Adult pertussis is unrecognized public health problem in Thailand

Abstract

BackgroundAlthough pertussis has been considered a disease of childhood, it is also recognized as an important respiratory tract infection in adolescents and adults. However, in countries with routine vaccination against pertussis with high coverage, pertussis is not usually taken into consideration for the etiology of prolonged cough in adults. Previous studies in a variety of populations in developed countries have documented that pertussis is quite common, ranging from 2.9 to 32 % of adolescents and adults with prolonged cough. The anticipation and early recognition of this change in the epidemiology is important because the affected adolescents and adults act as reservoirs of the disease and source of infection to the vulnerable population of infants, for whom the disease can be life threatening. We conducted a prospective study to determine the prevalence of pertussis in Thai adults with prolonged cough.MethodsSeventy-six adult patients with a cough lasting for more than 2 weeks (range, 14–180 days) were included in the present study. The data regarding medical history and physical examination were carefully analyzed. Nasopharyngeal swabs from all patients were obtained for the detection of deoxyribonucleic acid of Bordetella pertussis by the polymerase chain reaction (PCR) method. Paired serum samples were collected and tested for IgG antibody against pertussis toxin by using an ELISA method.ResultsOf 76 adult patients, 14 patients (18.4 %) with the mean age of 59 (range, 28–85) years and the mean duration of cough of 34 (range, 14–120) days had laboratory evidence of acute pertussis infection. One patient was diagnosed by the PCR method, while the rest had serological diagnosis. Whooping cough is a significantly associated symptom of patients with chronic cough who had laboratory evidence of pertussis. (p < .05, odds ratio 3.75, 95 % confidence interval: 1.00,14.06)ConclusionPertussis is being increasingly recognized as a cause of prolonged, distressing cough among adults in Thailand. This result addresses the need of pertussis vaccination in Thai adults for preventing transmission to a high risk group such as newborn infants.

Dynamical analysis of age‐structured pertussis model with covert infection

“…Let be the possibility of being infected during the weakening of vaccine. It is worth noting that, from the clinical performance, the covert infection cannot turn into the dominant infection through its own toxin, 24 and an individual with covert infection can become dominantly infectious by contacting infectious individuals with the infection force (1 − p) , which is consistent with the assumption in Boots et al 25 Infected individuals can enter the removed class because of natural recovery or treatment. Let 1 (a) and 2 (a) represent the age-dependent recovery rates of dominant and covert infections, respectively.…”

Pertussis in the Association of Southeast Asian Nations: epidemiology and challenges

“…Nine studies containing descriptive epidemiology data from ASEAN countries were identified: two hospital-based studies of children with severe pertussis (Kowalzik et al, 2007;Sadiasa et al, 2017), two hospital-based studies of adults with prolonged cough (Siriyakorn et al, 2016;Koh et al, 2016), two seroepidemiology surveys (Wanlapakorn et al 2016;Son et al 2018), and three studies of multiple etiologies of respiratory illness (Wertheim et al 2015;Barger-Kamate et al 2016;Lau et al 2018) (Table 3). Pertussis disease in ASEAN countries is poorly characterized, partly demonstrated by the fact that only six out of ten countries are represented by these nine studies.…”

“…Hospital-based studies of adults with prolonged cough. In Thailand, 14/76 (18.4%) pertussis cases were found in adults aged !15 years from 2010 to 2011 (Siriyakorn et al, 2016). The investigators of another multinational study conducted between 2012 and 2013 in adults aged !19 years used a commercial anti-PT IgG detection ELISA kit recommended by WHO on a single serum specimen and found 9/147 (6.1% [95%CI: 2.84-11.30%]) suspect cases in Thailand and 6/76 (7.9% [95%CI: 2.95-16.40%]) suspect cases in Malaysia (Koh et al, 2016;Riffelmann et al, 2010;World Health Organization, 2014).…”

Pertussis (whooping cough)

“…Nasopharyngeal bacterial culture obtained from a throat swab or aspirate is the best method for diagnosis of pertussis35 (sensitivity 58%, specificity 100%) 333637. The sensitivity is lower beyond two weeks of illness and in older people because of lower bacterial loads,3338 resulting in higher risk of a false negative result.…”