Clinical Complications

Infants and Children

Pertussis can cause serious and potentially life-threatening complications in infants and young children who have not received all the recommended vaccines.

In infants younger than 12 months of age who get pertussis, about half need treatment in a hospital. Hospitalization is most common in infants younger than 6 months of age. Of those infants  with pertussis who need treatment in a hospital approximately:

• 61% will have apnea
• 23% get pneumonia
• 1.1% will have seizures
• 1% will die
• 0.3% will have encephalopathy (as a result of hypoxia from coughing or possibly from toxin)

Other complications can include anorexia, dehydration, difficulty sleeping, epistaxis, hernias, otitis media, and urinary incontinence. More severe complications can include refractory pulmonary hypertension, pneumothorax, rectal prolapse, and subdural hematomas.

Adolescents and Adults

Adolescents and adults can also develop complications from pertussis, but they are usually less severe in this older age group, especially in those who received pertussis vaccines.

In one study, hospitalization rates were 0.8% for adolescents and 3% for adults with confirmed pertussis. Clinicians diagnosed pneumonia in 2% of each group. The most common complications in another study of adults with pertussis were:

• Weight loss (33%)
• Urinary incontinence (28%)
• Syncope (6%)
• Rib fractures from severe coughing (4%)

Other complications can include anorexia, dehydration, epistaxis, hernias, and otitis media. More severe complications can include encephalopathy as a result of hypoxia from coughing or possibly from toxin, pneumothorax, rectal prolapse, subdural hematomas, and seizures.

References

• Cortese MM, Bisgard KM. Pertussis. In: Wallace RB, Kohatsu N, Kast JM, ed. Maxcy-Rosenau-Last Public Health & Preventive Medicine, Fifteenth Edition. The McGraw-Hill Companies, Inc.; 2008:111–14.
• National Notifiable Diseases Surveillance System, 2004–2014. Division of Integrated Surveillance Systems and Services, National Center for Public Health Informatics, Coordinating Center for Health Information and Service, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, GA 30333.
• Tanaka M, Vitek CR, Pascual FB, Bisgard KM, Tate JE, Murphy TV. Trends in pertussis among infants in the United States, 1980-1999. JAMA. 2003;290:2968–75.

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