To assess the morbidity associated with the continued high levels of pertussis, we studied all children õ2 years of age who were admitted to the 11 Immunization Monitoring Program -Active (IMPACT) centers, which constitute 85% of Canada's tertiary care pediatric beds. In the 7 years preceding implementation of acellular pertussis vaccine, a total of 1,082 pertussis cases were reported, of which 49.1% were culture-confirmed. The median age of the patients was 12.4 weeks; 78.9% of cases were in children õ6 months of age. Complications of pertussis were common: pneumonia was reported in 9.4% of cases, new seizures in 2.3%, and encephalopathy in 0.5%. There were 10 deaths (0.9%), all in children £6 months of age. Duration of hospitalization was longer (9.3 days vs. 4.9 days; P Å .001) and intensive care was required more frequently (19.2% vs. 4.9%; P Å .001) in infants under õ6 months of age than in those §6 months. Pertussis continues to cause significant morbidity and occasional mortality in Canada, particularly in young infants.
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