Clinical aspects of evolution of pertussis in children under modern conditions
The objective. To study specificities of the clinical picture of pertussis in children of varied age in the evolutionary aspect. Patients and methods. Specificities of the clinical course of pertussis in children treated in the Moscow Infectious Clinical Hospital No 1 are presented. A comparative analysis of symptoms at different periods of disease in children of varied age has been performed among patients hospitalised in the 2000s and 1990s, in 517 and 487 patients younger than 1 year and in 267 and 232 older than 1 year of age, respectively. The dynamics of the clinical forms of pertussis among infants is presented beginning with the ‘80s (in 840 patients). For verification of pertussis the bacteriological, PCR and serological methods were used. Results. A comparative analysis of particular symptoms permitted to determine specificities of the course of pertussis depending on children's age. The most unfavourable course of pertussis, as previously, was observed in the group of 0 to 3-month-old infants, of whom 1/3 had a severe form of disease with marked respiratory disorders and hypoxia, development of neurological complications, which has become more frequent due to worsening of the premorbid background in this age group in the past years. Among children older than one year, hospitalised to the unit, moderate and mild pertussis was recorded. Conclusion. Under modern conditions, pertussis preserves its main characteristic features. In the 2000s, a higher percentage of severe pertussis has been recorded among infants younger than 3 months.