- Email: [email protected]
Pertussis
Pertussis Susan Shoshana Weisberg, MD, FCP, FAAP Whooping cough is caused by the gram-negative, pleomorphic bacilli Bordetella pertussis. The causative agent was first isolated in 1906 by Jules Jean Baptiste Vincent Bordet and his brother-in-law, Octave Gengou. The term “pertussis” is derived from the Latin words for intensive cough.1 It is respiratory droplet spread, and humans are the only known natural reservoirs. Most people who spread pertussis are themselves ill, but there are also atypically or minimally symptomatic carriers of the disease, usually adolescents or adults.2-6 In one study, three-fourths of such infected patients were found to have been previously immunized against pertussis.7 The first recorded epidemic of whooping cough was an outbreak in 1578 that started in Paris and then spread throughout Europe and the rest of the world. In the early 1900’s in the United States, pertussis was the leading cause of death from infectious disease in children.8,9 In 1923 alone, it killed 9269 American children.10 In the 1980s, the World Health Organization estimated more than a half million pertussis deaths annually worldwide, with a child dying of it every 53 seconds.11 By 2004, it was estimated that there were 50 million pertussis cases annually, with 300,000 deaths.9 In the United States in the early 1990s, there were about 3300 hospitalizations for pertussis every year, with 25 deaths.10 By 2003, American pertussis rates had risen, with over 11,000 cases and 13 deaths that year.12 Pertussis is more often reported, and with a higher mortality rate, in girls. It is also more severe in infants. Two-thirds of pertussis deaths occur in children less than 1 year old.13 The mortality rate from pertussis in infants under 2 months of age is 1%.14 Before there was a vaccine against pertussis, virtually everyone got pertussis during their lifetime, and 1 out of every 750 American children died of it before their first birthday.15 The incubation period for pertussis ranges from 5 to 21 days, and outbreaks often occur in 3- to 4-year cycles. Pertussis germs first lodge in the throat, and for the first week or so, whooping cough acts like a Dis Mon 2007;53:488-494 0011-5029/2007 $32.00 ⫹ 0 doi:10.1016/j.disamonth.2007.09.012 488
DM, October 2007
common cold. But within 2 weeks, the pertussis germs invade the lower respiratory tract, and the cough is on. Ciliary function is disrupted, and the pulmonary tree gets filled with debris and secretions. Cough attacks occur that are so forceful that they leave no time for breathing. After a run of coughs, victims gasp for air and make the “whoop” sound that gives pertussis its nickname. Whooping cough spells can lead to vomiting, rib fractures, hernias, apnea, subconjunctival hemorrhage, syncope, incontinence, seizures, and neurological sequelae from hypoxia.16 Pertussis usually lasts 6 to 10 weeks. In China it is called “the 100 days cough.” Ninety percent of deaths from pertussis are due to pneumonia. After surviving whooping cough, people can develop repeat coughing spasms with repeated respiratory tract infections for up to 2 years.17 Diagnosis is straightforward in the presence of the classic “whoop,” but similar severe coughs can also be caused by infection with Bordetella parapertussis, Bordetella bronchiseptica, Mycoplasma pneumonia, Chlamydia trachomatis, Chlamydia pneumoniae, respiratory syncytial virus, or adenovirus. Culture diagnosis of pertussis requires collection of a nasopharyngeal specimen using only Dacron or calcium alginate swabs, and prompt transport in Regan–Lowe media. Specimens must be incubated up to 10 days before declaring them negative. Polymerase chain reaction assay is faster, but specimen collection must be with Dacron swabs only. False-positive results can be common, depending on the laboratory processing the specimens. Direct fluorescent antibody testing is another option for diagnosis, but sensitivity is low. Serologic testing is also available, although not absolutely reliable. On peripheral blood smear, extreme lymphocytosis is often evident.14 Treatment of pertussis is symptomatic and supportive. Antibiotics are used primarily to decrease the period of contagiousness and limit the spread of disease. After the cough has already started, antibiotics do not change the clinical course of the illness for the person infected. Treatment is with erythromycin, azithromycin, or clarithromycin. For infants under 6 months of age, it should be remembered that azithromycin and clarithromycin are not FDA approved for use, and for infants less than 4 weeks of age, there is an association between the use of erythromycin and the development of hypertrophic pyloric stenosis. Trimethoprim–sulfamethoxazole is also used to treat pertussis. Steroids, exchange transfusion, and 2-adrenergic agents are of unproved efficacy in treating pertussis.14,18-20 Of the almost 11,000 American infants who got whooping cough during the 1980s, l in 5 got pneumonia, l in 33 suffered seizures, l in every 110 had swelling of the brain, and 1 in 170 died.21 During pertussis outbreaks DM, October 2007
489
in the United States from 2001 to 2003, there were 28,998 total cases with 33 cases of swelling of the brain and 56 deaths. Among the 5872 cases involving infants under 6 months of age, 1 in 8 got pneumonia, 7 in 10 had to be hospitalized, 1 in 50 had seizures, and 1 in every 115 died.22 In Sweden, a survey of families of children with pertussis found that all infected children were ill for more than 3 weeks. One in 20 had to be hospitalized for their illness. Swedish preschoolers with whooping cough missed classes for an average of 20 days, and their parents missed work an average of 12 days because of the disease.23 A survey of Spanish infants who suffered whooping cough between 1997 and 2001 found that two-thirds had episodes of hypoxia and cyanosis, one-quarter had apneic spells, and over one-third coughed so hard they vomited. One of every 125 of them died.24 In a 2004 pertussis outbreak in an Amish community with low immunization rates that involved 345 cases, one-third coughed to the point of vomiting.25 A follow-up study done in the United Kingdom on children who had been hospitalized for pertussis showed them three times more likely than expected to be “intellectually abnormal.”26 In children who have nervous system problems from pertussis, one-third die, one-third survive with permanent handicaps, and one-third survive and seem normal.27 Also particularly worrisome are whooping cough outbreaks that hit hospitals full of vulnerable patients. In 2003, 3 such outbreaks were reported in the United States. In a Kentucky hospital outbreak, 72 patients and 72 health care workers were exposed and given prophylactic antibiotics. A similar situation in a Pennsylvania hospital resulted in prophylaxis for 307 people, and in Oregon 90 people required antibiotics after hospital-based exposure.28 In addition to obvious, full blown pertussis cases, there are many more mild cases that go undiagnosed.29-32 As part of a vaccine effectiveness trial in Germany starting in 1990, all children with coughs lasting more than 1 week were tested for pertussis. Out of over 20,000 specimens collected, more than 2000 tested positive for whooping cough. Only 33 of those 2000 children had severe, classic pertussis symptoms.33 In Belgium, a study that screened household members of pertussis patients found that 19 of 25 contacts found to have pertussis had absolutely no symptoms whatsoever.34 In America, it has been estimated that 13% of all cases of prolonged coughs in adolescents and adults are due to whooping cough, adding up to about a million cases per year.35 Data from England, published in 2006, found blood immunoglobulin evidence of pertussis in one-third of children between 5 and 16 years of age who had been coughing for over 2 weeks. In the British study, over 4/5 of the children 490
DM, October 2007
with whooping cough had been immunized.36 More often, such milder pertussis cases occur in either partially immunized children or in adolescents and adults whose vaccine protection may have worn off.37-39 The presence of these milder pertussis cases makes it difficult to determine the true rates of whooping cough illness. New tests for the presence of the germ are so sensitive that they can give false-positive results and overdiagnose the infection. Even when accurately positive, polymerase chain reaction (PCR) tests can stay positive for up to 7 months, long after most experts think that active, contagious disease can be present.40,41 When tests are accurate, increased numbers of positive results may reflect better diagnosis as opposed to truly increased disease rates. In 1994, Massachusetts became the first state to use special blood tests for pertussis. Immediately afterward, their reported pertussis rate was 13 times that of the rest of America. This was dubbed a “pseudo” epidemic in one New England Journal of Medicine editorial.42 So when we hear that the rate of whooping cough has increased by a factor of 6 between 1980 and 2005, it is unclear what that really means.43 People with slight pertussis are certainly better off without the complications of whooping cough. But their mild disease allows them to be out and about as a storehouse of pertussis germs for people around them, not all of whom may weather the disease as well. A hospital outbreak traced to an infected rotating nurse resulted in 3179 employees being treated to stop the infection from spreading to vulnerable, already ill patients.44 When an 82-year-old woman died from pertussis in Minnesota in 2003, the source was her daughter, a high school nurse who most certainly picked it up at work.45 The biggest problem with mild pertussis cases is that they don’t stay so mild when they spread to babies. As cases of barely symptomatic whooping cough have increased in adolescents and young adults, so has the attack rate in infants. The pertussis rate in children under 1 year of age went up by 50% in the 1990s compared with the previous decade,46 as did the number of deaths from whooping cough. Those hardest hit are infants too young to have been immunized yet and older babies behind on vaccines.47 In England in 2000, there was a report of 9 severe pertussis cases in infants less than 7 weeks of age. Six of the babies died, with complications including seizures, shock, respiratory failure, and pneumothorax.48 Those cases were all traced to mothers or other immediate family members. In 3 pertussis epidemics in Australia between 1993 and 2001, most infected babies caught it from a parent.49 In the United States during the 1990s, the same pattern was found, with over 75% of cases in infants traced to a parent or other immediate family member.50 DM, October 2007
491
REFERENCES 1. 2. 3.
4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14.
15. 16. 17. 18. 19. 20.
21.
22. 492
What’s your diagnosis? Infect Dis Children 2007:78. Herwaldt LA. Pertussis in adults. What physicians need to know. Arch Intern Med 1991;151:1510-2. Long S, Welkon CJ, Clark JL. Widespread silent transmission of pertussis in families: antibody correlates of infection and symptomatology. J Infect Dis 1990;161:480. Eichenwald HF. Current abstracts: pertussis in adults: what physicians need to know. Pediatr Infect Dis J 1992;11(3):251. Mortimer EA Jr. Perspective: pertussis and its prevention: a family affair. J Infect Dis 1990;161:473-9. Nelson JD. The changing epidemiology of pertussis in young infants. The role of adults as reservoirs of infection. Am J Dis Child 1978;132:371-3. Broome CV, Preblud SR, Bruner B, et al. Epidemiology of pertussis, Atlanta, 1977. J Pediatr 1981;98:362-7. Cone TE Jr. Whooping cough is first described as a disease in sui generis by Ballou in 1640. Pediatrics 1970;46:522. Steele RW. Pertussis: is eradication achievable? Pediatr Ann 2004;33(8):525-34. Sutter RW, Conchi SL. Pertussis hospitalizations and mortality in the United States, 1985-1988. JAMA 1992;267(3):386-91. Cherry JD, Brunell PA, Golden GS, et al. Report on the task force on pertussis and pertussis immunization, 1988. Pediatrics 1988;81(6, part 2):939. Whooping cough making a comeback. Infect Dis Children 2004;1:26. Cherry JD, Brunell PA, Golden GS, et al. Report on the task force on pertussis and pertussis immunization, 1988. Pediatrics 1988;81(6, part 2):946. American Academy of Pediatrics. Pertissus. In: Pickering LK, Baker CJ, Long SS, et al., editors. Red Book: 2006 Report of the Committee on Infectious Diseases (27th ed). Elk Grove Village, IL: American Academy of Pediatrics, 2006. Cherry JD, Brunell PA, Golden GS, et al. Report on the task force on pertussis and pertussis immunization, 1988. Pediatrics 1988;81(6, part 2):951. Southall DP, Thomas MG, Lambert HP. Severe hypoxaemia in pertussis. Arch Dis Child 1988;63:598-605. Krugman S, Katz SL. Infectious Diseases of Children (7th ed). St. Louis, MO: CV Mosby Co., 1981. p. 244. Centers for Disease Control and Prevention. Fatal case of pertussis in an infant: West Virginia, 2004. MMWR 2005;54(3):71-2. Donoso AF, Cruces PI, Camacho JF, et al. Exchange transfusion to reverse severe tertussis-induced cardiogenic shock. Pediatr Infect Dis J 2006;25(9):846-8. Halperin SA, Vaundry W, Boucher FD, et al. Is pertussis immune globulin efficacious for the treatment of hospitalized infants with pertussis? No answer yet. Pediatr Infect Dis J 2007;26(1):79-81. CDC, Immunization Practices Advisory Committee. Diphtheria, tetanus, and pertussis: recommendations for vaccine use and other preventive measures. MMWR 1991;40(RR-10):4. Centers for Disease Control and Prevention. Pertussis: United States, 2001-2003. MMWR 2005;54(50):1283-6. DM, October 2007
23. 24.
25.
26.
27. 28. 29. 30. 31. 32.
33.
34.
35. 36.
37. 38. 39. 40. 41. 42. 43. 44.
Mark A, Granstrom M. Impact of pertussis on the afflicted child and family. Pediatr Infect Dis J 1992;11(7):554-7. Moraga F, Roca J, Mendez C, et al. Epidemiology and surveillance of pertussis among infants in Catalonia, Spain, during 1997-2001. Pediatr Infect Dis J 2005; 24(6):510-3. Centers for Disease Control and Prevention. Pertussis outbreak in an Amish community: Kent County, Delaware, September 2004 –February 2005. MMWR 2006;55(30):818-22. Butler NR, Golding J, Haslum M, et al. Recent findings from the 1970 children’s health and education study: preliminary communication. J Roy Soc Med 1982;75: 781-4. Zellweger H. Pertussis encephalopathy. Arch Pediatr 1959;76:381-6. Centers for Disease Control and Prevention. Outbreaks of pertussis associated with hospitals: Kentucky, Pennsylvania, and Oregon, 2003. MMWR 2005;54(3):67-71. Mink CM, Cherry JD, Christenson P, et al. A search for Bordetella Pertussis infection in university students. Clin Infect Dis 1992;14:464-71. Cromer BA, Goydos J, Hackell J, et al. Unrecognized pertussis infection in adolescents. Am J Dis Child 1993;147:575-7. Sotomayer J, Weiner LB, McMillan JA. Inaccurate diagnosis in infants with pertussis. Am J Dis Child 1985;139:724-6. Heininger U, Cherry JD, Eckhardt T, et al. Clinical and laboratory diagnosis of pertussis in the regions of a large vaccine efficacy trial in Germany. Pediatr Infect Dis J 1993;12(6):504-9. Heininger U, Frei R, Cherry JD, et al. Comparison of pulsed gel electrophoresis patterns of Bordetella pertussis isolates from unvaccinated children with severe or mild pertussis. Pediatr Infect Dis J 2004;23(3):211-6. De Schutter I, Malfroot A, Dab I, et al. Molecular typing of Bordetella pertussis isolates recovered from Belgian children and their household members. Clin Infect Dis 2003;36:1391-6. Cherry JD. Commentaries: the science and fiction of the “resurgence” of pertussis. Pediatrics 2003;112(2):405-6. Harnden A, Grant C, Harrison T, et al. Whooping cough in school age children with persistent cough: prospective cohort study in primary care. Br Med J 2006; 333:174-7. Edwards KM, Decker MD, Graham BS, et al. Adult immunization with acellular pertussis vaccine. J Am Med Assoc 1993;269(1):53-6. Herwaldt LA. Pertussis and pertussis vaccines in adults. J Am Med Assoc 1993; 269(1):93-4. Centers for Disease Control. Pertussis outbreaks: Massachusetts and Maryland, 1992. MMWR 1993;42(11):197-200. Wendling P. PCR testing for pertussis may be too sensitive. Pediatr News 2007:16. Pseudopertussis. Pediatr Infect Dis J Newsletter 2007;26(3). Halperin SA. The control of pertussis: 2007 and beyond. N Engl J Med 2007; 356(2):110-3. Hewlett EL, Edwards KM. Pertussis: not just for kids. N Engl J Med 2005; 352(12):1215-22. Weber D, Rutala W. Pertussis: a continuing hazard for health-care facilities. Infect Control Hosp Epidemiol 2001;12:736-40.
DM, October 2007
493
45. 46. 47.
48. 49. 50.
494
Centers for Disease Control and Prevention. Fatal case of unsuspected pertussis diagnosed from a blood culture: Minnesota, 2003. MMWR 2004;53(6):131-2. Tanaka M, Vitek CR, Pascual FB, et al. Trends in pertussis among infants in the United States, 1980-1999. JAMA 2003;290(22):2968-75. Vitek CR, Pascaul FB, Baughman AL, et al. Increase in deaths from pertussis among young infants in the United States in the 1990s. Pediatr Infect Dis J 2003;22(7):628-34. Smith C, Harish V. Eur J Pediatr 2000;159:898-900. Elliott E, McIntyre P, Ridley G, et al. National study of infants hospitalized with pertussis in the acellular vaccine era. Pediatr Infect Dis J 2004;23(3):246-52. Bisgard KM, Pascual B, Ehresmann KR. Infant pertussis: who was the source? Pediatr Infect Dis J 2004;23(11):985-9.
DM, October 2007
DM, October 2007
common cold. But within 2 weeks, the pertussis germs invade the lower respiratory tract, and the cough is on. Ciliary function is disrupted, and the pulmonary tree gets filled with debris and secretions. Cough attacks occur that are so forceful that they leave no time for breathing. After a run of coughs, victims gasp for air and make the “whoop” sound that gives pertussis its nickname. Whooping cough spells can lead to vomiting, rib fractures, hernias, apnea, subconjunctival hemorrhage, syncope, incontinence, seizures, and neurological sequelae from hypoxia.16 Pertussis usually lasts 6 to 10 weeks. In China it is called “the 100 days cough.” Ninety percent of deaths from pertussis are due to pneumonia. After surviving whooping cough, people can develop repeat coughing spasms with repeated respiratory tract infections for up to 2 years.17 Diagnosis is straightforward in the presence of the classic “whoop,” but similar severe coughs can also be caused by infection with Bordetella parapertussis, Bordetella bronchiseptica, Mycoplasma pneumonia, Chlamydia trachomatis, Chlamydia pneumoniae, respiratory syncytial virus, or adenovirus. Culture diagnosis of pertussis requires collection of a nasopharyngeal specimen using only Dacron or calcium alginate swabs, and prompt transport in Regan–Lowe media. Specimens must be incubated up to 10 days before declaring them negative. Polymerase chain reaction assay is faster, but specimen collection must be with Dacron swabs only. False-positive results can be common, depending on the laboratory processing the specimens. Direct fluorescent antibody testing is another option for diagnosis, but sensitivity is low. Serologic testing is also available, although not absolutely reliable. On peripheral blood smear, extreme lymphocytosis is often evident.14 Treatment of pertussis is symptomatic and supportive. Antibiotics are used primarily to decrease the period of contagiousness and limit the spread of disease. After the cough has already started, antibiotics do not change the clinical course of the illness for the person infected. Treatment is with erythromycin, azithromycin, or clarithromycin. For infants under 6 months of age, it should be remembered that azithromycin and clarithromycin are not FDA approved for use, and for infants less than 4 weeks of age, there is an association between the use of erythromycin and the development of hypertrophic pyloric stenosis. Trimethoprim–sulfamethoxazole is also used to treat pertussis. Steroids, exchange transfusion, and 2-adrenergic agents are of unproved efficacy in treating pertussis.14,18-20 Of the almost 11,000 American infants who got whooping cough during the 1980s, l in 5 got pneumonia, l in 33 suffered seizures, l in every 110 had swelling of the brain, and 1 in 170 died.21 During pertussis outbreaks DM, October 2007
489
in the United States from 2001 to 2003, there were 28,998 total cases with 33 cases of swelling of the brain and 56 deaths. Among the 5872 cases involving infants under 6 months of age, 1 in 8 got pneumonia, 7 in 10 had to be hospitalized, 1 in 50 had seizures, and 1 in every 115 died.22 In Sweden, a survey of families of children with pertussis found that all infected children were ill for more than 3 weeks. One in 20 had to be hospitalized for their illness. Swedish preschoolers with whooping cough missed classes for an average of 20 days, and their parents missed work an average of 12 days because of the disease.23 A survey of Spanish infants who suffered whooping cough between 1997 and 2001 found that two-thirds had episodes of hypoxia and cyanosis, one-quarter had apneic spells, and over one-third coughed so hard they vomited. One of every 125 of them died.24 In a 2004 pertussis outbreak in an Amish community with low immunization rates that involved 345 cases, one-third coughed to the point of vomiting.25 A follow-up study done in the United Kingdom on children who had been hospitalized for pertussis showed them three times more likely than expected to be “intellectually abnormal.”26 In children who have nervous system problems from pertussis, one-third die, one-third survive with permanent handicaps, and one-third survive and seem normal.27 Also particularly worrisome are whooping cough outbreaks that hit hospitals full of vulnerable patients. In 2003, 3 such outbreaks were reported in the United States. In a Kentucky hospital outbreak, 72 patients and 72 health care workers were exposed and given prophylactic antibiotics. A similar situation in a Pennsylvania hospital resulted in prophylaxis for 307 people, and in Oregon 90 people required antibiotics after hospital-based exposure.28 In addition to obvious, full blown pertussis cases, there are many more mild cases that go undiagnosed.29-32 As part of a vaccine effectiveness trial in Germany starting in 1990, all children with coughs lasting more than 1 week were tested for pertussis. Out of over 20,000 specimens collected, more than 2000 tested positive for whooping cough. Only 33 of those 2000 children had severe, classic pertussis symptoms.33 In Belgium, a study that screened household members of pertussis patients found that 19 of 25 contacts found to have pertussis had absolutely no symptoms whatsoever.34 In America, it has been estimated that 13% of all cases of prolonged coughs in adolescents and adults are due to whooping cough, adding up to about a million cases per year.35 Data from England, published in 2006, found blood immunoglobulin evidence of pertussis in one-third of children between 5 and 16 years of age who had been coughing for over 2 weeks. In the British study, over 4/5 of the children 490
DM, October 2007
with whooping cough had been immunized.36 More often, such milder pertussis cases occur in either partially immunized children or in adolescents and adults whose vaccine protection may have worn off.37-39 The presence of these milder pertussis cases makes it difficult to determine the true rates of whooping cough illness. New tests for the presence of the germ are so sensitive that they can give false-positive results and overdiagnose the infection. Even when accurately positive, polymerase chain reaction (PCR) tests can stay positive for up to 7 months, long after most experts think that active, contagious disease can be present.40,41 When tests are accurate, increased numbers of positive results may reflect better diagnosis as opposed to truly increased disease rates. In 1994, Massachusetts became the first state to use special blood tests for pertussis. Immediately afterward, their reported pertussis rate was 13 times that of the rest of America. This was dubbed a “pseudo” epidemic in one New England Journal of Medicine editorial.42 So when we hear that the rate of whooping cough has increased by a factor of 6 between 1980 and 2005, it is unclear what that really means.43 People with slight pertussis are certainly better off without the complications of whooping cough. But their mild disease allows them to be out and about as a storehouse of pertussis germs for people around them, not all of whom may weather the disease as well. A hospital outbreak traced to an infected rotating nurse resulted in 3179 employees being treated to stop the infection from spreading to vulnerable, already ill patients.44 When an 82-year-old woman died from pertussis in Minnesota in 2003, the source was her daughter, a high school nurse who most certainly picked it up at work.45 The biggest problem with mild pertussis cases is that they don’t stay so mild when they spread to babies. As cases of barely symptomatic whooping cough have increased in adolescents and young adults, so has the attack rate in infants. The pertussis rate in children under 1 year of age went up by 50% in the 1990s compared with the previous decade,46 as did the number of deaths from whooping cough. Those hardest hit are infants too young to have been immunized yet and older babies behind on vaccines.47 In England in 2000, there was a report of 9 severe pertussis cases in infants less than 7 weeks of age. Six of the babies died, with complications including seizures, shock, respiratory failure, and pneumothorax.48 Those cases were all traced to mothers or other immediate family members. In 3 pertussis epidemics in Australia between 1993 and 2001, most infected babies caught it from a parent.49 In the United States during the 1990s, the same pattern was found, with over 75% of cases in infants traced to a parent or other immediate family member.50 DM, October 2007
491
REFERENCES 1. 2. 3.
4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14.
15. 16. 17. 18. 19. 20.
21.
22. 492
What’s your diagnosis? Infect Dis Children 2007:78. Herwaldt LA. Pertussis in adults. What physicians need to know. Arch Intern Med 1991;151:1510-2. Long S, Welkon CJ, Clark JL. Widespread silent transmission of pertussis in families: antibody correlates of infection and symptomatology. J Infect Dis 1990;161:480. Eichenwald HF. Current abstracts: pertussis in adults: what physicians need to know. Pediatr Infect Dis J 1992;11(3):251. Mortimer EA Jr. Perspective: pertussis and its prevention: a family affair. J Infect Dis 1990;161:473-9. Nelson JD. The changing epidemiology of pertussis in young infants. The role of adults as reservoirs of infection. Am J Dis Child 1978;132:371-3. Broome CV, Preblud SR, Bruner B, et al. Epidemiology of pertussis, Atlanta, 1977. J Pediatr 1981;98:362-7. Cone TE Jr. Whooping cough is first described as a disease in sui generis by Ballou in 1640. Pediatrics 1970;46:522. Steele RW. Pertussis: is eradication achievable? Pediatr Ann 2004;33(8):525-34. Sutter RW, Conchi SL. Pertussis hospitalizations and mortality in the United States, 1985-1988. JAMA 1992;267(3):386-91. Cherry JD, Brunell PA, Golden GS, et al. Report on the task force on pertussis and pertussis immunization, 1988. Pediatrics 1988;81(6, part 2):939. Whooping cough making a comeback. Infect Dis Children 2004;1:26. Cherry JD, Brunell PA, Golden GS, et al. Report on the task force on pertussis and pertussis immunization, 1988. Pediatrics 1988;81(6, part 2):946. American Academy of Pediatrics. Pertissus. In: Pickering LK, Baker CJ, Long SS, et al., editors. Red Book: 2006 Report of the Committee on Infectious Diseases (27th ed). Elk Grove Village, IL: American Academy of Pediatrics, 2006. Cherry JD, Brunell PA, Golden GS, et al. Report on the task force on pertussis and pertussis immunization, 1988. Pediatrics 1988;81(6, part 2):951. Southall DP, Thomas MG, Lambert HP. Severe hypoxaemia in pertussis. Arch Dis Child 1988;63:598-605. Krugman S, Katz SL. Infectious Diseases of Children (7th ed). St. Louis, MO: CV Mosby Co., 1981. p. 244. Centers for Disease Control and Prevention. Fatal case of pertussis in an infant: West Virginia, 2004. MMWR 2005;54(3):71-2. Donoso AF, Cruces PI, Camacho JF, et al. Exchange transfusion to reverse severe tertussis-induced cardiogenic shock. Pediatr Infect Dis J 2006;25(9):846-8. Halperin SA, Vaundry W, Boucher FD, et al. Is pertussis immune globulin efficacious for the treatment of hospitalized infants with pertussis? No answer yet. Pediatr Infect Dis J 2007;26(1):79-81. CDC, Immunization Practices Advisory Committee. Diphtheria, tetanus, and pertussis: recommendations for vaccine use and other preventive measures. MMWR 1991;40(RR-10):4. Centers for Disease Control and Prevention. Pertussis: United States, 2001-2003. MMWR 2005;54(50):1283-6. DM, October 2007
23. 24.
25.
26.
27. 28. 29. 30. 31. 32.
33.
34.
35. 36.
37. 38. 39. 40. 41. 42. 43. 44.
Mark A, Granstrom M. Impact of pertussis on the afflicted child and family. Pediatr Infect Dis J 1992;11(7):554-7. Moraga F, Roca J, Mendez C, et al. Epidemiology and surveillance of pertussis among infants in Catalonia, Spain, during 1997-2001. Pediatr Infect Dis J 2005; 24(6):510-3. Centers for Disease Control and Prevention. Pertussis outbreak in an Amish community: Kent County, Delaware, September 2004 –February 2005. MMWR 2006;55(30):818-22. Butler NR, Golding J, Haslum M, et al. Recent findings from the 1970 children’s health and education study: preliminary communication. J Roy Soc Med 1982;75: 781-4. Zellweger H. Pertussis encephalopathy. Arch Pediatr 1959;76:381-6. Centers for Disease Control and Prevention. Outbreaks of pertussis associated with hospitals: Kentucky, Pennsylvania, and Oregon, 2003. MMWR 2005;54(3):67-71. Mink CM, Cherry JD, Christenson P, et al. A search for Bordetella Pertussis infection in university students. Clin Infect Dis 1992;14:464-71. Cromer BA, Goydos J, Hackell J, et al. Unrecognized pertussis infection in adolescents. Am J Dis Child 1993;147:575-7. Sotomayer J, Weiner LB, McMillan JA. Inaccurate diagnosis in infants with pertussis. Am J Dis Child 1985;139:724-6. Heininger U, Cherry JD, Eckhardt T, et al. Clinical and laboratory diagnosis of pertussis in the regions of a large vaccine efficacy trial in Germany. Pediatr Infect Dis J 1993;12(6):504-9. Heininger U, Frei R, Cherry JD, et al. Comparison of pulsed gel electrophoresis patterns of Bordetella pertussis isolates from unvaccinated children with severe or mild pertussis. Pediatr Infect Dis J 2004;23(3):211-6. De Schutter I, Malfroot A, Dab I, et al. Molecular typing of Bordetella pertussis isolates recovered from Belgian children and their household members. Clin Infect Dis 2003;36:1391-6. Cherry JD. Commentaries: the science and fiction of the “resurgence” of pertussis. Pediatrics 2003;112(2):405-6. Harnden A, Grant C, Harrison T, et al. Whooping cough in school age children with persistent cough: prospective cohort study in primary care. Br Med J 2006; 333:174-7. Edwards KM, Decker MD, Graham BS, et al. Adult immunization with acellular pertussis vaccine. J Am Med Assoc 1993;269(1):53-6. Herwaldt LA. Pertussis and pertussis vaccines in adults. J Am Med Assoc 1993; 269(1):93-4. Centers for Disease Control. Pertussis outbreaks: Massachusetts and Maryland, 1992. MMWR 1993;42(11):197-200. Wendling P. PCR testing for pertussis may be too sensitive. Pediatr News 2007:16. Pseudopertussis. Pediatr Infect Dis J Newsletter 2007;26(3). Halperin SA. The control of pertussis: 2007 and beyond. N Engl J Med 2007; 356(2):110-3. Hewlett EL, Edwards KM. Pertussis: not just for kids. N Engl J Med 2005; 352(12):1215-22. Weber D, Rutala W. Pertussis: a continuing hazard for health-care facilities. Infect Control Hosp Epidemiol 2001;12:736-40.
DM, October 2007
493
45. 46. 47.
48. 49. 50.
494
Centers for Disease Control and Prevention. Fatal case of unsuspected pertussis diagnosed from a blood culture: Minnesota, 2003. MMWR 2004;53(6):131-2. Tanaka M, Vitek CR, Pascual FB, et al. Trends in pertussis among infants in the United States, 1980-1999. JAMA 2003;290(22):2968-75. Vitek CR, Pascaul FB, Baughman AL, et al. Increase in deaths from pertussis among young infants in the United States in the 1990s. Pediatr Infect Dis J 2003;22(7):628-34. Smith C, Harish V. Eur J Pediatr 2000;159:898-900. Elliott E, McIntyre P, Ridley G, et al. National study of infants hospitalized with pertussis in the acellular vaccine era. Pediatr Infect Dis J 2004;23(3):246-52. Bisgard KM, Pascual B, Ehresmann KR. Infant pertussis: who was the source? Pediatr Infect Dis J 2004;23(11):985-9.
DM, October 2007