title: Epidemiological aspects of pertussis among adults and adolescents in a Korean outpatient setting: a multicenter, PCR-based study.
abstract: Epidemiological data of Bordetella pertussis infection among adolescents and adults are limited in Korea. Patients (≥ 11 yr of age) with a bothersome cough for less than 30 days were enrolled during a 1-yr period at 22 hospitals in Korea. Nasopharyngeal swabs were collected for polymerase chain reaction (PCR) and for bacteriologic culture. In total, 490 patients were finally enrolled, and 34 (6.9%) patients tested positive for B. pertussis; cough duration (14.0 days [7.0-21.0 days]) and age distribution were diverse. The incidence was the highest in secondary referral hospitals, compared to primary care clinics or tertiary referral hospitals (24/226 [10.6%] vs. 3/88 [3.4%] vs. 7/176 [4.0%], P = 0.012), and the peak incidence was observed in February and August (15.8% and 15.9%), with no confirmed cases between March and June. In the multivariate analysis, post-tussive vomiting was significantly associated with pertussis (odds ratio, 2.508; 95% confidence interval, 1.146-5.486) and secondary referral hospital showed a borderline significance. In conclusion, using a PCR-based method, 6.9% of adolescent and adult patients with an acute cough illness had pertussis infection in an outpatient setting. However, hospital levels and seasonal trends must be taken into account to develop a better strategy for controlling pertussis.
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Sunghoon
authors.identifier: 0000-0001-7004-6985
authors.initials: S
authors.lastname: Park
authors.affiliation: Seegene Medical Foundation, Seoul, Korea.
authors.forename: Sun Hwa
authors.identifier: 0000-0002-2002-0282
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Soonchunhyang University Hospital, Cheonan, Korea.
authors.forename: Ki-Hyun
authors.identifier: 0000-0002-0608-0676
authors.initials: KH
authors.lastname: Seo
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Yeungnam University Medical Center, Daegu, Korea.
authors.forename: Kyeong-Cheol
authors.identifier: 0000-0003-1972-1847
authors.initials: KC
authors.lastname: Shin
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Kangdong Sacred Heart Hospital, Seoul, Korea.
authors.forename: Yong Bum
authors.initials: YB
authors.lastname: Park
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, Korea.
authors.forename: Myung Goo
authors.initials: MG
authors.lastname: Lee
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Konkuk University Hospital, Seoul, Korea.
authors.forename: Kwang Ha
authors.identifier: 0000-0001-9969-2657
authors.initials: KH
authors.lastname: Yoo
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Wonkwnag University Sanbon Hospital, Gunpo, Korea.
authors.forename: Hui Jung
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Dankook University Hospital, Cheonan, Korea.
authors.forename: Jae Seuk
authors.identifier: 0000-0001-9307-1155
authors.initials: JS
authors.lastname: Park
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Inha University Hospital, Incheon, Korea.
authors.forename: Jae Hwa
authors.identifier: 0000-0002-3432-3997
authors.initials: JH
authors.lastname: Cho
authors.affiliation: Division of Pulmonary Medicine, Gwangju Christian Hospital, Gwangju, Korea.
authors.forename: Yongchun
authors.identifier: 0000-0001-5635-8579
authors.initials: Y
authors.lastname: Ko
authors.affiliation: Department of Allergy, Dong-A University Hospital, Busan, Korea.
authors.forename: Soo-Keol
authors.identifier: 0000-0002-5608-9927
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Onnuri Clinic of Internal Medicine, Jeonju, Korea.
authors.forename: Ki Tae
authors.initials: KT
authors.lastname: Cheon
authors.affiliation: Rapha Clinic of Otolaryngology, Anyang, Korea.
authors.forename: Do Il
authors.identifier: 0000-0001-9046-3970
authors.initials: DI
authors.lastname: Kim
authors.affiliation: Cheongchun Clinic of Internal Medicine, Daegu, Korea.
authors.forename: Jun Wook
authors.identifier: 0000-0003-4967-2302
authors.initials: JW
authors.lastname: Ha
authors.affiliation: Leejaemyeong Clinic of Internal Medicine, Anyang, Korea.
authors.forename: Jae-Myung
authors.identifier: 0000-0002-6241-6349
authors.initials: JM
authors.lastname: Lee
authors.affiliation: Hanaro Clinic of Internal Medicine, Daejeon, Korea.
authors.forename: Ji-Won
authors.identifier: 0000-0002-6649-9962
authors.initials: JW
authors.lastname: Suhr
authors.affiliation: Hallym Clinic of Internal Medicine, Hongcheon, Korea.
authors.forename: Eui Hun
authors.initials: EH
authors.lastname: Jeong
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Ki-Suck
authors.identifier: 0000-0002-6878-6543
authors.initials: KS
authors.lastname: Jung
mesh_terms: D000293:Adolescent; D000328:Adult; D001886:Bordetella pertussis / Q000235:genetics*; D002648:Child; D004269:DNA, Bacterial / Q000032:analysis*; D003710:Demography; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016133:Polymerase Chain Reaction; D056910:Republic of Korea / Q000453:epidemiology; D012621:Seasons; D014839:Vomiting / Q000209:etiology; D014917:Whooping Cough / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial
keywords: Adult; Hospitals; Incidence; Pertussis; Seasons