Clinical and Laboratory ObservationsPertussis: A Persistent Cause of Morbidity and Mortality in Young Infants
Section snippets
Methods
From January 1, 2012, to December 31, 2012, all positive nasopharyngeal polymerase chain reaction (PCR) tests for B pertussis (Analyte Specific Reagent for identification and differentiation of B pertussis and parapertussis; Cepheid, Sunnyvale, California) were identified by prospective surveillance of the Children's Medical Center Dallas (CMC) microbiology laboratory results by infection prevention and control staff members (J.T., J.S.). Pertussis cases were considered “confirmed” if the
Results
In 2012, Dallas County experienced an increased incidence of pertussis for the first time since 2008, with 220 cases (183 [83%] <18 years of age) that met surveillance definitions (Figure 1; available at www.jpeds.com). Of the 183 children, 131 (72%) were cared for at CMC; 33 (25%) children were hospitalized, with 10 (8%) requiring ICU admission. Infants ≤3 months of age (n = 38) accounted for 79% (n = 26) and 70% (n = 7) of the hospital and ICU admissions, respectively. There were 4
Discussion
Increased pertussis in Dallas County in 2012 resulted in serious disease and death in 2 infants ≤3 months of age and 2 young children with underlying medical conditions. For infants ≤3 months of age, fewer than one-half of their mothers were vaccinated with Tdap postpartum according to the 2011 ACIP guidelines for cocooning, including both mothers of the infants who died.5 Three mothers had onset of cough before delivery, suggesting that postpartum vaccination would not have prevented
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The authors declare no conflicts of interest.