Whooping cough in school age children with persistent cough: prospective cohort study in primary care.
OBJECTIVE
To estimate the proportion of school age children with a persistent cough who have evidence of a recent Bordetella pertussis infection.


METHODS
Prospective cohort study (October 2001 to March 2005).


METHODS
General practices in Oxfordshire, England.


METHODS
172 children aged 5-16 years who presented to their general practitioner with a cough lasting 14 days or more who consented to have a blood test.


METHODS
Serological evidence of a recent Bordetella pertussis infection; symptoms at presentation; duration and severity of cough; sleep disturbance (parents and child).


RESULTS
64 (37.2%, 95% confidence interval 30.0% to 44.4%) children had serological evidence of a recent Bordetella pertussis infection; 55 (85.9%) of these children had been fully immunised. At presentation, children with whooping cough were more likely than others to have whooping (odds ratio 2.85, 95% confidence interval 1.39 to 5.82), vomiting (4.35, 2.04 to 9.25), and sputum production (2.39, 1.14 to 5.02). Children with whooping cough were also more likely to still be coughing two months after the start of their illness (85% v 48%; P = 0.001), continue to have more than five coughing episodes a day (P = 0.049), and cause sleep disturbance for their parents (P = 0.003).


CONCLUSIONS
For school age children presenting to primary care with a cough lasting two weeks or more, a diagnosis of whooping cough should be considered even if the child has been immunised. Making a secure diagnosis of whooping cough may prevent inappropriate investigations and treatment.
Harnden
Anthony
A
Department of Primary Health Care, University of Oxford, Oxford OX3 7LF. anthony.harnden@dphpc.ox.ac.uk
Grant
Cameron
C
Harrison
Timothy
T
Perera
Rafael
R
Brueggemann
Angela B
AB
Mayon-White
Richard
R
Mant
David
D
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004739:England / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005194:Family Practice; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D037342:Pertussis Toxin / Q000276:immunology; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012893:Sleep Wake Disorders / Q000453:epidemiology; D014917:Whooping Cough / Q000453:epidemiology*
D007074:Immunoglobulin G; D037342:Pertussis Toxin