OBJECTIVES: To describe the clinical course of fatal cases of pertussis and identify predictors of death at the time of presentation for medical care. METHODS: Case-control study of 16 deaths from pertussis identified by the Immunization Monitoring Program, Active (IMPACT) surveillance network (January 1991-December 2001) matched with 32 nonfatal cases by age, date, and geography. Differences were compared by Fisher exact test and logistic regression. A multivariate model was developed using stepwise logistic regression. RESULTS: All 16 fatal cases were < or =6 months old; 13 were <2 months old. Fatal cases were less likely to have had cough complications during pregnancy (48% vs 14%; P=.046) and more likely to have pneumonia (63% vs 16%; P=.0024) before hospital admission and more likely to have seizures, pneumonia, leukocytosis, and hypoxemia after admission (P<.001 for all comparisons). White blood cell count and pneumonia were independent predictors of fatal outcome in the multivariate model. CONCLUSIONS: Infants too young to have begun their immunizations are at highest risk of fatal pertussis infection. Leukocytosis and pneumonia are predictors of a poor outcome; however, rapid progression of the disease may make interventions difficult.
OBJECTIVES: To describe the clinical course of fatal cases of pertussis and identify predictors of death at the time of presentation for medical care. METHODS: Case-control study of 16 deaths from pertussis identified by the Immunization Monitoring Program, Active (IMPACT) surveillance network (January 1991-December 2001) matched with 32 nonfatal cases by age, date, and geography. Differences were compared by Fisher exact test and logistic regression. A multivariate model was developed using stepwise logistic regression. RESULTS: All 16 fatal cases were < or =6 months old; 13 were <2 months old. Fatal cases were less likely to have had cough complications during pregnancy (48% vs 14%; P=.046) and more likely to have pneumonia (63% vs 16%; P=.0024) before hospital admission and more likely to have seizures, pneumonia, leukocytosis, and hypoxemia after admission (P<.001 for all comparisons). White blood cell count and pneumonia were independent predictors of fatal outcome in the multivariate model. CONCLUSIONS:Infants too young to have begun their immunizations are at highest risk of fatal pertussis infection. Leukocytosis and pneumonia are predictors of a poor outcome; however, rapid progression of the disease may make interventions difficult.
Authors: D MacDougall; B A Halperin; D MacKinnon-Cameron; L Li; S A McNeil; J M Langley; S A Halperin Journal: Hum Vaccin Immunother Date: 2015-06-19 Impact factor: 3.452
Authors: Joshua C Eby; Mary C Gray; Jason M Warfel; Christopher D Paddock; Tara F Jones; Shandra R Day; James Bowden; Melinda D Poulter; Gina M Donato; Tod J Merkel; Erik L Hewlett Journal: Infect Immun Date: 2013-02-19 Impact factor: 3.441