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Infection. 2018 Feb;46(1):83-91. doi: 10.1007/s15010-017-1095-z. Epub 2017 Nov 1.

Pertussis and parapertussis in children and adults with a persistent cough: an observational study.

Author information

1
Department of Microbiology, University of Tartu, Tartu, Estonia. Piia.Jogi@kliinikum.ee.
2
Children's Clinic of Tartu University Hospital, Tartu, Estonia. Piia.Jogi@kliinikum.ee.
3
Department of Family Medicine, University of Tartu, Tartu, Estonia.
4
Institute of Veterinary Medicine and Animal Sciences, Estonian University of Life Sciences, Tartu, Estonia.
5
Department of Public Health, University of Tartu, Tartu, Estonia.
6
Family Doctors' Centre "Tereza Maskina FIE", Paide, Estonia.
7
Merekivi Family Doctors' Centre, Tallinn, Estonia.
8
Department of Microbiology, University of Tartu, Tartu, Estonia.

Abstract

PURPOSE:

We aimed to determine the prevalence, symptoms and course of pertussis and parapertussis among patients at any age with a cough of unknown aetiology that had lasted for ≥ 7 days and to assess the diagnostic value of the symptoms included in the World Health Organisations' (WHO) clinical case definition of pertussis.

METHODS:

Patients were enrolled between the 23 April 2012 and 31 December 2014 at 25 general practitioner (GP) centres and three paediatric hospitals. Pertussis was confirmed by culture and/or polymerase chain reaction (PCR) and/or quantitative serology. Parapertussis was confirmed by culture and/or PCR.

RESULTS:

Altogether, 549 patients were recruited. Of them, 22 (4.0%; 95% CI 2.5-6.0) had pertussis (predominately diagnosed by positive serology 17/22) and 7 (1.3%; 95% CI 0.5-2.6) had parapertussis. Patients with pertussis were more likely to have inspiratory whooping and posttussive emesis than those with a cough of another/unknown aetiology. However, the presence or absence of these two symptoms did not definitively confirm or exclude pertussis. The sensitivity and specificity of the WHO's clinical definition was 0.77 and 0.38, respectively.

CONCLUSIONS:

The prevalence of pertussis and parapertussis among patients with a persistent cough of unknown aetiology in Estonia is low. As clinical symptoms alone cannot be used to distinguish pertussis, we recommend that laboratory testing for pertussis is performed in all patients with a persistent cough regardless of age.

KEYWORDS:

Clinical characteristics; Epidemiology; Pertussis toxin; Pertussis vaccine; Prevalence; Whooping cough

PMID:
29094317
DOI:
10.1007/s15010-017-1095-z
[Indexed for MEDLINE]

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