Published 27 November 2008, doi:10.1136/bmj.39575.715787.80
Cite this as: BMJ 2008;337:a343

Practice

Lesson of the Week

Rapidly fatal invasive pertussis in young infants—how can we change the outcome?

U Theilen, consultant1, E D Johnston, specialist registrar2, P A Robinson, clinical fellow1

1 Paediatric Intensive Care Unit, Royal Hospital for Sick Children, Edinburgh EH9 1LF, 2 Medical Paediatrics, Royal Hospital for Sick Children, Edinburgh EH9 1LF

Correspondence to: U Theilen ulf.theilen@luht.scot.nhs.uk

Prevention of infection may be the only effective intervention against whooping cough for unimmunised infants

The first 150 words of the full text of this article appear below.

Although vaccination of infants has greatly reduced morbidity and mortality in children,1 the incidence of pertussis is rising in the non-paediatric population.2 In adults persistent cough for more than two weeks is the cardinal feature of pertussis, but with a wide differential and an atypical course, pertussis is often undiagnosed.3 Infectious adults in a family are the main source of infection for unimmunised infants.4 We report two fatal cases of invasive pertussis in unvaccinated infants.

A 1 month old boy presented to a district general hospital with a five day history of cough, runny nose, and difficulty feeding. A working diagnosis of bronchiolitis was made.

Both parents and an older sibling reported coughing episodes for the preceding fortnight. The baby’s mother gave a history of vomiting after these spells, and classic bouts with "whoop" were observed. The sibling had been fully vaccinated. The practice searched unsuccessfully for the childhood vaccination . . . [Full text of this article]


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Rapid Responses:

Read all Rapid Responses

What is really the cause of deaths in newborn infants who usually contracted pertussis from their vaccinated family members sufferring whooping cough at the time of these babies' birth
Dr Viera Scheibner PhD
bmj.com, 9 Dec 2008 [Full text]
Pertussis in infants: Some key issues need clarification
M A Anjay
bmj.com, 17 Jan 2009 [Full text]
Re: What is really the cause of deaths in newborn infants who usually contracted pertussis
Peter J Flegg
bmj.com, 19 Jan 2009 [Full text]
Have these cases been reported as possible adverse drug reactions?
Wouter Havinga
bmj.com, 19 Jan 2009 [Full text]
Early ECMO referral must be considered
Giles J Peek, et al.
bmj.com, 26 Jan 2009 [Full text]
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