[Clinical and epidemiological differences between Bordetella pertussis and respiratory syncytial virus infections in infants: a matched case control study]

Abstract

Introduction: An increase in cases of pertussis, mainly in young infants, has been reported in the last few years. The clinical presentation of this disease is very similar to that produced by respiratory syncytial virus (RSV), which makes the diagnosis difficult.

Objective: To compare the clinical and epidemiological characteristics between Bordetella pertussis and RSV infections in infants admitted to hospital.

Material and methods: An analytical matched case-control study was conducted during the period 2008-2011. Cases were defined as infants admitted with pertussis confirmed by PCR in nasopharyngeal aspirate. Each case was matched by age, sex and date of admission to two controls defined as patients with RSV infection detected by immunochromatography in nasal aspirate. Demographic, clinical, laboratory data were compared.

Results: Seventy eight patients (26 cases of pertussis and 52 controls RSV+) were included. Sociodemographic characteristics were similar in both groups. Cases had more days of symptoms prior to admission, longer hospital stays, and increased frequency of epidemic family environment. Apnoea and cyanosis were more frequent. Cases of pertussis were more likely to have apnoea, cyanosis, and lymphocytosis while RSV infections had more frequent fever, vomiting and respiratory distress.

Conclusions: The clinical presentations of pertussis and RSV infection are similar, but there are some characteristics that can help to distinguish between them.

Keywords: Bronchiolitis; Bronquiolitis; Infecciones respiratorias; Respiratory infections; Respiratory syncytial virus; Tos ferina; Vaccines; Vacunas; Virus respiratorio sincitial; Whooping cough.