Severe infantile pertussis in Nigeria, report of two cases: the need for review of current pertussis vaccination schedule
Keywords:
Bordetella, developing countries, diagnosis, infant, maternal immunization, Nigeria, pertussis, prevention, whooping coughAbstract
Title: Severe infantile pertussis in Nigeria, report of two cases: the need for review of current pertussis vaccination schedule.
Background: Pertussis, whooping cough is a highly contagious bacterial infection. Although the growing majority of cases are above 6years, 10-15% of all cases of pertussis occur in infants younger than 6 months and more than 90% of deaths occur in this age group. Vaccination against the disease in Nigeria usually occurs between 6 and 14 weeks of age, leaving these neonates and infants largely unprotected, especially when exposed before and during this period.
Case report: We present two cases; a 6 week old male infant and a 9 week old female; who presented with symptoms of severe cough, apnoeic episodes and seizures. Full blood count showed lymphocytosis and chest x-ray revealed patchy opacities in one of them. Diagnosis was made clinically and they were managed with erythromycin and azithromycin respectively as well as intensive supportive care.
Conclusion: Pertussis should be considered in any infant presenting with cough and apnoea, as it can be associated with significant morbidity and mortality requiring aggressive supportive care. The management of pertussis in developing countries urgently needs a scale up of diagnostic capacity and prevention strategies.
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