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Crocus sativa, saffron, is a herbaceous plant native to the Mediterranean region (Greece) and is cultivated in several countries, including Iran, Spain, Italy, Greece, India and Morocco. The part used is the stigma which mainly contain carotenoid-like compounds such as crocin and crocetin as well as picrocrocin and safranal. Saffron has a long history in traditional medicine. It has been used to treat insomnia, asthma, whooping cough, depression, anxiety, heartburn and to reduce cough. Pharmacologically, the drug is responsible for several activities including antioxidant, antibacterial, antidepressant and anxiolytic properties. Saffron also exerts effects on cognitive function and showed antidiabetic and anticancer activities (in vitro and in vivo). Clinically, studies carried out with saffron carotenoids extracts have demonstrated statistically significant results in both glaucoma and AMD. Acute toxicity tests show that saffron, safranal and crocin are mild to non-toxic agents. Other studies have reported that effective doses of saffron used in clinical practice are significantly lower than toxic doses. [ABSTRACT FROM AUTHOR]

Pertussis is a real public health problem due to high neonatal morbidity rates and resurgence despite high vaccination coverage. The purpose of this study is to analyze the epidemiological profile of pertussis in infants hospitalized from 2012 to 2019. We conducted a retrospective, descriptive study over a 7-year and 8-month period from January 2012 to July 2019. It involved 500 infants admitted with clinical suspicion of pertussis. The average age of infants was 72 days, ranging from 28 days to 18 months; 75% of infants were less than 3 months old. The peak incidence was registered in 2012 and 2016, with a summer predominance (32%); 460 infants (92%) were not or incompletely vaccinated, 42.2% of whom were too young to be vaccinated. A probable contaminant in the entourage was found in 43,6% of cases. Whooping cough and cyanosis were the main reason for hospitalization (77.6%). Chest radiography objectified bronchial disease (25,4%) and alveolar foci (22.7%). Blood count performed in 410 infants showed hyperlymphocytosis in 67.5% of cases. Polymerase chain reaction (PCR) on nasopharyngeal sample collected from 206 infants was positive for Bordetella pertussis in 64% of cases; 118 PCR performed in mothers were positive in 47.7% of cases. All infants received Clarithromycin. Pertussis is a major cause of morbidity in infants in Casablanca. The prevention strategy is based on vaccination of family members of infants. However, vaccination of pregnant women appears to be more effective. [ABSTRACT FROM AUTHOR]

Pertussis is a highly contagious respiratory disease which is dramatic for infants less than two months old who can't be vaccinated. Vaccinating pregnant women against Pertussis can protect newborn against this serious infection by transplacental transfer of maternal antibodies. Recommended in several countries since a decade this strategy is well tolerated and efficacious. It is recommended at each pregnancy between 20 and 36 weeks of gestation. This strategy allows the infant to be protected against a severe disease. He will be then completely protected after his primary vaccination and his first booster. Vaccine boosters of adolescents and adults surrounding the infant are also important and need to be pursued. [ABSTRACT FROM AUTHOR]

The article focuses on enhancing vaccination coverage for children, teenagers, and pregnant women, aiming to address the significant lag in this area. Topics covered include recent recommendations such as vaccinating pregnant women against whooping cough, the introduction of Rotavirus vaccines into the French vaccination schedule, and advancements in meningococcal vaccines.

Introduction: In 1980, partners initiated a mobile simplified EPI (Expanded programme on immunization) strategy for immunizing, with mobile teams, rural and urban populations in Western Africa. This strategy delivered EPI vaccines in two sessions: 1) 3-8 month-old children: BCG-Diphteria Tetanus Pertussis + reinforced killed Polio vaccine; 2) 9-15 month-old children: Diphteria Tetanus Pertussis + reinforced killed Polio vaccine, Measles-Yellow Fever. This strategy was compared to WHO-UNICEF extended EPI strategy, but results were never published in the context of a planned rapid polio eradication with oral polio vaccine., Methods: For comparison with standard WHO-UNICEF extended EPI strategy, using oral polio vaccine in four sessions, all the costs generated by these two strategies in 1988 have been collected in two adjacent zones in Burkina Faso, Western Africa: 203,642 inhabitants for WHO-UNICEF extended EPI strategy (Yako); 109,483 inhabitants for mobile simplified EPI strategy (Gourci). An EPI coverage survey at the end of this year has been done in these two adjacent zones with efficiency (costs per fully immunized child) computed., Results: In Africa, the simplified mobile EPI strategy using reinforced killed polio vaccine was found two times more efficient (12.71 US$ per fully immunized child) than WHO-UNICEF extended EPI strategy using oral polio vaccine (29.67 US$ per fully immunized child), even if DTP-reinforced killed polio vaccine (0.52 US$ per dose) was more expensive than DTP and oral polio vaccine (0.14 US$ for the combined dose). The missed opportunities uncaught up would have doubled coverage in the WHO-UNICEF extended EPI strategy, versus only a 10% increase with the mobile simplified EPI strategy. The main reason for uncaught up missed opportunities in WHO extended EPI strategy was the absence of requested vaccine delivered by a health agent when attending population at meeting point, due to insufficient cold box volume carried on his moped for transport of vaccine., Discussion: After 30 years, since 1990, of poliomyelitis eradication in Africa using oral polio vaccine and with non-added costs in this study of polio mass campaigns, these results should be published to review EPI strategy., (Copyright © 2023 SFMTSI.)

Résumé: La toux désespérante de l’enfant constitue une source d’angoisse pour les familles et un défi de prises en charge diagnostique et thérapeutique pour le clinicien. Une démarche rigoureuse avant tout clinique est essentielle pour ne pas méconnaître une cause organique nécessitant un traitement spécifique. Les troubles somatoformes constituent un groupe étiologique difficile à diagnostiquer et à prendre en charge. L’asthme ű difficile à traiter Ƈ est aussi une situation complexe, où la persistance de la toux doit faire vérifier la validité du diagnostic d’asthme et rechercher des pathologies associées, notamment le syndrome d’hyperventilation et la dysfonction des cordes vocales. Dans la plupart des cas, aucun signe d’alerte n’est présent mais le caractère répété du symptôme est vécu comme insupportable par les familles. Une écoute des parents et des explications simples permettent d’apaiser leurs craintes, d’éviter tout nomadisme médical, et de les aider à mieux tolérer ce symptôme. [ABSTRACT FROM AUTHOR]

Résumé: Objectifs: Résultats d’une enquête sur les vaccinations de médecins généralistes (MG) du département de la Loire, France, en 2010. Sujets et méthodes: Enquête déclarative par auto-questionnaire auprès de 460 MG, 288 (64 %) ont répondu. Résultats: La couverture vaccinale pour DT-polio depuis moins de dix ans, BCG, coqueluche, grippe saisonnière, grippe A/H1N1 souche 2009 et hépatite B était respectivement de 81, 74, 59, 73, 65 et 87 %. Soixante-quatre pour cent des MG ont déclaré être vaccinés contre la rougeole et 49 % contre la varicelle ; 76 % disaient connaître les recommandations vaccinales des soignants, mais 41 % auraient souhaité plus d’informations sur ce thème. En analyse multivariée, les plus jeunes MG étaient mieux vaccinés vis-à-vis de DT-polio, hépatite B, grippe saisonnière et rougeole. Conclusions: Les vaccinations des MG (connaissances, pratiques) doivent être améliorées, notamment par une information annuelle, la formation continue et un suivi médical dans le cadre professionnel. [ABSTRACT FROM AUTHOR]

Summary: Objective: To assess the levels of primary care physicians’ adherence to the 2010 French vaccination schedule against pertussis, measles-mumps-rubella (MMR), and pneumococcal infections in northern France. Methods: Two hundred forty-nine primary care physicians were questioned over the phone from February 15th to May 27th 2010. Results: The total response rate was 61% (n =152) : 43 pediatricians and 109 general practitioners (GPs). The conjugated pneumococcal vaccination was routinely proposed by 93% of the physicians (100% of the pediatricians and 90% of the GPs, P =0.02), and the recommended immunization schedule was correctly stated by 98% of the pediatricians and 70% of the GPs, P <0.001. While the pertussis vaccination was proposed by all the physicians, the recommended immunization schedule was correctly followed in only 46% of the cases (there was no significant difference between the 2 groups of physicians). As for the MMR vaccination, 1 physician did not propose it; 27% had correct knowledge about the MMR vaccination schedule (44% of the pediatricians and 20% of the GPs, P <0.01); 39% initiated an early MMR vaccination schedule for children in day care centers. The main source of their information was medical representatives of pharmaceutical companies, medical journals, and to a lesser degree, weekly epidemiological bulletins and continuing medical education meetings. Conclusion: The level of physicians’ knowledge about the vaccination schedule in children was insufficient in northern France, especially for pertussis and measles. This can decrease vaccination coverage levels as well as its beneficial effects for children. [Copyright &y& Elsevier]

Abstract: Pertussis is a potentially serious illness in very young infants. The growing number of cases encountered in the past few years is partly explained by the loss of immunity, either natural or post vaccinal. To prevent the occurrence of pertussis in newborns and very young infants, it is mandatory to ensure compliance with vaccination recommendations regarding the general population (vaccination of young adults likely to have a child, of fathers and siblings during pregnancies, of mothers soon after birth), as well as professionals in contact with infants too young to have received their three doses of primary vaccination (diphtheria-tetanus-polio-pertussis booster may be performed as soon as the latest is more than two years). Obstetricians, midwives and pediatricians are directly concerned by this vaccinal strategy, owing to their prominent place in both informing couples during pregnancy and after delivery, and performing maternal vaccines soon after birth. [Copyright &y& Elsevier]

Summary: Background: Despite good rates of immunization among children, an apparent increase in the incidence of pertussis disease in infants in France has been observed, mainly because of low vaccination coverage among adults. Guidelines drawn up in 2004 recommend a vaccination strategy called cocooning for parents, but those guidelines are rarely followed by the medical community. Raising the vaccination rate among parents to 65% and the extension of pertussis vaccine booster for people between 26 and 28 years old could help control the disease. Objective and methods: In a primary healthcare setting in 2009, we studied 2 groups of 188 and 190 parents of newborns in a maternity unit. We proposed 2 strategies: information and vaccine prescription for both parents (if eligible) at the time of discharge from the maternity unit (group 1) or vaccination proposed to both parents during hospitalization in the maternity unit (group 2). After 6 weeks, the vaccination rates of both groups were compared. Results: Analysis shows that parents had insufficient knowledge of the disease. Parents were often unaware of their vaccination status. Hence, objective data concerning the vaccination status was quickly available for only 42% of the population, making determination of eligibility unreliable. Only 8% of the parents were up to date for pertussis vaccination in the last 10 years, whereas 90% of the parents had the opportunity for vaccination and 37% of them had been eligible before the pregnancy. At the end of the study, 53% of the parents in group 1 were vaccinated, showing the positive impact of the medical encounter and vaccine prescription. During the study, 40% of the parents in group 2 who were proposed immediate vaccination in the maternity unit accepted it. This increased to 43% of group 2 parents being immunized by the time they had left the maternity unit. Proposing the vaccination at the maternity hospital was the more effective of the 2 strategies (P =0.03): at the end of the study, the objective was nearly reached with 64% of the parents being vaccinated. Conclusions: The promotion of parental vaccination by the pediatrician in the maternity ward is simple and effective. Medical encounters resulting from prescriptions made during hospitalization could raise awareness in general practitioners and enable them to identify eligible adults for pertussis vaccination and vaccinate themselves. There is a need to discuss the complementarity and interactions between perinatal teams and general practitioners within the community healthcare network. [Copyright &y& Elsevier]

Abstract: Objective: The authors had for aim to analyze pertussis epidemiology in Tunisia by studying nasopharyngeal specimens of infants hospitalized in Tunis. Methods: Between march 2007 and march 2008, clinical nasopharyngeal samples were collected from infants with a suspected diagnosis of whooping cough, pertussoid cough, or pertussis-like syndrome, admitted at the Tunis children''s hospital. The laboratory diagnostic criteria were culture isolation of Bordetella species on Bordet-Gengou medium and real-time PCR. Results: Fifty-nine percent of the 74 investigated children with suspected pertussis were less than two months of age. The diagnosis of pertussis was proved positive by real-time PCR for 41%. Culture was negative in all cases. Conclusions: Whooping cough is still prevalent in Tunisia despite an important vaccination coverage. Real-time PCR is an invaluable tool for the rapid diagnosis of pertussis, however culture must also be associated. [Copyright &y& Elsevier]

Summary: Three infants aged less than 2 months were hospitalized for malignant pertussis. Echocardiography showed pulmonary hypertension. High-frequency oscillations and nitric oxide were ineffective. Respiratory and hemodynamic conditions deteriorated secondarily. The third case received an exchange transfusion without success. All three infants died following multiorgan failure. Malignant pertussis is the leading cause of infectious death in infants less than 2 months of age, treatment is often ineffective, and prevention, targeting the population of young adults, is particularly important. [Copyright &y& Elsevier]

Abstract: The origin of contamination in pertussis of young infants is generally the close relatives. From 2000 to 2004, only serology and culture were available in our hospital. The families of 16 young infants (age below one year) hospitalized for pertussis were screened using serological tests: 21/48 contacts were positive. After 2004, PCR was available for exploration of index cases and families: 35/85 contacts were positive. Of the mothers tested 23/46 were positive compared to 14/41 fathers. Only one parent presented with a typical paroxystic pertussis cough, 60% presented with a nonparoxystic cough having lasted for more than five days and 40% of positive adults did not present with cough. Despite official recommendations, none of these young parents had received an antipertussis booster vaccination. This study shows the high frequency of atypical or nonsymptomatic pertussis in adults in the close family of infected young infants. These adults contribute to spreading the disease. [Copyright &y& Elsevier]

Abstract: The prevalence of pertussis in newborns led French health authorities to recommend using a booster dose at 13 years of age, and adding a booster dose for parents, siblings, and health care workers. Objective: The aim of the study was to check if the new recommendations were applied by health care workers and if mothers still in the maternity ward were informed and agreed with these recommendations. Method: A questionnaire assessing knowledge, acceptance of the recommendations was sent to different health care workers and given to mothers in two maternity wards. Results: Three hundred and seventy-five questionnaires filled out by health care workers were analyzed (298 general practitioners, 30 pediatricians, 24 obstetricians, 21 midwives) and 100 questionnaires by mothers. Only 1% of mothers and 55% of health care workers knew about the new recommendations, but only 8.3% of obstetricians and 4.8% of midwives. 92.6% of health care workers considered they were justified, but not applicable in 21.3%, 75% declared informing mothers systematically, and 14.5% documenting their pertussis vaccine status. The vaccination status was greater than 80% for diphtérie-tétanos-polio (dTP) in health care workers, 29.5% of these workers and 49% of mothers considered being vaccinated in a near future. Conclusion: Information, educational campaigns and specific actions are needed to apply the new recommendations which will warrant the success of targeted vaccination, in order to reduce pertussis in infants of more than six months of age. [Copyright &y& Elsevier]

Abstract: Universal vaccination of infants against pertussis has transformed the epidemiology of the disease. Pertussis has however become frequent, although not often diagnosed, in adolescents and adults and thus contributes to permanent transmission of Bordetella pertussis in France and contamination of young infants at risk of severe disease. Control of transmission of pertussis in France necessitates reinforcement of vaccination with late boosters in adolescents and adults and, in addition, education of physicians to recognize and treat early cases ofpertussis, especially in adolescents and adults with a persistant or chronic cough, and to take appropriate prophylactic measures (antibiotics and recall vaccination) of those in contact with confirmed cases. Effective treatment does little to reduce symptoms but it does reduce transmission. Macrolides are the recommended treatment for pertussis. [Copyright &y& Elsevier]

Abstract: Universal vaccination of infants against pertussis has transformed the epidemiology of the disease. Pertussis has however become frequent, although not often diagnosed, in adolescents and adults and thus contributes to permanent transmission of Bordetella pertussis in France and contamination of young infants at risk of severe disease. Control of transmission of pertussis in France necessitates reinforcement of vaccination with late boosters in adolescents and adults and, in addition, education of physicians to recognize and treat early cases of pertussis, especially in adolescents and adults with a persistant or chronic cough, and to take appropriate prophylactic measures (antibiotics and recall vaccination) of those in contact with confirmed cases. Effective treatment does little to reduce symptoms but it does reduce transmission. Macrolides are the recommended treatment for pertussis. [Copyright &y& Elsevier]

Copyright of Revue Francophone des Laboratoires is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Pertussis is a highly contagious acute respiratory tract infection, with a poor prognosis in non-vaccinated new-borns. Objectives: The authors had for aim to investigate an epidemic of 5 pertussis cases among health care workers (HCW) in our maternity ward with potential exposure of new-borns and to evaluate HCW compliance and experience gain. Methods: A retrospective study was made using a questionnaire with HCW on preventive measures taken (antibiotic prophylaxis with erythromycin and wearing a mask). Results: Two hundred and thirty-eight patients were warned of a potential pertussis contamination. No nosocomial case was detected among patients or their new borns. Ten proved or probable cases were identified among 101 HCW having answered (N =101/210, 48%). Sixty percent of HCW people followed the antibiotic treatment and 85% wore a mask among whom 46% adequately. Non-compliance factors were mainly related to adverse effects (41%), delayed information (41%), and false vaccine protection (22%). Crisis communication was felt as unsatisfactory for 72% of HCW and recommendations not adapted for 39% of the staff. Conclusion: This survey points out the difficulty of managing a pertussis alert in a medical ward. [Copyright &y& Elsevier]

Abstract: The evolution of the epidemiology of pertussis, new licensed macrolides and vaccines, new recommendations for vaccination among adolescents and adults need an update of the French guidelines for prevention of the disease around one or grouped cases of the disease. A particular attention should be raised to the diagnosis of whooping cough in adults who are presently the main reservoir of Bordetella pertussis. Whooping cough in adults presents as an unexplained prolonged cough with nocturnal exacerbation witch accounts for most of the contaminations of young infants. A bacteriological confirmation of pertussis should be provided before implementation of preventive measures: culture and PCR are presently the gold standard for the diagnosis of pertussis in infants, children and even adults who have been coughing for less than 20 days. Later on, serology (Elisa, immuno-empreinte) is the only technique available, but cannot be interpreted if the patient has been vaccinated less than one year ago. Infants under three months should be admitted to hospital and every case submitted to respiratory isolation. Eviction from the community should be pronounced within the five first days following the onset of an effective antibiotic treatment. New macrolides should be favoured: clarithromycine for seven days or azithromycine for five days. Household contacts should be given the same prophylactic antibiotic treatment: children and adolescent not correctly immunized, parents of the index case as adults parents of not or not completely immunized infants. The vaccination program of the household should be updated. The same measures should be applied in case of grouped cases (at least two contemporary or consecutive cases in the same area). In that case, the Public Health System doctors should be involved in the investigation and the classification of the cases. The close contacts not or not completely immunized should be prescribed and antibiotic prophylaxis and an update of their vaccination program. Among the occasional contacts, high-risk people only should be treated. In the day care centres an antibioprophylaxis should be given to children who have received less than four vaccine shots against pertussis and to the personnel contact to the cases as well. In the schools, the antibiotic prophylaxis should be prescribed to all children of the classroom(s) not completely vaccinated and to the teacher(s) as well. In the boarding schools and institutions with handicapped children, antibiotic prophylaxis could be applied to every member if the pertussis vaccine coverage is at less than 50%. In hospitals, coughing personnel should wear masks and investigations towards pertussis should be performed in people with a more than seven day unexplained cough. Preventive measures should be applied in case of confirmation of pertussis. [Copyright &y& Elsevier]

Copyright of EMC-Maladies infectieuses is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Les vaccins figurent parmi les armes présentant le meilleur rapport coût/efficacité dans l’arsenal de la médecine moderne. Les politiques volontaristes et les stratégies rationnelles de vaccination ont un fort impact en santé publique. Grâce aux vaccins, l’éradication de la variole a été obtenue, la poliomyélite a disparu de la plus grande partie du monde et un net recul d’un certain nombre d’infections de l’enfant, telles que rougeole, diphtérie, tétanos et coqueluche, a été obtenu. En France, comme dans la plupart des pays, on dispose de comités d’experts dépendant du Ministère de la Santé (Conseil Supérieur d’Hygiène Publique de France et Comité Technique des Vaccinations) qui sont chargés de proposer des modifications du calendrier vaccinal ou l’intégration de nouveaux vaccins dans le programme national de vaccination. Les décisions sont publiées annuellement dans le Bulletin Epidémiologique Hebdomadaire.Mots clés : vaccins, calendrier vaccinal, maladies infectieuses @SUMMARY HD2 = Abstract Vaccines are among the most cost-effective preventive measures against infectious diseases in the armamentarium of modern medicine. When used aggressively with a rational epidemiological strategy, vaccines achieve great success. Vaccines have eradicated smallpox globally, eliminated poliomyelitis from the Western hemisphere, and have drastically diminished the incidence of a number of childhood infections, such as measles, diphtheria, tetanus and pertussis. As is the situation in most countries, in France the Ministry of Health (Conseil Supérieur d’Hygiène Publique de France and Comité Technique des Vaccinations) has appointed committees of experts, with a mandate to assess proposals for the modification or inclusion of new vaccines into the national immunisation programme. The decisions are published annually in the Bulletin Epidémiologique Hebdomadaire.Keywords: vaccine, immunisation programme, infectious diseases [ABSTRACT FROM AUTHOR]

Copyright of EMC-Pediatrie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Whooping cough is a respiratory infection particularly severe for infants. The agents of the disease are the bacteria Bordetella pertussis and B. parapertussis. Before vaccination, the disease affected majority of the children. Due to the high circulation of the bacteria, adolescents and adults were regularly in contact with the bacteria and had natural boosters. Forty years after generalized vaccination in some countries, a change in the transmission of the disease is observed. Children between 2 and 5–10 years of age are not infected (depending of the vaccine used and the vaccine calendar) because they were vaccinated in their infancy. However, adolescents and adults are becoming susceptible because they do not receive any vaccinal or natural boosters. They can be infected and contaminated infants are too young to be vaccinated. Clinical symptoms in adolescents and adults, previously vaccinated or infected, are very variable and for this reason biological diagnosis are now necessary to confirm the infection. These diagnostics are culture, PCR and serology. [Copyright &y& Elsevier]

Pertussis remains in France the first cause of bacterial, infectious death in infant aged 10 days to 2 months. It is especially in this age group that malignant pertussis occurs.Case report. – A 40-day-old infant was admitted in the intensive care unit with symptoms of bronchiolitis along with a 200 bpm permanent tachycardia. He presented a marked leukocytosis with lymphocytosis. On the second day, convulsions and coma occurred, followed rapidly by respiratory failure, with a subsequent deterioration due to the development of severe pulmonary hypertension. Circulatory failure caused the infant’s death on the beginning of the 5th day. Pertussis was confirmed by PCR on nasopharyngeal swab. Intra-familial contamination was most likely.Comments. – Malignant pertussis is characterized by the very young age of patients, permanent tachycardia sine materia, dyspnea with early respiratory failure, frequent neurological symptoms, severe hyperleukocytosis and hyperlymphocytosis, and deep hyponatremia with oliguria and edema. Mortality remains superior to 75% despite the various treatments and life support measures that have been attempted. Adult pertussis, which represents one third of the cases of prolonged cough in this age group, is the main source of contamination of non-immunized young infants. This mode of transmission stresses the importance of the generalization of pertussis vaccine booster in early adolescence, which is recommended in France since 1998. Its extension towards the adult age is under study. [Copyright &y& Elsevier]

Objectives. – The resurgence of whooping cough observed in France convinced us to develop a specific PCR assay to detect B. pertussis in nasopharyngeal secretions in parallel of the culture. The aim of our study was to show the value of the PCR in routine diagnosis.Material and methods. – From November 1996 to August 2000, in two hospitals located in the Yvelines (France), the children consulting for a cough compatible with the diagnosis of whooping cough were included in this study. A questionnaire including clinical, biological and radiological items was completed for each one of these patients. A culture of Bordetella and a detection by PCR of B. pertussis were carried out on each nasopharyngeal aspirate. The diagnosis of whooping cough was retained if the detection was positive in PCR and/or culture.Results. – Among the 215 investigated children with suspected cases of whooping cough, the diagnosis was positive for 45 (20.9%), of which 39 were less than one year old (median: three months). Sixteen (35.5,%) were positive at the same time for both the PCR and the culture, 26 (57.8%) for only PCR and three (6.7%) for only culture. The PCR was positive in 93.3% of the cases. The results were obtained with an average time of 48 hours. The culture was positive in 61.2% of the cases with an average time of six days. The monthly distribution of the cases of whooping cough was very inhomogeneous and of epidemic appearance. The majority of the cases was located between two periods: 42% between November 1996 and September 1997 and 40% between November 1999 and August 2000. Among the infected children, 15 were less than two months old and were not yet vaccinated ; among the 24 others infants, a delay in the vaccine calendar was noted in 50% of the cases. Four children between six and 14 years old were correctly vaccinated. The evolution was favourable in all the children.Conclusion. – The PCR due to its sensitivity, its specificity and its rapidity offers to the clinician a powerful tool for the diagnosis of whooping cough. Nevertheless, the culture must be associated with the PCR, in order to follow the epidemiology and the sensitivity to antibiotics of B. pertussis. [Copyright &y& Elsevier]

Summary: Pertussis is ranked among the leading causes of childhood mortality. The most catastrophic clinical complication of pertussis in infants, intractable pulmonary hypertension with shock, is not very well known. We describe the clinical course of a fatal case of severe pertussis complicated by refractory pulmonary hypertension and shock in a 2-month-old infant. [ABSTRACT FROM AUTHOR]

Objective: Since July 2006, it has been recommended to give a booster of a pertussis vaccine to women just after delivery, if they have received their last dose more than 10 years before. The aim of this study was to evaluate the pertussis vaccine coverage in a cohort of women just after delivery. Patients and methods: All patients (n =31) hospitalized in the postpartum unit on the 15th of September 2006 were included in the study. They were given a questionnaire and medical records available in the department were reviewed. Results: The vaccination coverage was not indicated in any medical records. Only six patients claimed they knew their pertussis vaccination status (less than five years: two patients, between five and 10 years: two patients, more than 10 years: two patients). Two patients had their vaccination booklet. The pertussis vaccine coverage is probably very low. Discussion and conclusion: The information about pertussis vaccine status in postpartum women is not available currently because it is not recorded by medical teams and is unknown by patients themselves. An effort in educating obstetricians and corrective actions are necessary if we want the recent vaccine schedule to be followed. [Copyright &y& Elsevier]