title: Under-recognized pertussis in adults from Asian countries: a cross-sectional seroprevalence study in Malaysia, Taiwan and Thailand.
abstract: Surveillance data on the burden of pertussis in Asian adults are limited. This cross-sectional study evaluated the prevalence of serologically confirmed pertussis in adults with prolonged cough in Malaysia, Taiwan and Thailand. Adults (⩾19 years) with cough lasting for ⩾14 days without other known underlying cause were enrolled from outpatient clinics of seven public and/or private hospitals. Single blood samples for anti-pertussis toxin antibodies (anti-PT IgG) were analysed and economic impact and health-related quality of life (EQ-5D) questionnaires assessed. Sixteen (5·13%) of the 312 chronically coughing adults had serological evidence of pertussis infection within the previous 12 months (anti-PT IgG titre ⩾62·5 IU/ml). Three of them were teachers. Longer duration of cough, paroxysms (75% seroconfirmed, 48% non-seroconfirmed) and breathlessness/chest pain (63% seroconfirmed, 36% non-seroconfirmed) were associated with pertussis (P < 0·04). Of the seroconfirmed patients, the median total direct medical cost per pertussis episode in public hospitals (including physician consultations and/or emergency room visits) was US$13 in Malaysia, US$83 in Taiwan (n = 1) and US$26 in Thailand. The overall median EQ-5D index score of cases was 0·72 (range 0·42-1·00). Pertussis should be considered in the aetiology of adults with a prolonged or paroxysmal cough, and vaccination programmes considered.
authors.affiliation: University of Malaya,Kuala Lumpur,Malaysia.
authors.forename: M T
authors.initials: MT
authors.lastname: Koh
authors.affiliation: Family Medicine Department,China Medical University Hospital,Taichung,Taiwan.
authors.forename: C-S
authors.initials: CS
authors.lastname: Liu
authors.affiliation: Division of Pediatric Infectious Diseases,Department of Pediatrics,Chang Gung Children's Hospital,Chang Gung University,Taoyuan,Taiwan.
authors.forename: C-H
authors.initials: CH
authors.lastname: Chiu
authors.affiliation: Khon Kaen University,Thailand.
authors.forename: W
authors.initials: W
authors.lastname: Boonsawat
authors.affiliation: Department of Pediatrics,Phramongkutklao Hospital,Bangkok,Thailand.
authors.forename: V
authors.initials: V
authors.lastname: Watanaveeradej
authors.affiliation: University of Malaya,Kuala Lumpur,Malaysia.
authors.forename: N
authors.initials: N
authors.lastname: Abdullah
authors.affiliation: GSK Vaccines,Singapore.
authors.forename: Xh
authors.initials: X
authors.lastname: Zhang
authors.affiliation: GSK Vaccines,Bangalore,India.
authors.forename: R
authors.initials: R
authors.lastname: Devadiga
authors.affiliation: GSK Vaccines,Singapore.
authors.forename: J
authors.initials: J
authors.lastname: Chen
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood*; D001886:Bordetella pertussis / Q000276:immunology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D037342:Pertussis Toxin / Q000276:immunology*; D015995:Prevalence; D016036:Seroepidemiologic Studies; D013624:Taiwan / Q000453:epidemiology; D013785:Thailand / Q000453:epidemiology; D014917:Whooping Cough / Q000097:blood* / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial; D037342:Pertussis Toxin
keywords: Bordetella pertussis; epidemiology; infectious disease epidemiology; pertussis (whooping cough); public health