PT - JOURNAL ARTICLE AU - Liese, J G AU - Renner, C AU - Stojanov, S AU - Belohradsky, B H AU - The Munich Vaccine Study Group TI - Clinical and epidemiological picture of <em>B pertussis</em> and <em>B parapertussis</em> infections after introduction of acellular pertussis vaccines AID - 10.1136/adc.88.8.684 DP - 2003 Aug 01 TA - Archives of Disease in Childhood PG - 684--687 VI - 88 IP - 8 4099 - http://adc.bmj.com/content/88/8/684.short 4100 - http://adc.bmj.com/content/88/8/684.full SO - Arch Dis Child2003 Aug 01; 88 AB - 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.