Article Text

Download PDFPDF
Clinical and epidemiological picture of B pertussis and B parapertussis infections after introduction of acellular pertussis vaccines
  1. J G Liese,
  2. C Renner,
  3. S Stojanov,
  4. B H Belohradsky,
  5. The Munich Vaccine Study Group
  1. University Childrens Hospital Munich, Ludwig-Maximilians-Universität, Lindwurmstr. 4, 80337 Munich, Germany
  1. Correspondence to:
    Dr J Liese, Universitäts-Kinderklinik im Dr. v. Haunerschen Kinderspital, Ludwig-Maximilians-Universität, Lindwurmstr. 4, 80337 Munich, Germany;
    Johannes.Liese{at}kk-i.med.uni-muenchen.de

Abstract

Aims: To investigate the clinical picture and frequency of Bordetella pertussis and B parapertussis infections after introduction of acellular pertussis (acP) vaccines in Germany.

Methods: Prospective surveillance for B pertussis and B parapertussis in 14 144 toddlers. Pertussis vaccination coverage was 86%, either with acP (75%) or whole cell pertussis (wcP) vaccine (11%). All children presenting with cough for more than seven days were examined for B pertussis and B parapertussis by culture, PCR, and serology (for cough duration ≥21 days).

Results: There were 180 Bordetella infections; 116 (64%) were caused by B pertussis and 64 (36%) by B parapertussis. Incidence rates were 4.8 and 2.8 per 1000 person-years, respectively. Paroxysmal cough, post-tussive whooping, and vomiting ≥21 days was found in 53%, 22%, and 8% of all B pertussis cases and in 22%, 5%, and 0% of all B parapertussis cases, respectively. A total of 81/116 (70%) B pertussis cases and 56/64 (87.5%) B parapertussis cases had received at least one dose of pertussis vaccine. Typical pertussis with paroxysmal cough ≥21 days was present in 29/35 (83%) unvaccinated B pertussis cases, in contrast to 33/81 (41%) vaccinated B pertussis cases.

Conclusion: Following the increase of pertussis vaccination coverage, we observed a relative increase of B parapertussis cases in comparison to B pertussis cases. In vaccinated children B pertussis disease frequently presented as a mild disease, clinically difficult to distinguish from diseases associated with coughing caused by B parapertussis and other viral or bacterial infections.

  • B pertussis
  • B parapertussis
  • epidemiology
  • incidence
  • pertussis vaccine

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Footnotes