title: Mixed outbreak of Bordetella pertussis and Bordetella parapertussis infection in Finland.
abstract: The epidemiology of whooping cough in a vaccinated population was studied during an outbreak of paroxysmal cough in an elementary school with 258 pupils in Turku, Finland. Nasopharyngeal specimens for isolation of Bordetella pertussis and/or sera for ELISA detection of antipertussis immunoglobulin M, A and G antibodies were taken from 94% of children who were prospectively followed for two months. Bordetella pertussis was isolated in six patients, and 17 culture-positive cases with Bordetella parapertussis were identified. Patients with Bordetella pertussis or Bordetella parapertussis were found simultaneously in the same classrooms. Comparison of immunoglobulin M responses to Bordetella pertussis and Bordetella parapertussis was used for differential diagnosis of these two infections. Twenty-six cases with pertussis and 27 cases with parapertussis were diagnosed. The results of this prospective study suggest that Bordetella parapertussis is a more common etiologic agent of mild respiratory tract infection among vaccinated school-aged children than is generally recognised. The possibility that Bordetella pertussis was converted to Bordetella parapertussis during this outbreak is discussed.
authors.forename: J
authors.initials: J
authors.lastname: Mertsola
mesh_terms: D000907:Antibodies, Bacterial / Q000032:analysis*; D000918:Antibody Specificity; D001426:Bacterial Proteins / Q000276:immunology; D001427:Bacterial Toxins / Q000276:immunology; D001884:Bordetella / Q000276:immunology*; D001886:Bordetella pertussis / Q000276:immunology; D002648:Child; D004196:Disease Outbreaks; D005260:Female; D005387:Finland; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis; D008297:Male; D010566:Virulence Factors, Bordetella; D014917:Whooping Cough / Q000453:epidemiology / Q000382:microbiology*
chemical_list: D000907:Antibodies, Bacterial; D001426:Bacterial Proteins; D001427:Bacterial Toxins; D007075:Immunoglobulin M; D010566:Virulence Factors, Bordetella