Online Program

Pertussis hospitalizations among Oregon infants, february 2009 – september 2012

Wednesday, November 6, 2013 : 12:56 p.m. - 1:14 p.m.

Juventila Liko, MD, MPH, Oregon Health Authority, Immunization Program, Portland, OR
Laura Reynolds, RN, BSN, MPH, Communicable Disease Services, Multnomah County Health Department, Portland, OR
Paul R. Cieslak, MD, Oregon Health Authority, Office of Disease Prevention and Epidemiology, Portland, OR
Background: During 2012, 907 cases of pertussis were reported in Oregon — the highest number since 1953. Infants have consistently had the highest incidence: 259/100,000 persons. During February 2009 – September 2012, 87 (33%) of the 263 infant cases were hospitalized, while the same was true for only 22 (1.5%) of the 1425 non-infant cases.

Methods: Review of medical records of infants hospitalized with pertussis reported in Oregon during a 44-month period.

Results: Reviewed 80 (92%) of the 87 medical charts. Median duration of hospitalization was 4 (range, 1–128) days. Symptoms included cough (100%), paroxysms (90%), apnea (80%), posttussive vomiting (69%), and whoop (51%). Twenty (45%) developed pneumonia. Other complications included seizures (4 patients), pulmonary hypertension (2 patients), hemorrhages in the CNS and acute encephalopathy (1 patient). Supplemental oxygen was administered to 30 (38%) infants. Twenty-three (29%) infants were admitted to ICU; five required mechanical ventilation. Another infant was supported with extracorporeal membrane oxygenation for > 40 days. One infant <6 months old died. One patient was discharged on oxygen. Fifty-four (62%) of the infants were <2 months old. Of the 24 infants >2 months of age, 14 (58%) were unvaccinated, and 7 were appropriately vaccinated for their age.

Conclusions: Most of the suffering from pertussis is experienced by infants too young to be vaccinated. To reduce exposure to pertussis the best practices remain vaccination of all persons in close contact with infants, pregnant women during the last trimester, timely vaccination of infants, early treatment of cases and antibiotic prophylaxis around infants.

Learning Areas:

Public health or related research

Learning Objectives:
Describe infants’ clinical presentation, course and severity of pertussis during hospital admissions. Identify the age groups where most of the severe disease occurs among infants Define best practices to reduce pertussis exposure among infants

Keyword(s): Public Health, Immunizations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I work as epidemiologist with Oregon Public Health Division in communicable disease control with a main focus in vaccine preventable diseases. I am co-principal investigator of federally funded grants focusing on the epidemiology of pertussis and evaluation of pertussis vaccination in Oregon.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.