Title : A retrospective review of children and young people with pertussis positive swabs in Southern Health and Social Care Trust from January 2024 to August 2024
Abstract:
Background: Pertussis (whooping cough) is a highly infectious disease caused by Bordetella pertussis. Malignant pertussis affects young infants, characterized by respiratory distress, perpetual tachycardia and hyperleukocytosis up to 30 G/l, leading to multiple organ failure and death in 75% of cases 2.
Pertussis is a vaccine preventable disease and part of the UK Immunisation schedule. It is available for infants, children and pregnant mothers 3. In 2024, there was a sharp increase in cases across all regions in the UK particularly in under 3 months, although this was below the 2019 peak 4.
The aim of our study is to analyse patient demographics including immunisation status, clinical presentation, course and outcome of children and young people with positive pertussis swabs within the Southern Health and Social Care Trust (SHSCT) area.
Methods: Positive pertussis swabs from January -August 2024 were obtained and data on presentations and outcomes recorded and analysed
Phone interviews with seven mothers whose infants presented under 3 months of age
Results:
·37 positive swabs represent 27 patients (some had repeat), 3 excluded as outside Trust, N=24
·13 males, 11 females
·13 under 1 year
·7 under 3 months (none of the mothers had received pertussis vaccine)
·6 between 4-12
·Children had received all primary immunisations
·16 patients required hospital admission between 1-9 days, median 1-2 days
·Symptoms included spasmodic cough, colour change, feeding difficulties
·1 had seizures but was not as a direct result of pertussis as she has epilepsy
·11 required blood tests. No one had white cell counts over 30.
·3 patients were readmitted all under 3 months due to ongoing spasmodic cough and maternal anxiety
·No one required admission to PICU
·We contacted seven mothers whose infants were age under 3 months on admission. All babies continued to cough for 8-12 weeks but currently well
·3 mothers did not recall being offered the antenatal vaccine, 1 was offered it too late in pregnancy, 1 forgot to attend appointment, 1 was wrongly told that she did not require and 1 was unsure.
·All 7 mothers agreed they would take it in future pregnancies
Conclusions
·We found an almost equal sex distribution
·Over half the patients were under 1 year and a third under 3 months at presentation
·We saw no malignant pertussis
·All who presented under 3 months were born to mothers did not receive antenatal pertussis vaccine
