Severe infantile pertussis in Nigeria, report of two cases: the need for review of current pertussis vaccination schedule

Yeside Akinbolagbe, Omotola Majiagbe, Omotola Majiagbe


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.


Bordetella, developing countries, diagnosis, infant, maternal immunization, Nigeria, pertussis, prevention, whooping cough


CDC. Pertussis | Whooping cough. Aug 2017. [assessed and cited on 2018 January 4] available from URL:

WHO position paper. Pertussis vaccines. September 2015. Wkly Epidemiol Record 2015; 90:433-60.

Gabutti G, Maria C. Pertussis: A Review of Disease Epidemiology Worldwide and in Italy. Int J Environ Res Public Health 2012 Dec; 9(12): 4626-4638.

Nigeria pertussis cases, 1949-2016. [Assessed and cited on 2018 January 7]. Available from URL:

Pertussis: Practice Essentials, Background, Etiology and Pathophysiology. [Assessed and cited on 2018 January 10], available from: URL:

WHO. Vaccines and diseases: Pertussis. [Assessed and cited on 2018 January 10] Available from URL:

Bisgard KM, Pascual FB, Ehresmann KR, et al. Infant pertussis: who was the source? Pediatr Infect Dis J.2004 Nov; 23 (11): 985-9.

Oloyede IP, Ekanem AM, Udoh EE. Pattern of childhood pertussis in a tertiary hospital in Nigeria: a five-year review (2007-2011). Niger J Paed 2015: Vol 42 (2) 83-87.

The World Bank’s updated International Poverty Line, a case of poor measurement? April 2016. [Assessed and cited on 2018 March 8] available from: URL:>2016/04.

Dabrera G, Amirthalingam G, Andrews N, et al. A case-control study to estimate the effectiveness of maternal pertussis vaccination in protecting newborn infants in England and Wales, 2012-2013. Clin Infect Dis. 2015 Feb 1; 60 (3): 333-7.

Sobanjo-Ter Meulen A, Duclos P, Mclntyre P, et al. Assessing the evidence for maternal pertussis immunization: A Report from Bill & Melinda Gates Foundation symposium on Pertussis Infant disease burden in low and lower-middle-income countries. Clin Infect Dis 2016; 63(Suppl 4), S123-S133.

Villena R, Vidal P, Carrillo F, Salinas M. Pertussis vaccination in pregnancy: Security and effectiveness in the protection of the infant. Rev Chil Pediatr. 2017; 88 (3):318-323.

Sadoh AE, Oladokun RE. Re-emergence of diphtheria and pertussis: implications for Nigeria. Vaccine 2012 Nov 26; 30 (50): 7221-8.

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ISSN: 1597-4292