Hospitalization and complications in children under 2 years of age with Bordetella pertussis infection

We prospectively followed 725 children under 2 years of age with laboratory -diagnosed Bordetella pertussis infection to investigate the hospitalizatio n rate and complications. Diagnosis was made by culture and polymerase chai n reaction (PCR) from nasopharyngeal swabs in 11,016 children who presented with greater than or equal to 7 days of cough at 63 pediatric practices in Germany. Of these children, 33 (4.5%) were hospitalized at a mean age of 4 .8 months (range, 17 days to 19.5 months). Complications occurred in 16 (48 %) of the 33 patients. Pneumonia developed in two (6%) children and a convu lsion was observed in one (3%) Intensive care monitoring was required for 2 3 (70%) children. Further complications were bradycardia (21%), apnea (12%) , conjunctivitis (12%), loss of weight (12%), otitis media (6%), atelectasi s (3%) and dehydration (3%) Children aged 6-24 months who had not received any dose of pertussis vaccine had a ten-fold increased risk of hospitalizat ion compared to those who had been partially or fully immunized (p < 0.05). Pertussis immunization should be given at an early point in time and compl etely in order to prevent severe courses of pertussis and hospitalization i n young children.