WHOOPING COUGH IN CHILDREN: EXPERIENCE OF HOSPITAL SÃO JOÃO (2003-2009)
Rita Santos Silva
Portugal 
5 slide(s) – English – 2010-10-23
Background: Bordetella pertussi (BP) is a worldwide public health problem, which affects 20 to 40 million people each year.
Objective: To describe the clinical and epidemiological pattern of BP hospitalization among children.
Methods: We analyzed the clinical files of children with a PCR-confirmed BP in nasopharyngeal aspiration who were hospitalized in a tertiary care hospital between January 2003 and the December 2009.
Results: There were 36 admissions for whooping cough; 75% of them were infants younger than 2 month-old and 69% had never been vaccinated. The average length of hospitalization was 12.7 days. There was no difference between winter and summer months. The prevalence was higher in 2006 (28% of all cases). Dual infection of BP with other agents occurred in 31% (7 cases of respiratory syncytial virus and 1 case each of metapneumovirus, parainfluenza 3 and adenovirus).
Cough was the most frequent symptom (89%; median duration of 12 days). Leukocytosis occurred in 33% and lymphocytosis in 64%.
All patients were treated with macrolides (74% erythromycin). Supplemental oxygen was used in 47% (median 8.5 days); bronchodilators in 64%, systemic corticosteroids in 33% and respiratory exercise in 8%.
The major complications were apneas (25%) and pneumonia (19%). There were 7 (19%) severe cases that required mechanical ventilation, all in children younger than 3 month-old. One death occurred in a 1 month-old patient.
Conclusion: Despite widespread vaccination, the incidence of BP has been rising. New vaccination strategies should be evaluated to protect infants as early in life as possible.
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