PEDIATRICS Vol. 5 No. 5 May 1950, pp. 840-852
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CASE FATALITY IN INFANTS AND CHILDREN WITH PERTUSSIS, 1942-1946

JEROME L. KOHN M.D.1, ALFRED E. FISCHER M.D.1, and HERBERT H. MARKS A.B.1

1 The Willard Parker Hospital, Department of Hospitals, and the Statistical Bureau of the Metropolitan Life Insurance Company, New York, N.Y.

Analysis of data on patients with pertussis during 1942-1946 obtained by means of a questionnaire from communicable disease hospitals and from health officers in a number of cities in the United States and Canada showed these results:

Case fatality rates of patients admitted to hospitals for treatment have declined substantially in the period under review. This decline is general, both among infants under one year of age and among older children. In 1946, the case fatality rate of the infants hospitalized for the disease was 5.0% in those cities for which data for at least four years were available. This may be compared with the rate of 7.8% in 1942 and 11.1% in 1943. At ages one year and over, the rate was only 1.3% in 1946, as compared with 1.7% in 1942 and 3.7% in 1943.

The rates in the hospitals with larger experiences were generally more favorable than in hospitals with smaller experiences.

Despite the incomplete reporting of pertussis, which results in exaggerating the case fatality rate for the general population, the level of these rates in the community as a whole was lower than for hospitalized cases. This reflects the higher proportion of the severer cases in the hospitalized group. Indications are that in many places hospitalization is limited more and more to severe cases.

Progress in the management of pertussis, especially of the severer cases admitted to hospitals, is believed to be the chief factor in the decline in case fatality of pertussis.

A request contained in the questionnaire for an opinion on the severity of pertussis during the period studied elicited few replies, and these replies showed a division of opinion on the matter. It appears unlikely that there has been much of any change in the severity of the disease.

Submitted on August 22, 1949