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J Pediatric Infect Dis Soc. 2018 Dec 3;7(4):310-316. doi: 10.1093/jpids/pix081.

Clinical Characteristics of Hospitalized Infants With Laboratory-Confirmed Pertussis in Guatemala.

Author information

1
Division of Infectious Diseases, School of Medicine.
2
Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City.
3
Department of Epidemiology, Centers for Disease Control and Prevention, Central American Regional Office, Guatemala City, Guatemala.
4
Division of Global Health Protection, Centers for Disease Control and Prevention, Central American Regional Office, Guatemala City, Guatemala.
5
Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
6
Department of Pediatrics, Hospital Nacional de Cuilapa, Santa Rosa, Guatemala.
7
Department of Pediatrics, Hospital Regional de Occidente, Quetzaltenango, Guatemala.
8
Hubert Department of Global Health, Rollins School of Public Health.
9
Emory Vaccine Center, Emory University, Atlanta, Georgia.

Abstract

Background:

Pertussis is an important cause of hospitalization and death in infants too young to be vaccinated (aged <2 months). Limited data on infant pertussis have been reported from Central America. The aim of this study was to characterize acute respiratory illnesses (ARIs) attributable to Bordetella pertussis among infants enrolled in an ongoing surveillance study in Guatemala.

Methods:

As part of a population-based surveillance study in Guatemala, infants aged <2 months who presented with ARI and required hospitalization were enrolled, and nasopharyngeal and oropharyngeal swab specimens were obtained. For this study, these specimens were tested for B pertussis using real-time polymerase chain reaction (PCR).

Results:

Among 301 infants hospitalized with ARI, we found 11 with pertussis confirmed by PCR (pertussis-positive infants). Compared to pertussis-negative infants, pertussis-positive infants had a higher mean admission white blood cell count (20900 vs 12579 cells/μl, respectively; P = .024), absolute lymphocyte count (11517 vs 5591 cells/μl, respectively; P < .001), rate of admission to the intensive care unit (64% vs 35%, respectively; P = .054), and case fatality rate (18% vs 3%, respectively; P = .014). Ten of the 11 pertussis-positive infants had cough at presentation; the majority (80%) of them had a cough duration of <7 days, and only 1 had a cough duration of >14 days. Fever (temperature ≥ 38°C) was documented in nearly half (45%) of the pertussis-positive infants (range, 38.0-38.4°C).

Conclusions:

In this study of infants <2 months of age hospitalized with ARI in Guatemala, pertussis-positive infants had a high rate of intensive care unit admission and a higher case fatality rate than pertussis-negative infants.

PMID:
29045690
PMCID:
PMC5899054
DOI:
10.1093/jpids/pix081
[Indexed for MEDLINE]
Free PMC Article

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