Bordetella pertussis in a four‐time kidney transplant recipient: A call for immunization programs at transplant centers

Abstract

Pertussis, or whooping cough, is a highly contagious respiratory illness caused most frequently by Bordetella pertussis. Clinical presentation ranges in severity, but lifethreatening illness disproportionately affects children and immunocompromised individuals. Acellular vaccines for pertussis have been available for decades, and they are recommended throughout the lifespan. A patient who had received a kidney transplant presented with respiratory distress and dry cough as manifestations of coinfection with B pertussis and Bordetella parapertussis/bronchiseptica. The goal of this case report was to highlight the importance of immunization programs at transplant centers, which are in the unique position to care for patients both with end-stage organ disease and in the post-transplant setting. K E Y W O R D S Bordetella, immunization, kidney transplant, pneumonia, transplant | 5 of 5 HOVEL Et aL. Derrick J. Chen

Notifiable Infectious Diseases Among Organ Transplant Recipients: A Data-Linked Cohort Study, 2000–2015

“…Although already recommended by guidelines [ 31 ], our work adds emphasis to pertussis vaccination posttransplant, which is likely underreported elsewhere among organ recipients [ 32 ]. The reduction in excess influenza and pertussis cases over time could indicate improved vaccination, but this needs dedicated study.…”

Evidence for Immunity against Tetanus, Diphtheria, and Pertussis through Natural Infection or Vaccination in Adult Solid Organ Transplant Recipients: A Systematic Review

“…Tetanus, diphtheria, and pertussis are rare bacterial VPIs in adult SOT recipients [3][4][5][6]. In a recent cohort of SOT recipients from Switzerland, no case of diphtheria or tetanus was found within 12 years post-transplantation; however, two cases of pertussis were detected, resulting in an incidence rate of 10 per 100,000 person-years of follow-up [2].…”

“…In France, another case involved a renal transplant recipient who developed generalized tetanus 12 years post-transplantation; although anti-tetanus antibodies were detectable, the patient required prolonged intensive care and could not ingest food for 11 days due to trismus [4]. Additional reports from the USA and Spain have described pertussis infections in renal transplant recipients that were diagnosed and treated after significant delays, with patients experiencing a month of coughing [5,6]. Due to the potential risk of severe infection and poor outcomes, vaccination with tetanus and diphtheria toxoids vaccine (Td) or tetanus, diphtheria, and acellular pertussis (Tdap) vaccine are recommended in adult SOT recipients before or after transplantation [7,8].…”