title: Pertussis in north-central and northwestern regions of Algeria.
abstract: BACKGROUND
  Pertussis outbreaks continue to occur in many countries despite high vaccination coverage. Under-diagnosed cases in adolescents and adults may result in increased transmission to infants, who are at risk of severe pertussis. Additional measures to protect both groups should be considered.
  
  
  METHODS
  Nasopharyngeal samples and sera were collected from patients and household contacts with clinically suspected pertussis. Diagnoses were confirmed by culture, real-time polymerase chain reaction (PCR), and serology. Bordetella pertussis isolates were characterized by antimicrobial sensitivity and fimbrial serotyping.
  
  
  RESULTS
  Of 392 participants, 134/248 patients (54%) and 66/144 contacts (45.8%) had confirmed pertussis infections. B. parapertussis was not detected. All B. pertussis isolates were sensitive to the antibiotics tested, and all expressed the Fim3, not the Fim2, fimbrial serotype. Most patients (81.2%) were <6 months (51.8% of whom were <3 months) of age; 77.6% were unvaccinated, and most positive contacts were mothers 20-40 years of age.
  
  
  CONCLUSIONS
  Despite high vaccination coverage, pertussis is circulating in Algeria. Most infections occur in unvaccinated infants <6 months of age, with mothers as the main source of infection. An adolescent/adult booster should be considered. Adoption of sensitive and specific laboratory tests would improve pertussis diagnosis and surveillance.
authors.affiliation: Institut Pasteur of Algeria, Algiers, Algeria. n_benamrouche@yahoo.fr.
authors.forename: Nabila
authors.initials: N
authors.lastname: Benamrouche
authors.forename: Hassiba
authors.initials: H
authors.lastname: Tali Maamar
authors.forename: Malika
authors.initials: M
authors.lastname: Lazri
authors.forename: Sonia
authors.initials: S
authors.lastname: Hasnaoui
authors.forename: Abdelkarim
authors.initials: A
authors.lastname: Radoui
authors.forename: Ourida
authors.initials: O
authors.lastname: Lafer
authors.forename: Rachida
authors.initials: R
authors.lastname: Boukari
authors.forename: Chawki
authors.initials: C
authors.lastname: Kaddache
authors.forename: Zakia
authors.initials: Z
authors.lastname: Arrada
authors.forename: Kheira
authors.initials: K
authors.lastname: Rahal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000462:Algeria / Q000453:epidemiology; D000907:Antibodies, Bacterial / Q000097:blood; D001431:Bacteriological Techniques; D001886:Bordetella pertussis / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009305:Nasopharynx / Q000382:microbiology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012698:Serologic Tests; D044967:Serum / Q000276:immunology; D014917:Whooping Cough / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial