[Pertussis in young infants].

Four infants, three girls aged 4 weeks, 2.5 months and 3 months, and a boy aged 2 months, were hospitalized because of severe respiratory distress. Apnoea spells with bradycardia and hypoxia were seen in two of the patients, one showing convulsions as well, and bronchopneumonia in the other two, of whom one eventually died. All suffered from pertussis. During outbreaks of pertussis, infants less than 6 months of age are at highest risk for severe disease. In this age group, however, the clinical signs of pertussis are often atypical. Classical symptoms such as paroxysms of cough and loud whoops may be absent while feeding problems, apnoea, cyanosis and bradycardia may be present. For infants younger than 6 months with signs indicating pertussis hospitalization is indicated. In the current vaccination schedule in the Netherlands infants are vaccinated at 3, 4, 5 and 11 months of age. Starting in 1999 the first vaccination will be administered at the age of 2 months.