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Pertussis Morbidity in Children 12–59 Months of Age

A NSW Public Health Network Study

Staff, Michael, PhD*; Nyinawingeri, Adelaide, MIPH/MHM*; Denniss, Kathy, MPH; Ingleton, Andrew, MIPH*; Jelfs, Jane, PhD; Corben, Paul, MAppSci

The Pediatric Infectious Disease Journal: June 2019 - Volume 38 - Issue 6 - p 553–558
doi: 10.1097/INF.0000000000002234
Original Studies

Background: Pertussis continues to be a significant public health problem despite high levels of vaccination. Although hospitalizations and deaths among children greater than 12 months of age are much less frequent than among infants less than 6 months of age, only limited information is available for this age group on other measures of morbidity.

Methods: A cross-sectional study with a 6-week follow-up component was conducted in New South Wales, Australia in 2017 to measure morbidity among children 12–59 months of age notified to health authorities. Measures used included cough duration, cough severity, constitutional symptoms and impacts on the family. Associations between these outcomes and age group, vaccination status, asthma, treatment and family structure were explored.

Results: Three hundred and five of 472 (65%) notified cases were interviewed at baseline with approximately 20% having a severe cough with no trend in prevalence across age groups. Forty-eight percent of cases had experienced 3 or more constitutional symptoms with rates significantly higher among younger children. Children who had received an 18-month booster vaccination were significantly less likely to experience 3 or more constitutional symptoms (odds ratio: 0.46, 95% confidence interval: 0.22–0.97). Fifty-one percent of cases were still coughing at 6 weeks. One-third of carers initially reported having disrupted sleep 4 or more nights per week with substantial disruption to carers’ sleep still recorded at 6 weeks.

Conclusions: Substantial morbidity was observed in this age group with some evidence that the reintroduction of an 18-month acellular pertussis booster lessened disease severity.

From the *Public Health Unit, Sydney Local Health District Hornsby, NSW Australia.

Public Health Unit, Murrumbidgee and Southern NSW Local Health Districts Goulburn, NSW Australia

North Coast Public Health Unit, Mid North Coast and Northern NSW Local Health Districts Port Macquarie, NSW Australia.

Accepted for publication September 26, 2018.

The authors have no funding or conflicts of interest to disclose.

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Address for correspondence: Adelaide Nyinawingeri, MIPH/MHM, Public Health Unit, Northern Sydney Local Health District. E-mail:

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