Serhat ÜNAL, Pınar ZARAKOL, Hatice BÖLEK, Mine Durusu TANRIÖVER, Ahmet İLBAY, Ezgi Çalışkan GÜZELCE

Pertussis prevalence among adult patients with acute cough

Background/aim: Bordetella pertussis infection remains an important health problem in adults due to the increasing prevalence in recent years. Pertussis in adults can be easily overlooked or misdiagnosed. We aimed to determine the prevalence of pertussis in adult patients with acute cough and the clinical features of the pertussis cases. Materials and methods: Internal Medicine and Pulmonology inpatient wards and outpatient clinics were screened between March 2017 and June 2018. Patients with cough duration between 1 week and 1 month were enrolled. Those who were on antibiotics for more than 5 days were excluded. A total of 115 patients were enrolled. Nasopharyngeal swabs were taken and real-time polymerase chain reaction analyses were done. Results: According to the pertussis case definition, 47.8% of the patients were diagnosed with probable pertussis. We found the prevalence of pertussis as 3.5% in our cohort. All of the patients with pertussis had a history of paroxysmal cough with a mean duration of 20 days. Conclusions: These results show that pertussis continues to be a health problem for adults and may present with acute cough. The growing number of adult pertussis cases suggest that vaccination of children is inadequate to prevent pertussis and the concept of ‘lifelong vaccination’ should be strengthened.

PDF

___

1. Hegerle N, Guiso N. Epidemiology of whooping cough & typing of Bordetella pertussis. Future microbiology. 2013;8(11):1391- 403. doi: 10.2217/fmb.13.111
2. Masseria C, Krishnarajah G. The estimated incidence of pertussis in people aged 50 years old in the United States, 2006–2010. BMC infectious diseases. 2015;15(1):534. doi: 10.1186/s12879-015-1269-1
3. Centers for Disease Control and Prevention (2012). Pertussis epidemic--Washington, 2012. Morbidity and mortality weekly report. July 20, 2012 / 61(28);517-522. 1545-861X
4. Skoff TH, Baumbach J, Cieslak PR. Tracking pertussis and evaluating control measures through enhanced pertussis surveillance, Emerging Infections Program, United States. Emerging infectious diseases. 2015;21(9):1568. doi: 10.3201/ eid2109.150023
5. Zouari A, Smaoui H, Kechrid A. The diagnosis of pertussis: which method to choose? Critical Reviews in Microbiology. 2012;38(2):111-21. doi: 10.3109/1040841X.2011.622715
6. Faulkner AE, Skoff TH, Tondella ML, Cohn A, Clark TA et al. Trends in Pertussis Diagnostic Testing in the United States, 1990 to 2012. The Pediatric Infectious Disease Journal. 2016;35(1):39-44. doi: 10.1097/INF.0000000000000921
7. Senzilet LD, Halperin SA, Spika JS, Alagaratnam M, Morris A et al. Pertussis is a frequent cause of prolonged cough illness in adults and adolescents. Clinical Infectious Diseases. 2001;32(12):1691-7. doi: 10.1086/320754
8. Cornia PB, Hersh AL, Lipsky BA, Newman TB, Gonzales R. Does this coughing adolescent or adult patient have pertussis? The Journal of the American Medical Association. 2010;304(8):890-6. doi: 10.1001/jama.2010.1181
9. Oksuz L, Hancerli S, Somer A, Salman N, Gurler N. Pertussis in children in the Istanbul Faculty of Medicine: results for four years. The Turkish Journal of Pediatrics. 2014;56(6):632-7
10. Esen B, Coplu N, Kurtoglu D, Gozalan A, Akin L. Prevalence of high antibody titers of pertussis in Turkey: reflection of circulating microorganism and a threat to infants. Journal of clinical laboratory analysis. 2007;21(3):154-61. doi: 10.1002/ jcla.20127
11. Teepe J, Broekhuizen BD, Ieven M, Loens K, Huygen K et al. Prevalence, diagnosis, and disease course of pertussis in adults with acute cough: a prospective, observational study in primary care. British Journal of General Practice. 2015;65(639):e662-e7. doi: 10.3399/bjgp15X686917
12. Karagul A, Ogunc D, Midilli K, Ongut G, Ozhak Baysan B et al. Epidemiology of pertussis in adolescents and adults in Turkey. Epidemiology and Infection. 2015;143(12):2613-8. doi: 10.1017/S0950268814003483
13. Sonmez C, Coplu N, Gozalan A, Yilmaz U, Bilekli S et al. Serological evaluation of Bordetella pertussis infection in adults with prolonged cough. Mikrobiyoloji Bülteni. 2016;50(3):361- 70. doi: 10.5578/mb.27692
14. Guiso N, Liese J, Plotkin S. The Global Pertussis Initiative: meeting report from the fourth regional roundtable meeting, France, April 14-15, 2010. Human Vaccines. 2011;7(4):481-8. doi: 10.4161/hv.7.4.14528
15. Cherry JD. Adult pertussis in the pre- and post-vaccine eras: lifelong vaccine-induced immunity? Expert Review of Vaccines. 2014;13(9):1073-80. doi: 10.1586/14760584.2014.935765
16. Dalby T, Andersen PH, Hoffmann S. Epidemiology of pertussis in Denmark, 1995 to 2013. Eurosurveillance. 2016;21(36):30334. doi: 10.2807/1560-7917.ES.2016.21.36.30334
17. Wendelboe AM, Njamkepo E, Bourillon A, Floret DD, Gaudelus J et al. Transmission of Bordetella pertussis to young infants. The Pediatric Infectios Disease Journal. 2007;26(4):293-9. doi: 10.1097/01.inf.0000258699.64164.6d
18. Tanriover MD, Soyler C, Ascioglu S, Cankurtaran M, Unal S. Low seroprevalance of diphtheria, tetanus and pertussis in ambulatory adult patients: the need for lifelong vaccination. European journal of internal medicine. 2014;25(6):528-32. doi: 10.1016/j.ejim.2014.04.010
19. Vittucci AC, Spuri Vennarucci V, Grandin A, Russo C, Lancella L et al. Pertussis in infants: an underestimated disease. BMC infectious diseases. 2016;16:414. doi: 10.1186/s12879-016- 1710-0
20. Solano R, Crespo I, Fernandez MI, Valero C, Alvarez MI et al. Underdetection and underreporting of pertussis in children attended in primary health care centers: Do surveillance systems require improvement? American Journal of Infection Control. 2016;44(11):e251-e6. doi: 10.1016/j.ajic.2016.03.033
21. Heil J, Ter Waarbeek HLG, Hoebe C, Jacobs PHA, van Dam DW et al. Pertussis surveillance and control: exploring variations and delays in testing, laboratory diagnostics and public health service notifications, the Netherlands, 2010 to 2013. Eurosurveillance. 2017;22(28). doi: 10.2807/1560-7917. ES.2017.22.28.30571