A clinical analysis of the 2024 pertussis outbreak among pediatric patients in an infectious diseases hospital in Bucharest, Romania.

Introduction: The objective of this study was to identify and analyze cases of pertussis hospitalized in 2024 that met the clinical criteria, epidemiological context, and laboratory confirmation through polymerase chain reaction (PCR) or serological testing for Bordetella pertussis. This study aimed to assess the age distribution of cases, vaccination rates, identify severe cases, and associated complications such as apnea, acute respiratory failure, and acute pneumonia. The findings aim to provide valuable data to enhance diagnostic and therapeutic strategies for managing pertussis in the pediatric population.

Methods: We conducted a retrospective study from January to November 2024, involving pediatric patients admitted to the Pediatric Departments of the National Institute of Infectious Diseases "Prof. Dr. Matei Balş," Bucharest, Romania, diagnosed with pertussis. The diagnosis was established based on epidemiological and clinical criteria and confirmed through laboratory tests, including serology or PCR testing. The selection criteria focused on hospitalized patients presenting clinical signs suggestive of pertussis, with laboratory confirmation.

Results: Among the hospitalized patients, a significant proportion, 56.9%, were unvaccinated, while 12.5% had incomplete vaccination status. Common comorbidities contributing to increased hospitalization risk included prematurity, malnutrition, and asthma. Co-infections were identified in 32% of cases, with common pathogens such as measles, SARS-CoV-2, rhinovirus, and adenovirus. Respiratory complications were frequent, with apnea occurring in 51% of cases, pneumonia in 60%, and respiratory failure in 13.2%. Despite these complications, no fatalities were reported.

Conclusions: This study highlights significant concerns related to low vaccination coverage in the pediatric population, emphasizing the importance of improving vaccination rates to prevent severe pertussis cases. The study also identifies the frequent occurrence of severe complications, including respiratory failure, apnea, and pneumonia, underlining the need for early intervention and effective management. Co-infections with respiratory pathogens further complicate diagnosis and treatment, underscoring the importance of comprehensive clinical evaluation in suspected cases of pertussis.