-- Robert Preidt
THURSDAY, Jan. 10 (HealthDay News) -- Taking early and repeated
white blood cell counts is vital in diagnosing whooping cough
(pertussis) in infants and identifying which of them have the
highest risk of dying from the respiratory infection, according to
a new study.
Researchers examined the medical records of 31 infants admitted
to five pediatric intensive-care units in California between
September 2009 and June 2011. In 2010, California had its highest
pertussis rate in 60 years.
The study, which was published online Jan. 10 and in the March
print issue of the
Journal of the Pediatric Infectious Diseases Society, found
that the eight infants with more severe pertussis had higher white
blood cell counts and were more likely to show at least a 50
percent increase in white blood cells. They had median peak white
blood cell counts of about 74,000, compared with about 24,000 among
infants with less severe pertussis.
All but one infant with more severe pertussis had at least a 50
percent increase in white blood cells within 48 hours, while none
of the infants with less severe pertussis had more than a 50
percent increase in white blood cells.
The researchers also found that the infants with more severe
pertussis had higher maximum heart and breathing rates and were
more likely to develop pneumonia. These conditions occurred earlier
in infants with more severe pertussis than in those with less
In addition, infants with more severe pertussis were more likely
to suffer seizures, shock and kidney failure, and to require a
breathing tube. They also were more likely to receive an exchange
blood transfusion, in which most of the blood is replaced with
Six of the infants received exchange transfusions, and four of
them died. The four who died were in shock at the time of the
transfusion, while the two who survived were not in shock.
"Because very young infants have not yet been vaccinated and are at the highest risk for severe disease, we need to better manage and treat it," study lead author Erin Murray, an epidemiologist at the California Department of Public Health, said in a journal news release.
"This study shows the importance of aggressive pediatric intensive care and provides us additional metrics as we treat these very young patients," Murray added.
In 2012, pertussis rates in the United States were the highest
in 50 years, according to the U.S. Centers for Disease Control and
The U.S. Centers for Disease Control and Prevention has more
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