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Pertussis in German adults

S Schmitt-Grohé1, J D Cherry, U Heininger

  • 1Universitätsklinik für Kinder and Jugendliche, Erlangen, Germany.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|October 1, 1995
PubMed
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Adults frequently experience pertussis (whooping cough), even after childhood infection. Past infection or vaccination may not guarantee lifelong immunity against Bordetella pertussis.

Area of Science:

  • * Infectious Diseases
  • * Vaccinology
  • * Epidemiology

Background:

  • * Pertussis remains a significant public health concern, with endemic and epidemic cycles observed in Germany.
  • * The duration of immunity following childhood infection or vaccination is not fully understood.
  • * Adults may serve as reservoirs for Bordetella pertussis, contributing to community transmission.

Purpose of the Study:

  • * To evaluate the occurrence and characteristics of Bordetella pertussis infections in adults during a pertussis vaccine efficacy trial.
  • * To assess the reliability of serological evidence of past infection as an indicator of protection against pertussis.
  • * To challenge the prevailing belief in lifelong clinical immunity after B. pertussis infection.

Main Methods:

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  • * A prospective study involving evaluation of adults reporting cough illness lasting over 14 days.
  • * Confirmation of recent Bordetella pertussis infection through culture, PCR, and/or serological assays (agglutination, ELISA).
  • * Analysis of clinical presentation, including the presence of whooping and history of previous pertussis or family primary cases.

    • Main Results:

    • * Out of 246 evaluated adults, 64 showed evidence of B. pertussis infection.
    • * Among infected adults, 38% experienced whooping, 26% had a prior pertussis history, and 48% were the initial cases in their households.
    • * The estimated adult attack rate was 133 per 100,000 population per year. Serological controls universally had antibodies to B. pertussis antigens.

    Conclusions:

    • * Adults are susceptible to Bordetella pertussis infection, with significant attack rates observed.
    • * Serological evidence of past infection does not necessarily confer protection against pertussis.
    • * The assumption of lifelong clinical immunity following B. pertussis infection is likely inaccurate, highlighting potential gaps in immunity in adult populations.