb J. Severity of whooping cough in England before and after the decline in pertussis immunization . Arch Dis Child . 1984;59:162-165.Crossref 11. Romanus V, Jonsell R, Bergquist SO. Pertussis in Sweden after the cessation of general immunization in 1979 . Pediatr Infect Dis J . 1987;6:364-371.Crossref 12. Phillips E, Nash P. Culture media . In: Lennette EH, Balows A, Hausler WJ Jr, Shadomy HJ, eds. Manual of Clinical Microbiology . Washington, DC: American Society for Microbiology; 1985:1051-1092. 13. Nelson JD. The changing epidemiology of pertussis in young infants . AJDC . 1978;132:371-373. 14. Whitaker JA, Donalson P, Nelson JD. Diagnosis of pertussis by the fluorescent-antibody method . N Engl J Med . 1960;263:850-851.Crossref 15. Onorato IM, Wassilak SGF. Laboratory diagnosis of pertussis: the state of art . Pediatr Infect Dis J . 1987;6:145-151.Crossref 16. Patriaca PA, Biellik RJ, Sanden G, et al. Sensitivity and specificity of clinical case definitions for pertussis . Am J Public Health . 1988;78:833-836.Crossref 17. Steketee RW, Burstyn DG, Wassilak SGF, et al. A comparison of laboratory and clinical methods for diagnosing pertussis in an outbreak in a facility for the developmentally disabled . J Infect Dis . 1988;157:441-449.Crossref 18. Nelson KE, Gavitt F, Batt MD, Kallick CA, Reddi KT, Levin S. The role of adenoviruses in the pertussis syndrome . J Pediatr . 1975;86:335-341.Crossref 19. Keller MA, Aftandelians R, Connor JD. Etiology of pertussis syndrome . Pediatrics . 1980; 66:50-55. 20. Zellweger H. Pertussis encephalopathy . Arch Pediatr . 1959;76:381-386. 21. Bellamy EA, Johnston IDA, Wilson AG. The chest radiograph in whooping cough . Clin Radiol . 1987;38:39-43.Crossref 22. Fine PEM, Clarkson JA. Reflections on the efficacy of pertussis vaccines . Rev Infect Dis . 1987;9:866-883.Crossref 23. Nelson A. The pediatric vaccine controversy: what should the doctor do? JAMA . 1984;252: 3013-3014.Crossref 24. Cherry JD. The epidemiology of pertussis and pertussis immunization in the United Kingdom and the United States: a comparative study . Curr Probi Pediatr . 1984;14:1-78. 25. Centers for Disease Control. International notes: pertussis—England and Wales . MMWR . 1982;31:629-632. 26. Kanai K. Japan's experience in pertussis epidemiology and vaccination in the past thirty years . Jpn J Med Sci Biol . 1980;33:107-143.Crossref 27. Hinman AR, Koplan JP. Pertussis and pertussis vaccine: reanalysis of benefits, risks and costs . JAMA . 1984;251:3109-3113.Crossref 28. Koplan JP, Schoenbaun SC, Weinstein MC, Fraser DW. Pertussis vaccine: an analysis of benefits, risks and costs . N Engl J Med . 1979;301:906-911.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Oct 1, 1990

References