Bordetella pertussis and Chronic Cough in Adults

Abstract

To evaluate Bordetella pertussis as a cause of persistent cough in adults, we examined 201 patients who had a cough for 2-12 weeks and no pulmonary disease. We obtained the following at presentation: medical history, chest radiograph, respiratory function measurement, nasopharyngeal aspirate for polymerase chain reaction (PCR), nasopharyngeal swab specimen for culture, and a blood sample (acute serum). Four weeks later a second blood sample (convalescent serum) was obtained. Control sera were obtained from 164 age-matched healthy blood donors with no history of cough during the previous 12 weeks. Four patients were B. pertussis culture-positive; 11 (including the culture-positive patients) were B. pertussis PCR-positive; and 33, including 10 of the 11 PCR-positive patients, had serological evidence of recent B. pertussis infection. Pertussis-positive and -negative patients could not be discriminated by a history of cough. We conclude that B. pertussis infection is a common cause of persistent cough in adults. This is of concern, because these patients may be B. pertussis reservoirs from which transmission may occur to infants, in whom the disease can be devastating.

Role of (p)ppGpp in biofilm formation and expression of filamentous structures in Bordetella pertussis

“…Pertussis is traditionally described as an acute and life-threatening disease in unvaccinated children (Carbonetti, 2007), and is also common among adolescents and adults, in whom it often manifests as persistent, but less paroxymal, cough with milder and atypical symptoms (Birkebaek et al, 1999;Halperin, 2007). However, over the past two decades, pertussis has experienced a worldwide resurgence in individuals of 15 years or older (He & Mertsola, 2008).…”

The Role of Bordetella Infections in Patients with Acute Exacerbation of Chronic Bronchitis

“…Interestingly, in a recent study of 155 health-care workers at a German children's hospital with regular contact to patients, 6% were found to have elevated IgG and/or IgA antibodies against PT or FHA by using the same serological methods [17]. Applying the definitions by DeMelker et al [19] (relying on a single IgG anti-PT > 100 EU/ml) or Birkebaek et al [20] (relying on a single Ig Ganti-PT > 123 EU/ml) to our data, (28) a One patient with evidence for infection with B. pertussis or B. parapertussis was lost for follow-up at 4-6 weeks; b p = 0.012 Table 2 Presence of clinical findings in 26 patients a with acute exacerbation of chronic bronchitis depending on evidence for infection with B. pertussis or B. parapertussis.…”

“…only one patient would have fulfilled the serological criteria for acute B. pertussis infection [19,20]. In contrast to this and other previously published serological definitions for recent exposure to B. pertussis, which are based solely on IgG antibody analyses [19][20][21], our definition includes IgG and IgA antibody tests.…”

“…In contrast to this and other previously published serological definitions for recent exposure to B. pertussis, which are based solely on IgG antibody analyses [19][20][21], our definition includes IgG and IgA antibody tests. Importantly, four of the five patients fulfilling our definition of B. pertussis infection do this based on elevated anti-PT IgA antibodies.…”

Development of improved vaccines against whooping cough: Current status

“…2 Adolescents and adults do not exhibit the characteristic cough and infection can be either asymptomatic or manifested as a mild but persistent cold-like illness. 5,6 B. parapertussis can also infect humans but the disease state is often milder and far less common than the B. pertussis aetiology, whereas the remaining Bordetella spp, B. bronchiseptica, B. holmesii, B. avium, B. hinzii and B. trematum rarely cause infections in humans. 1 …”