Clinical profile of pertussis among pediatric patients admitted at the Philippine General Hospital

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> The aim of this research was to describe the epidemiologic, clinical laboratory and microbiologic characteristics, complications and outcome of pertussis among pediatric patients at the Philippine General Hospital.<br /><strong>METHODS:</strong> A retrospective chart review was performed which included pediatric patients with final diagnosis of pertussis, both clinical and laboratory -confirmed admitted from December 2012 to August 2013 at the Philippine General Hospital. <br /><strong>RESULTS:</strong> This chart review included 28 pertussis patients highest in those aged 1-3 months (86%), females (57%) and from region 4A (57%). 26 (93%) had exposure to household members with respiratory symptoms and unknown pertussis vaccination status. Of those patients who were eligible for vaccination, only 24% received age-appropriate DPT vaccination.<br />Onset of illness varied from 3-56 days; majority 9/L, range: 14.7-111.5x109/L;), lymphocytic predominance (mean lymphocyte 0.47, range: 0.20-0.72;) and thrombocytosis (mean platelet count: 567x109/L, range: 269-823x109/L;). 28% were culture positive for B. pertussis, while 86% tested positive for PCR.<br />The most common complications  were pneumonia requiring mechanical ventilation (64%), ARDS (28%), seizures (21%), nosocomial pneumonia (11%) and myocarditis (11%). The average length of hospital stay was 7.4 days with 13 deaths or 46% case fatality rate. Deaths were attributed to respiratory failure due to progressive pneumonia and ARDS. Other contributing causes were arrhythmia, MODS, and  septic shock.<br /><strong>CONCLUSION:</strong> Susceptible young infants acquire pertussis from household contacts with respiratory symptoms. Paroxysmal cough and cyanosis are common clinical features, with leukocytosis, lymphocytosis and thrombocytosis. High case fatality rate for pertussis was noted among these patients.<br /><br /></p>

Lethal paralytic shellfish poisoning from consumption of green mussel broth, Western Samar, Philippines, August 2013

Background：In July 2013, the Philippines’ Event-Based Surveillance & Response Unit received a paralytic shellfish poisoning (PSP) report from Tarangnan, Western Samar. A team from the Department of Health conducted an outbreak investigation to identify the implicated source and risk factors in coastal villages known for green mussel production and exportation.Methods：A case was defined as a previously well individual from Tarangan, Western Samar who developed gastrointestinal symptoms and any motor and/or sensory symptoms after consumption of shellfish from 29 June to 4 July 2013 in the absence of any known cause. The team reviewed medical records, conducted active case finding and a case-control study. Relatives of cases who died were interviewed. Sera and urine specimens, green mussel and seawater samples were tested for saxitoxin levels using high performance liquid chromatography.Results：Thirty-one cases and two deaths were identified. Consumption of > 1 cup of green mussel broth was associated with being a case. Seawater sample was positive for Pyrodinium bahamense var. compressum and green mussel samples were positive for saxitoxin. Inspection revealed villagers practice open defecation and improper garbage disposal.Conclusion：This PSP outbreak was caused by the consumption of the green mussel broth contaminated by saxitoxin. As a result of this outbreak, dinoflagellate and saxitoxin surveillance was established, and since the outbreak, there have been no harmful algal blooms event or PSP case reported since. A “Save Cambatutay Bay” movement, focusing on proper waste disposal practice and clean-up drives has been mobilized.