Study: Critical Pertussis

Study Type: Observational
Study Period: December 2009 – July 2014
Enrollment: 225
Consent: Yes


Despite high coverage for childhood vaccination, pertussis causes substantial morbidity and mortality in U.S. children, especially among young infants. Although pertussis is a well-known precipitant of critical illness, especially in infants, several gaps of knowledge about critical pertussis (pertussis associated with a PICU admission) exist. In the United States, no national studies have assessed the acute course of critical pertussis. Worldwide, no published studies have comprehensively assessed sequelae of critical pertussis among survivors. Understanding the morbidity of severe pertussis will inform national prevention strategies, generate hypotheses, and help prioritize research.

Among children under 18 years of age with pertussis who require hospitalization in the PICU, the aims of this multicenter study were to:

1) characterize the acute course during the PICU admission;
2) assess reported health status and family impact following PICU discharge;
3) assess developmental sequelae and quality of life at 12-months following PICU discharge among infants who were less than 12 months old at time of PICU admission; and,
4) assess risk factors associated with developmental sequelae in infants.

A prospective cohort of children with critical pertussis was identified through the National Institute for Child Health and Human Development (NICHD), Collaborative Pediatric Critical Care Research Network (CPCCRN) and other PICU sites utilizing existing national research infrastructure. With enhanced PICU surveillance, 223 children with critical pertussis were enrolled. Eligible pertussis cases were defined using study case definitions. Demographic and clinical information were collected through chart abstraction and parental interview. Six months after hospital discharge, health status was assessed through questionnaires administered by mailed or telephone survey. Among infants less than 12 months old at the time of PICU admission, developmental sequelae were evaluated with the validated Mullen Scales of Early Learning. Potential risk factors for sequelae were assessed through univariable and multivariable analyses.


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