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[Whooping cough in adults].

C H Wirsing von König1, A Tacken, H Finger

  • 1Institut für Hygiene und Laboratoriumsmedizin, Städtische Krankenanstalten Krefeld.

Deutsche Medizinische Wochenschrift (1946)
|April 26, 1991
PubMed
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Pertussis in adults is often characterized by persistent cough, differing from childhood symptoms. Diagnosis requires considering pertussis (whooping cough) in adults with prolonged cough, even without typical childhood signs.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Bacteriology

Background:

  • Pertussis, commonly known as whooping cough, is a highly contagious respiratory infection.
  • While typically diagnosed in children, pertussis can affect adults, often presenting with atypical symptoms.
  • Understanding adult pertussis is crucial for accurate diagnosis and public health management.

Purpose of the Study:

  • To investigate the clinical presentation, diagnosis, and epidemiological characteristics of pertussis in adults.
  • To compare adult pertussis cases with those in a pediatric control group.
  • To emphasize the importance of considering pertussis in adult differential diagnoses for persistent cough.

Main Methods:

  • Retrospective analysis of 169 adult pertussis cases diagnosed over four years.

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  • Comparison with a control group of 2,771 children.
  • Diagnostic methods included symptom assessment, bacteriological examination of nasopharyngeal swabs, and serological testing for Bordetella pertussis antibodies (IgG, IgA, IgM).
  • Main Results:

    • Adults predominantly presented with persistent cough; characteristic childhood symptoms like rib retraction and vomiting were significantly less common.
    • Bordetella pertussis was confirmed bacteriologically in 11% of adults versus 45% in children; serological confirmation was high in adults (IgG 81%, IgA 91%).
    • More women than men were diagnosed with pertussis in the adult group (P < 0.01), contrasting with the sex distribution in children.

    Conclusions:

    • Pertussis in adults often manifests primarily as a persistent cough, necessitating its inclusion in the differential diagnosis.
    • Diagnostic approaches should integrate clinical symptoms, bacteriology, and serology for accurate identification in adults.
    • The higher incidence in adult women warrants further investigation into potential contributing factors.