Expert says Calif. whooping cough deaths stemmed from misdiagnosis

A California state review has determined that all eight of the infants who have died during the state’s pertussis epidemic had been taken to clinics several times before being accurately diagnosed.

Pertussis, also known as whooping cough, is notoriously difficult to diagnose. Health officials have urged doctors to suspect the bacterial disease in any infant under the age of six months that has had trouble breathing, according to the Los Angeles Times.

"In several cases … the infants were treated only for nasal congestion or mild upper respiratory infection," Dr. John Talarico, a California Department of Public Health immunization official, wrote in a recent letter to healthcare providers, according to the Los Angeles Times. "By the time these infants developed severe respiratory distress, it was usually too late for any intervention to prevent their tragic deaths."

Dr. James D. Cherry, a University of California Los Angeles professor and pertussis expert, reviewed all eight of the cases. He agrees that the diagnosis is difficult, but believes in these eight instances, pertussis should have been looked at earlier. In his opinion, delayed hospitalization contributed to the deaths

“All of those should have been diagnosed earlier. And a couple of them, even after they were diagnosed, the [healthcare providers] didn’t take it as serious enough, quick enough,” Cherry said to the Los Angeles Times.

Because infant health can deteriorate rapidly, Cherry advises physicians to consider hospitalizing suspected cases in a medical center with access to an intensive care unit. A quick diagnosis, followed by treatment with antibiotics, can keep a patient from becoming seriously ill.

The outbreak shows no sign of letting up, and, according to state health officials, it may get worse with children returning to classrooms this week. Health officials in Los Angeles and San Francisco have warned that it is possible that children who have not been immunized may be kept from attending school.

California is in the middle of the worst pertussis outbreak it has seen since 1958, after which widespread vaccination programs accelerated. This year, 3,600 cases have been reported, a seven-fold increase from this time last year.

All of the infants who died were under three months of age. Four of them lived in the Los Angeles area.