Evidence of Bordetella pertussis infection in adults presenting with persistent cough in a french area with very high whole-cell vaccine coverage.
Although France has had a vaccination program for 40 years, since 1990, an increase in whooping cough cases with parent-infant transmission has been observed. This study prospectively assessed the frequency of Bordetella pertussis infection in adults who consulted general practitioners for a persistent cough without an evident diagnosis. Among 217 patients, 70 (32%) confirmed whooping cough cases were identified. One case was culture positive, 36 were polymerase chain reaction positive, and 40 had increases or decreases of > or =2-fold in anti-pertussis toxin IgG titer between serum samples collected during the acute and convalescent phases. The median duration of cough in confirmed cases was 49 days (range, 13-123 days). Of the patients, 60% reported vaccination, and 33% reported whooping cough in infancy. Pertussis should be considered for diagnosis of acute and chronic cough in adults. Future studies should evaluate the public health interest of booster doses of pertussis vaccine in adults.
Département de Médecine Générale, Faculté de Médecine Necker-Enfants Malades, Paris, France. gilberg@necker.fr
Serge
S
Gilberg
Elisabeth
E
Njamkepo
Isabelle Parent
IP
Du Châtelet
Henri
H
Partouche
Pascale
P
Gueirard
Christian
C
Ghasarossian
Martin
M
Schlumberger
Nicole
N
Guiso
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D001428:Bacterial Vaccines / Q000276:immunology / Q000592:standards; D001886:Bordetella pertussis / Q000235:genetics / Q000254:growth & development* / Q000276:immunology; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010297:Paris / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D013183:Sputum / Q000382:microbiology; D018709:Statistics, Nonparametric; D014611:Vaccination; D014917:Whooping Cough / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology
D000907:Antibodies, Bacterial; D001428:Bacterial Vaccines; D004269:DNA, Bacterial