Authors:
Marshall H, Clarke M, Rasiah K, Richmond P, Buttery J, Reynolds G, et al.
Authors notes:
Pediatric Infectious Disease Journal. 2014;Online
Keywords:
Pertussis, hospitalisation, children, pertussis scoring system
Abstract:
Australia recently experienced its worst pertussis epidemic since introduction of pertussis vaccine into the National Immunisation Program.
This study aimed to determine factors associated with severe pertussis in hospitalized children during an epidemic using a novel pertussis severity scoring (PSS) system.
120 hospitalized children 0-17 years of age were enrolled with a median PSS of 5.
Most (61.7 %) were classified as not severe with 38.3% (46/120) severe.
Most severe cases (54.3%) were <2 months of age. Presence of co-infection, < 2 months old, fever >37.5C, and history of prematurity were independently associated with severe disease.
Of the 70 cases in children 2 months of age, almost a third (n=23) had not received pertussis vaccine.
Most severe pertussis occurred in young, unimmunized infants, although severe disease was also observed in children > 12 months of age and previously vaccinated children.
Children admitted with pertussis with evidence of co-infection, history of prematurity or fever on presentation need close monitoring.