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Frequency of pertussis in children with prolongued cough

Inci Yildirim1, Mehmet Ceyhan, Omer Kalayci

  • 1Department of Paediatric Infectious Diseases, Hacettepe University School of Medicine, 06100 Sihhiye, Ankara, Turkey. inciy@hacettepe.edu.tr

Scandinavian Journal of Infectious Diseases
|October 16, 2007
PubMed

Insights

Pertussis, or whooping cough, is common in children with prolonged cough, even with high immunization rates. Diagnosis utilized polymerase chain reaction (PCR) and serological testing for Bordetella pertussis.

Area of Science:

  • Pediatric Infectious Diseases
  • Bacteriology
  • Immunology

Background:

  • Pertussis (whooping cough) remains a significant concern in pediatric populations worldwide.
  • Despite high vaccination coverage, pertussis outbreaks continue to occur, necessitating accurate diagnostic methods.
  • Prolonged cough in children can be indicative of various respiratory infections, including pertussis.

Purpose of the Study:

  • To investigate the prevalence of pertussis (whooping cough) in children under 16 presenting with a prolonged cough (>= 14 days).
  • To evaluate the utility of polymerase chain reaction (PCR) and serological testing for diagnosing Bordetella pertussis infection in this cohort.
  • To compare cough duration and serological responses between pertussis-positive and pertussis-negative patients.

Main Methods:

  • A prospective study was conducted at a pediatric hospital's outpatient clinic.
  • Nasopharyngeal swabs were collected for Bordetella pertussis culture and PCR testing.
  • Paired serum samples were analyzed for immunoglobulin A (IgA) and immunoglobulin G (IgG) antibodies against pertussis toxin (PT) using ELISA.

Main Results:

  • Pertussis was diagnosed in 16.9% (25 out of 148) of children with prolonged cough.
  • PCR detected Bordetella pertussis in 12 patients, while serology identified 9 cases; 4 children were positive by both methods.
  • Patients with pertussis had a significantly longer duration of cough (median 33 days) compared to those without (median 20 days).
  • Higher pertussis toxin seropositivity was observed in pertussis-negative patients at enrollment (65% vs. 24%).

Conclusions:

  • Bordetella pertussis is a frequent cause of prolonged cough in children in this population, despite high whole-cell vaccine immunization rates.
  • Diagnostic methods including PCR and serology are crucial for identifying pertussis in children with persistent cough.
  • The study highlights the need for considering pertussis even when cough duration is shorter than traditional case definition criteria.

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