Pertussis Infection in the United States: Role for Vaccination of Adolescents and Adults

Dennis A. Brooks, MD; Richard Clover, MD

Disclosures

J Am Board Fam Med. 2006;19(6):603-611. 

In This Article

Complications of Pertussis

Life-threatening complications are most common in infants <3 months of age,[19,21] but infection can also be severe in some adult cases. Secondary bacterial pneumonia is diagnosed in up to one quarter of young infants with pertussis[21,25] and is the most common complication and the cause of most pertussis-related deaths across age groups. Data from 1997 to 2000 indicate that pneumonia occurred in up to 5.2% of all reported pertussis cases, and 11.8% of infants <6 months of age.[7] Other complications include seizures (0.8% of all cases, 1.4% of infants <6 months of age) and encephalopathy (0.1% of all cases, 0.2% of infants <6 months of age).

Death due to pertussis is rare (0.2%). The vast majority (90%) occurs in children younger than 6 months of age with no predisposing conditions.[2] Risk factors for death among infants include premature birth, Hispanic ethnicity, and having a young mother.[2,26] Pertussis has also been linked to sudden infant death (3% to 5%).[27,28] Other less severe complications in infants include otitis media, anorexia, and dehydration. Pressure effects of severe paroxysms may lead to pneumothorax, epistaxis, subdural hematomas, hernias, and rectal prolapse. Additional complications identified in adolescents and adults include urinary incontinence, rib fracture, unilateral hearing loss, herniated disk, and precipitation of angina pectoris.[5,24]

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