Survey of pertussis in patients with prolonged cough

Jen-Jan Hu¹, Chun-Yi Lu², Luan-Yin Chang², Chin-Hao Huang³, Chen-Cheng Chou², Fu-Yuan Huang⁴, Chin-Yun Lee², Li-Min Huang^2
1Department of Pediatrics, Taiwan Adventist Hospital, Taipei; Departments of ²Pediatrics and ³Otolaryngology, National Taiwan University Hospital, Taipei; and ⁴Department of Pediatrics, Taipei Mackay Memorial Hospital, Taipei, Taiwan

Received: March 17, 2005 Revised: August 18, 2005 Accepted: August 29, 2005

Corresponding author: Dr. Li-Min Huang, Division of Infectious Diseases, Department of Pediatrics, National Taiwan University Hospital, No. 7, Chung-Shan South Road, , Taiwan. E-mail:

Background and Purpose: Pertussis is an acute respiratory tract illness resulting from Bordetella pertussis. Widespread use of pertussis vaccine over the past 50 years has decreased the incidence of pertussis. The incidence of pertussis in adolescents and adults has increased in many areas of the world. This study aimed to evaluate the etiologic role of B. pertussis in patients with prolonged cough in Taiwan.
Methods: Patients with cough lasting for more than 1 week were recruited. Nasopharyngeal swabs were taken for culture of B. pertussis and detection of nucleic acid of B. pertussis by polymerase chain reaction. Serum samples were collected in a subset of patients for assay of immunoglobulin G and immunoglobulin A antibodies against pertussis toxin.
Results: In total, 111 patients were recruited. Thirty-three patients agreed to have their serum samples taken and tested. Eight patients had evidence of acute infection with B. pertussis; among them, 1 was diagnosed by polymerase chain reaction and 7 by serology. Older subjects were more likely to suffer from pertussis than younger subjects. The incidence of pertussis in patients with prolonged cough was 7.2%. However, the rate could have been as high as 21% in those with serum samples tested.
Conclusions: We conclude that pertussis is a prevalent disease in Taiwan, especially in adolescents and adults.

Key words: Bordetella pertussis, child, cough, pertussis vaccine, polymerase chain reaction

J Microbiol Immunol Infect 2006;39:54-58.