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The role of respiratory virus infection in suspected pertussis: A prospective study

Angela Esposito Ferronato1, Daniela Leite2, Sandra Elisabete Vieira3

  • 1University Hospital, Universidade de São Paulo, Brazil.

Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi
|August 14, 2019
PubMed

Insights

Respiratory viruses are frequently detected in infants suspected of having pertussis (BP), sometimes exceeding BP prevalence. Differentiating these infections requires laboratory testing, as clinical signs overlap significantly.

Area of Science:

  • Pediatric Infectious Diseases
  • Respiratory Pathogen Research
  • Clinical Microbiology

Background:

  • Bordetella pertussis (BP) infections cause severe illness in unvaccinated infants.
  • Clinical presentations of BP mimic other respiratory viral infections.
  • Accurate etiological diagnosis is crucial for appropriate management.

Purpose of the Study:

  • To investigate the prevalence of Bordetella pertussis and respiratory viruses in hospitalized infants with suspected pertussis.
  • To identify clinical and laboratory predictors differentiating BP from viral infections.
  • To compare the severity of Bordetella pertussis and respiratory virus infections.

Main Methods:

  • Prospective cohort study of infants under one year old hospitalized with suspected pertussis.
  • Etiological investigation including nasopharyngeal swabs for BP (culture/PCR) and aspirates for respiratory viruses (indirect immunofluorescence).
  • Collection of clinical, demographic, and laboratory data.

Main Results:

  • An etiological agent was identified in 62.8% of infants.
  • Respiratory viruses were identified in 32% and Bordetella pertussis in 23.7% as sole agents; co-detection occurred in 4%.
  • Leukocytosis predicted pertussis, while wheezing predicted viral infection; severity was similar for both.

Conclusions:

  • Respiratory virus infections are common in infants with suspected pertussis, potentially more prevalent than BP.
  • Clinical and laboratory findings are suggestive but not definitive for diagnosis.
  • Simultaneous testing for respiratory viruses and Bordetella pertussis is essential in this clinical setting.
Abstract

Keywords:
Bordetella pertussisCodetectionRespiratory virusSigns and symptomsWhooping cough

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