Infants at highest risk of death from pertussis says study

Study has found that taking early and repeated white blood cell counts is critical in determining whether infants have pertussis and which of those children are at highest risk of death from the disease whether infants have pertussis and which of these children are at highest risk of death from the disease.

 In the year 2010, California reported its highest pertussis rates in 60 years. Murray, et al.’s retrospective study used the medical records from five Southern California Pediatric Intensive Care Units between September 2009 and June 2011.

Of the 31 infants studied, the eight comprised a group considered to have more severe infections that included suffering from pulmonary hypertension and death from the pertussis.

The study also showed that infants who had more severe disease had higher WBC counts and were more likely to show at least 50% increase in WBC.

The infants with more severe disease had median peak WBC counts of 74,100 compared to 24, 200 among infants with less severe disease. But, one of those with more severe disease had at least a 50% increase in WBC within 48 hours, and none of those infants with less severe disease had more than a 50% increase in WBC.

Besides, the group with more severe infections had higher maximum heart and respiratory rates and was more likely to develop pneumonia.

The group was also more likely to have seizures, hypotension, shock, renal failure and was also more likely to be intubated and receive exchange transfusions. The six of the infants received exchange transfusions, and four of those died.

Those four were also in shock at the time of their transfusions; the two who survived were not in a shock at the time of transfusion.

Pertussis is a highly contagious bacterial infection of the respiratory tract. The U.S. Centers for Disease Control and Prevention reports that 2012 rates of the disease are at their highest level in 50 years and some states are reporting case counts not seen since the 1930s, which was prior to the vaccine era.

Erin Murray, lead author of the study, and epidemiologist at the California Department of Public Health said, “Because very young infants have not yet been vaccinated and are at the highest risk for severe disease, we need to better manage and treat it”, said, Erin Murray, lead author of the study and epidemiologist at the California Department of Public Health. Mr. Murray also said, “This study also shows the importance of aggressive pediatric intensive care and provides us additional metrics as we treat these young patients.”