Table 4.
Clinical Characteristics and Underlying Conditions in Hospitalized Pertussis Patients by Age Group at Enhanced Pertussis Surveillance Sites, United States, 2011–2015
| Characteristic | All Ages (n = 515) |
By Age Group | |||||
|---|---|---|---|---|---|---|---|
| <2 Months (n = 151) | 2–11 Months (n = 166) | 1–11 Years (n = 58) | 12–20 Years (n = 23) | 21–64 Years (n = 76) | ≥65 Years (n = 41) | ||
| N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | |
| Median delay from onset to hospitalization (days)a | 11 (6–17) | 7 (4–13) | 11 (7–16) | 12 (6–21) | 12 (9–14) | 13 (7–23) | 17 (10–30) |
| Median delay from onset to macrolide antibiotic administration (days)a | 13 (7–21) | 10 (6–16) | 12 (17–19) | 13 (7–20) | 13 (7–20) | 14 (7–22) | 15 (8–26) |
| ICU admission | 107 (21.0) | 57 (38.0) | 30 (18.3) | 5 (8.6) | 2 (8.7) | 9 (12.0) | 4 (10.0) |
| Median length of stay (days)a | |||||||
| Hospitalization | 3 (1.7–6.9) | 5.9 (2.4–10.9) | 2.6 (1.1–5.4) | 1.8 (1–3.9) | 2 (1–3.9) | 3.5 (1.9–6.5) | 3.1 (2–5.9) |
| ICU | 4 (2–9) | 5 (3–11) | 3 (2–7) | 3 (1–3) | 1 (1-1) | 2 (1–3) | 3 (1–13) |
| Symptoms | |||||||
| Paroxysmal cough | 505 (98.1) | 149 (98.7) | 165 (99.4) | 55 (94.8) | 21 (91.3) | 76 (100.0) | 39 (95.1) |
| Whoop | 249 (48.4) | 76 (50.3) | 39 (56.0) | 31 (53.5) | 7 (30.4) | 27 (35.5) | 15 (36.6) |
| Post-tussive emesis | 315 (61.2) | 97 (64.2) | 109 (65.7) | 45 (77.6) | 18 (78.3) | 33 (43.4) | 13 (31.7) |
| Apnea | 184 (35.7) | 93 (61.6) | 65 (39.2) | 11 (19.0) | 1 (4.4) | 9 (11.4) | 5 (12.2) |
| Cyanosis | 227 (44.1) | 102 (67.6) | 101 (60.8) | 16 (27.6) | 5 (21.7) | 3 (4.0) | 0 (0.0) |
| Laboratory findingsb | |||||||
| Maximum white blood cell >30 × 109/L | 31/351 (8.9) | 15/100 (15.0) | 7/86 (8.1) | 5/33 (15.6) | 2/18 (11.1) | 2/74 (2.7) | 0/40 (0.0) |
| Viral codetection | 54/271 (19.9) | 19/92 (20.7) | 21/91 (23.1) | 6/21 (28.6) | 3/14 (21.4) | 3/34 (8.8) | 2/19 (10.5) |
| Respiratory syncytial virus | 22 (8.1) | 11 (12.0) | 10 (11.0) | 1 (4.8) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Rhinovirus/enterovirus | 14 (5.2) | 5 (5.4) | 4 (4.4) | 2 (9.5) | 2 (14.3) | 1 (2.9) | 0 (0.0) |
| Adenovirus | 9 (3.3) | 1 (1.1) | 4 (4.4) | 2 (9.5) | 2 (14.3) | 0 (0.0) | 0 (0.0) |
| Human metapneumovirus | 8 (3.0) | 3 (3.3) | 3 (3.3) | 1 (4.8) | 0 (0.0) | 0 (0.0) | 1 (5.3) |
| Otherc | 11 (4.1) | 4 (4.3) | 2 (2.2) | 2 (9.5) | 0 (0.0) | 2 (5.9) | 1 (5.3) |
| Complications | |||||||
| Pneumonia | 127 (24.7) | 34 (22.5) | 28 (16.9) | 13 (22.4) | 8 (34.8) | 29 (38.2) | 15 (36.6) |
| New-onset seizures | 16 (3.1) | 3 (2.0) | 1 (0.6) | 3 (5.2) | 4 (17.4) | 4 (5.3) | 1 (2.4) |
| Encephalopathy | 7 (1.4) | 1 (0.7) | 0 (0.0) | 0 (0.0) | 2 (8.7) | 3 (4.0) | 1 (2.4) |
| Pulmonary hypertensiond | 4 (0.8) | 2 (1.3) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 2 (2.6) | 0 (0.0) |
| Underlying medical conditions | |||||||
| At least 1 conditionf | 168 (32.6) | 9 (6.0) | 20 (12.1) | 19 (32.8) | 18 (78.3) | 65 (85.5) | 37 (90.2) |
| Asthma or reactive airway disease | 58 (11.3) | 0 (0.0) | 4 (2.4) | 13 (22.4) | 10 (43.5) | 20 (26.3) | 11 (26.8) |
| Obesity | 58 (11.3) | 0 (0.0) | 0 (0.0) | 1 (1.7) | 1 (4.4) | 40 (52.6) | 16 (39.0) |
| Smoking (current or past) | 37 (7.2) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 26 (34.2) | 11 (26.8) |
| Immunocompromising condition/medication usee | 35 (6.8) | 0 (0.0) | 2 (1.2) | 2 (3.5) | 8 (34.8) | 19 (25.0) | 4 (9.8) |
| Cardiac condition | 31 (6.0) | 4 (2.7) | 6 (3.6) | 1 (1.7) | 1 (4.4) | 7 (9.2) | 12 (29.3) |
| Diabetes | 28 (5.4) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 15 (19.7) | 13 (31.7) |
| Other respiratory tract/pulmonary condition | 27 (5.2) | 1 (0.7) | 6 (3.6) | 5 (8.6) | 1 (4.4) | 6 (7.9) | 8 (19.5) |
| Chronic obstructive pulmonary disease | 22 (4.3) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 11 (14.5) | 11 (26.8) |
| Neurologic disorder | 18 (3.5) | 1 (0.7) | 2 (1.2) | 2 (3.5) | 5 (21.7) | 4 (5.3) | 4 (9.8) |
| Renal disease | 15 (2.9) | 0 (0.0) | 1 (0.6) | 1 (1.7) | 1 (4.4) | 8 (10.5) | 4 (9.8) |
| Genetic disorder | 10 (1.9) | 1 (0.7) | 1 (0.6) | 4 (6.9) | 3 (13.0) | 1 (1.3) | 0 (0.0) |
| Illicit drug use or perinatal drug exposure | 9 (1.8) | 3 (2.0) | 4 (2.4) | 0 (0.0) | 0 (0.0) | 2 (2.6) | 0 (0.0) |
| Clinical interventions | |||||||
| Mechanical ventilation | 26 (5.1) | 20 (13.3) | 1 (0.6) | 0 (0.0) | 0 (0.0) | 3 (4.0) | 2 (4.9) |
| Extracorporeal membrane oxygenation | 1 (0.2) | 1 (0.7) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Exchange transfusion | 1 (0.2) | 1 (0.7) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Inhaled nitric oxide | 5 (1.0) | 2 (1.3) | 1 (0.6) | 1 (1.7) | 0 (0.0) | 0 (0.0) | 1 (2.4) |
| Inotropic or vasopressor support | 6 (1.2) | 4 (2.7) | 1 (0.6) | 1 (1.7) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Outcome | |||||||
| Died | 3 (0.6) | 1 (0.7) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (1.3) | 1 (2.4) |
| Discharged with supplemental oxygen | 37 (7.3) | 9 (6.0) | 9 (5.5) | 3 (5.4) | 1 (4.4) | 8 (10.7) | 7 (18.9) |
Abbreviations: ICU, intensive care unit.
aExpressed as median (interquartile range).
Denominators:
bOnly among case-patients in whom testing was performed (N = 350 for white blood cell and N = 271 for viral testing).
cIncludes influenza A and B, coronavirus, parainfluenza, and human herpes virus 6.
dTwenty-seven case-patients underwent echocardiogram or cardiac catheterization.
eNot possible to determine based on chart review whether the case-patient was currently immunosuppressed.
fIncludes other conditions not listed.