Identification is key for infants too young to receive pertussis vaccine

A recent study found that early identification is key for the implementation of interventions in infants too young to receive the pertussis vaccine.

The California Department of Public Health's Erin Murray and her colleagues retrospectively reviewed data from 31 patients younger than 90 days with pertussis who were admitted to five different pediatrics ICUs in an attempt to identify factors that were associated with death and pulmonary hypertension, reports.

Of the 31 patients who were admitted between September 2009 and June 2011, eight had more severe infections, six had pulmonary hypertension and four died.

No significant differences in demographics were found between the infants with more severe versus less severe pertussis infection. Additionally, no differences in the number of days from cough onset to dates of medical care, hospitalization, pediatric ICU admission, first pertussis test or macrolide antibiotic initiation were found, according to

One difference that the researchers noted was that infants with more severe infections had white blood cell counts exceeding 30,000 cells/mm3, as well as heart rates exceeding 170 beats per minute and respiratory rates exceeded 70 breaths per minute more rapidly after cough onset than the 23 infants with less severe illness.

"Our data suggest that a predictor of more severe Bordetella pertussis disease in young infants is an elevated and rapidly rising WBC count, making early and serial WBC count determinations critical to the evaluation of all infants with suspected or proven pertussis," the study's researchers said, reports. "Furthermore, close monitoring of heart and respiratory rates is imperative because these were demonstrated to correlate with more severe disease progression."