Fever with pertussis a predictor of severe disease

Associate Professor Helen Marshall, head of the Vaccine and Immunology Research Trials Unit at the Robinson Research Institute at the University of Adelaide, and colleagues, assessed factors associated with pertussis disease severity in 120 children aged 0–17 years hospitalised in Australia during the 12 months of the pertussis epidemic that occurred during 2009–10.

Most severe pertussis occurred in young, unimmunised infants, although severe disease was also observed in children older than 12 months of age and in previously vaccinated children.

Children admitted with pertussis younger than two months, or with evidence of co-infection, history of premature birth or fever over 37.5°C at presentation, need close monitoring, the authors said, because all factors were independently associated with severe disease.

Presence of fever was the strongest predictor of severe disease, with febrile children six times more likely to develop