Analysis of epidemic characteristics and clinical features of inpatients with pertussis in 2012-2014 / 中华实用儿科临床杂志

ABSTRACT

Objective To provide basis for the diagnosis,treatment,prevention and control of pertussis by analyzing serological test findings and clinical features of inpatients.Methods Serological test findings (including outpatients and inpatients) of suspected cases and medical records diagnosed as pertussis (severe group and non-severe group) were analyzed in Shandong Provincial Hospital Affiliated to Shandong University from January 1,2012 to December 31,2014.This retrospective study was conducted to explore the epidemiological characteristics,clinical manifestations,image manifestations of pertussis in recent years.Results The incidence of pertussis was obviously higher in 2014 than the previous 2 years,nearly 10 times than that of 2013;summer and autumn were high-occurrence seasons;pertussis was found predominately in children under 6 years old,as 68％-80％,and the majority of them were 3 months-1 year old and 4-6 years old,and there was a notable increase in children more than 6 years old in 2014;the clinical manifestations tended to be atypical,primarily spasmodic cough (79.01％,64/81 cases),cyanosis (60.49 ％,49/81 cases),vomiting after cough (35.80％,30/81 cases),conjunctiva haemorrhage (22.22 ％,18/81 cases) apnea or heart rate decrease(9.88％,8/81 cases),and whooping cough (7.41％,6/81 cases).There were significant differences(all P ＜ 0.05) in age (t =2.940),paroxysmal cyanosis (x2 =4.505),elevated white blood cell count (x2 =4.410),and lymphocyte percentage increase(x2 =7.830) between severe group and non-severe group.There was no statistical difference in sex(x2 =0.847),season (x2 =0.178),spasmodic cough (x2 =0.097),whooping cough (x2 =0.002),conjunctiva hemorrhage (x2 =0.395),apnea (x2 =0.395) and fever (x2 =0.301) between the 2 groups (all P ＞ 0.05).Mixed infection with mycoplasma was most common.Imaging manifestations of pertussis were not specific,and they might manifest uneven density,patchy inflammatory infiltrates and atelectasis.Conclusions The morbidity of pertussis is rising and atypical cases is increasing in these years,and severe cases are seen most frequently in small infants,it is necessary to perfect the laboratory test methods and immunization strategy.