When is acute persistent cough in school-age children and adults whooping cough?

Pertussis has low prevalence in adults with acute cough and is difficult to distinguish clinically from other causes

“…Strengths of the study include the large size, different primary care settings across Europe and the inclusion of older patients (mean age 50, SD 17) and those with comorbidites (28%), which is likely to be more reflective of the general primary care population, increasing applicability of the findings. The prevalence of 3% is lower than found in other primary care studies,3 which, as the authors suggest, may be related to including patients with acute rather than persistent cough, where the prior probability of pertussis is higher. However, this may also relate to their method of diagnosis: it seems that patients were only required to have either nasopharyngeal swab or serum sample, and it is not discussed how many patients only had one.…”

“…In adults, symptoms may be milder and without the classical paroxysms, whoop and vomiting traditionally associated with pertussis, but nonetheless can be associated with considerable morbidity 1. Several previous studies have investigated incidence and clinical characteristics of pertussis in adults with persistent cough, including a recent study in New Zealand (2 weeks cough duration or greater, n=156 adults) in which 7% adults had laboratory-confirmed pertussis 3. The present study aimed to investigate the prevalence and clinical features of pertussis in adults presenting to primary care with acute cough.…”

Prevalence of Atypical Pathogens in Patients With Cough and Community-Acquired Pneumonia: A Meta-Analysis

“…60 Table 3 summarizes data from 8 studies of the prevalence of B pertussis in outpatients with prolonged or bothersome cough, largely in primary care. 17,[64][65][66][67][68][69][70] Three studies enrolled adults and children; 4, children only; 68 The prevalence of B pertussis is summarized in the forest plot in Figure 5. While there was significant heterogeneity when including all studies, this was primarily due to heterogeneity in the 4 studies of children only.…”

Pertussis (whooping cough)

“…The results with testing blood (sensitivity 88-92%, specificity 98-99%)44 or oral fluid or a throat swab (sensitivity 80%, specificity 97%)45 are comparable. Oral fluid testing is easier to perform, especially in children,4647 but this medium is not often available in primary care and may instead be issued by public health agencies directly. Serology is not advised in infants and in patients vaccinated within the previous year, as the test cannot differentiate vaccine induced or maternal antibodies from infection induced antibodies 3348…”