A Search for Bordetella pertussis Infection in University Students

Abstract

University students with persistent cough of greater than or equal to 6 days' duration were evaluated for evidence of infection with Bordetella pertussis. Of 130 students studied during a 30-month period, 34 (26%) were found to have evidence of recent infections with B. pertussis. Infection was identified by direct fluorescent antibody assay of a nasopharyngeal specimen in one student and serologically in 33 additional subjects. B. pertussis was not recovered on culture of nasopharyngeal specimens from any subjects. Students with B. pertussis infection were identified in seven of the eight 3-month periods in which students were enrolled during the 30-month investigation, suggesting an endemic rather than epidemic pattern of infection in this university population. Illnesses of students with pertussis were similar to the illnesses of students without pertussis. The findings in this study suggest that adult populations in which endemic illness occurs at a relatively constant rate may be the reservoirs for pertussis outbreaks in susceptible children. Immunization programs in the future will need to employ booster doses for adults if complete control of B. pertussis infection is our goal.

The Role of Bordetella Infections in Patients with Acute Exacerbation of Chronic Bronchitis

“…Also, we cannot exclude the possibility that our reference values, deriving from adults without chronic bronchitis, are different from those in patients with chronic bronchitis. Overall, however, the proportion of B. pertussis infections in our study is in line with the 20-25% found among otherwise healthy adults with cough illnesses [3,[22][23][24].…”

“…The overall similar clinical presentation of AECB associated with Bordetella infection compared to nonBordetella infection in our study is of no surprise and has also been observed in patients without underlying pulmonary disease [24,35,36]. However, given the frequency of cough exacerbations in patients with chronic bronchitis, our finding of Bordetella infection in up to 30% of these episodes is relevant.…”

A model based evaluation of the 1996–7 pertussis epidemic in the Netherlands

“…As in our previous study [16] we assume that 1 out of 10 primary infections is notified ( p " l 0n1), and only 1 out of 100 secondary infections ( p # l 0n01). Although these figures are not based on any comprehensive research, they are not implausible for the situation in the Netherlands, and they are compatible with other studies [8,9,[22][23][24][25][26]. Throughout this paper we will consider two scenarios (labelled 1 and 2) with respect to the preepidemic situation (1988-95), and two scenarios with respect to the type of vaccination related change in the population (labelled A and B).…”

“…In fact, in these years the incidence based on notifications was quite comparable in the vaccinated and unvaccinated populations of 4 years and older. This indicates that protection against infection after vaccination does not last lifelong [8][9][10].…”

Molecular Pathogenesis, Epidemiology, and Clinical Manifestations of Respiratory Infections Due toBordetella pertussisand OtherBordetellaSubspecies

“…In most primary infections in children, there is a distinct leukocytosis with an absolute lymphocytosis (149). In contrast, infections in adults (which are always reinfections) are not associated with an absolute lymphocytosis (149,550). Occasional primary infections in young infants also do not elicit a lymphocytosis.…”