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Query: UMLS:C0043167 (
pertussis
)
19,595
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
University students with
persistent cough
of greater than or equal to 6 days' duration were evaluated for evidence of infection with Bordetella
pertussis
. Of 130 students studied during a 30-month period, 34 (26%) were found to have evidence of recent infections with B.
pertussis
. Infection was identified by direct fluorescent antibody assay of a nasopharyngeal specimen in one student and serologically in 33 additional subjects. B.
pertussis
was not recovered on culture of nasopharyngeal specimens from any subjects. Students with B.
pertussis
infection were identified in seven of the eight 3-month periods in which students were enrolled during the 30-month investigation, suggesting an endemic rather than epidemic pattern of infection in this university population. Illnesses of students with
pertussis
were similar to the illnesses of students without
pertussis
. The findings in this study suggest that adult populations in which endemic illness occurs at a relatively constant rate may be the reservoirs for
pertussis
outbreaks in susceptible children. Immunization programs in the future will need to employ booster doses for adults if complete control of B.
pertussis
infection is our goal.
...
PMID:A search for Bordetella pertussis infection in university students. 155 32
Bordetella
pertussis
, the causative agent of whooping cough, produces an acute and chronic respiratory infection in infants and young children. B.
pertussis
is still a major health problem of young children throughout the world even though effective immunization against whooping cough is available. While predominantly a childhood disease, it has been reported also to be a cause of
persistent cough
in adults. This review discusses the numerous bacterial virulence factors that may play roles in the pathogenesis of
pertussis
and in immunity to infection. The present problems with
pertussis
diagnosis, recent advances, and future prospects for new and improved rapid diagnostics tests also are explored.
...
PMID:Pertussis: the disease and new diagnostic methods. 290 14
An enzyme-linked immunosorbent assay (ELISA) for Bordetella
pertussis
-specific immunoglobulin (Ig)A antibody in serum was used to demonstrate B.
pertussis
infection. The upper limit of normal for the assay (mean + 3 SD) was established by testing sera that had been collected from a group of healthy blood donors. All 13 patients with clinical whooping cough from whom B.
pertussis
was isolated and 25.7% of 218 adults, who were aged 18-81 years, who were referred to a consultant physician for the investigation of a
persistent cough
, had elevated levels of IgA to B.
pertussis
. The study confirms the B.
pertussis
IgA ELISA as a sensitive test for the diagnosis of B.
pertussis
infections and that these infections cause respiratory illness, in particular,
persistent cough
in adults.
...
PMID:Bordetella pertussis infection: a cause of persistent cough in adults. 357 77
Pertussis
, though uncommon in people older than 9 years, does occur (in girls and women primarily) and should be considered in the differential diagnosis of
persistent cough
. Earlier this year in British Columbia a 12-year-old girl contracted the disease, even though she had been fully vaccinated against it at the appropriate ages. The source of her infection was unknown. The clinical picture was classic except that the girl experienced intense headaches, lasting up to an hour, after the episodes of paroxysmal coughing. Canadian physicians and public health practitioners should encourage vaccination against
pertussis
.
...
PMID:Pertussis in a vaccinated 12-year-old girl. 649 2
52 children with severe cough persisting for more than 10 days were randomized to treatment with amoxycillin/clavulanic acid or placebo in a prospective double-blinded study. Clinically suspected cases of
pertussis
were excluded, yet 12 (23%) of the children had laboratory verified
pertussis
infection. The nasopharyngeal colonization showed a predominance of Moraxella catarrhalis which was isolated in 37 (71%) children. Streptococcus pneumoniae and Haemophilus influenzae were isolated in 11 (20%) and 16 (30%) children, respectively. The antibiotic-treated group had a significantly better recovery in both the pediatrician's estimation (p = 0.02) and the independent parental judgement (p = 0.002). These findings are consistent with the view that Moraxella catarrhalis could be directly involved in the pathogenesis of
persistent cough
in children.
...
PMID:Children with persistent cough--outcome with treatment and role of Moraxella catarrhalis? 771 May 36
To evaluate the role of adults in the transmission of
pertussis
during an epidemic, persons presenting with unexplained cough to ambulatory care clinics were evaluated for evidence of
pertussis
infection. Nasopharyngeal specimens for culture and serum samples for IgG and IgA antibodies to filamentous hemagglutinin and
pertussis
toxin antigens of Bordetella
pertussis
were obtained. Thirty-eight adults were enrolled in the study; 10 (26%) had serologic evidence of B.
pertussis
infection. Clinical findings were not significantly different among persons with and without evidence of
pertussis
infection.
Pertussis
should be considered in the differential diagnosis of
persistent cough
in all age groups. Future use of new acellular
pertussis
vaccines in adults may substantially impact the control of the infection.
...
PMID:Pertussis infection among adults during the 1993 outbreak in Chicago. 776 11
The benefits of antibiotic treatment and a nasopharyngeal culture in children with longstanding cough were analysed in a prospective randomized open study. Clinically suspected
pertussis
was excluded. Of 40 children given erythromycin for 7 days, 35 (88%) recovered in one week, compared with 17/47 (36%) untreated (p < 0.0001). Erythromycin eliminated Moraxella catarrhalis from the nasopharynx in 21/31 children (68%), compared with spontaneous disappearance in 7/35 (20%) untreated controls (p < 0.001). Purulent bronchitis or otitis media occurred in 2 children (5%) in the treatment group and in 21 (45%) in the control group (p < 0.01). To evaluate the clinical role of isolated pathogens, the 47 untreated subjects were studied. Seven of 35 children harbouring M. catarrhalis recovered, compared with 8/12 in whom this bacterium was absent (p < 0.01). No correlation was found between the isolation of Haemophilus influenzae or Streptococcus pneumoniae and the clinical outcome. Children with
persistent cough
> 10 days may benefit from erythromycin treatment. M. catarrhalis in the nasopharynx indicates prolonged symptoms and increased risk of bacterial complications.
...
PMID:Erythromycin treatment is beneficial for longstanding Moraxella catarrhalis associated cough in children. 836 28
Throughout this century infants and young children have remained most susceptible to
pertussis
-related morbidity and mortality. In recent years infants younger than 6 months who are not old enough to have received three doses of the diphtheria-tetanus-
pertussis
vaccine and under-vaccinated preschool children have been at highest risk for
pertussis
-associated complications.
Pertussis
infection rates dropped dramatically after the whole cell
pertussis
vaccine came into widespread use, and an all-time low in reported cases in the United States was reached in 1976. Just as widespread immunization helped control the incidence of
pertussis
, it has probably been the primary factor in reducing
pertussis
-related mortality. Despite a stable or increasing vaccination rate in the United States since 1962,
pertussis
infection rates have been rising since the early 1980s. In 1993 the number of cases of
pertussis
reported represented an 82% increase over reported cases during the previous year and the highest incidence of
pertussis
since 1967. In 1993
pertussis
became the most commonly reported vaccine-preventable disease among children in the United States younger than 5 years old. Growth of a susceptible adult population appears to be the primary factor contributing to the resurgence of
pertussis
in the United States; widespread immunization has reduced the potential for individuals to acquire exposure-induced immunity. It has been suggested that the majority of patients now infected with Bordetella
pertussis
are adults. Several studies have confirmed the importance of
pertussis
as the cause of
persistent cough
among teenagers and adults. As the diagnosis of
pertussis
goes unrecognized in these older patients and treatment is delayed or administered only partially, adolescents and adults have become an important source for transmission of B.
pertussis
infection to other household members, particularly infants and young children who are not adequately immunized.
...
PMID:Epidemiology of pertussis. 910 62
A duplex PCR to detect Bordetella
pertussis
and Bordetella parapertussis was developed with the insertion sequences IS481 (B.
pertussis
) and IS1001 (B. parapertussis) and evaluated with specimens from 520 consecutive patients presenting with possible
pertussis
. No culture-positive-PCR-negative results occurred, giving the method a sensitivity of 100%. For B.
pertussis
, 58 of 520 patients (11.2%) were positive by PCR compared to 17 of 520 patients positive (3.3%) by culture. For B. parapertussis, 7 of 520 patients (1.3%) were positive by PCR compared to 2 of 520 patients positive (0.4%) by culture. Two patients were positive for both B.
pertussis
and B. parapertussis. Patient records were reviewed to determine the validity of PCR-positive-culture-negative results. Forty-two of 49 patients who could be evaluated fulfilled the criteria for a case definition of
pertussis
, with 32 patients being <1 year of age and having classical
pertussis
symptoms. The seven patients who did not fulfil the criteria were aged 7 to 55 years and had a
persistent cough
for >2 weeks. The method was also used to investigate a classroom outbreak in which B.
pertussis
culture was positive for 5 of 28 patients. All five culture-positive specimens were confirmed by PCR, and an additional eight were positive by PCR. Of 25 patients from a suspected
pertussis
outbreak in a girls' dormitory, seven of seven specimens were negative for B.
pertussis
, although 13 of 25 patients were positive for B.
pertussis
immunoglobulin M (IgM) (2 of which produced equivocal IgA results, with 23 of 25 patients being negative). Five symptomatic patients were subsequently found to be positive (by IgM and particle agglutination assays) for Mycoplasma pneumoniae, demonstrating the value of PCR in rapidly excluding B.
pertussis
infection in an outbreak situation. Twenty-two of 71 (30. 1%) throat swabs were positive by PCR compared to 2 of 71 (2.8%) throat swabs positive by culture, indicating that a reassessment of the use of throat swabs should be considered, particularly for older patients, in contact tracing, and in situations in which specimen collection is difficult.
...
PMID:Nested duplex PCR to detect Bordetella pertussis and Bordetella parapertussis and its application in diagnosis of pertussis in nonmetropolitan Southeast Queensland, Australia. 998 20
An epidemic of
pertussis
is described among elderly people in a religious institution in the Netherlands in 1992. Subjects were evaluated for their vaccination status and for history and presence of respiratory symptoms. Specimens were collected for culture, polymerase chain reaction, and serological evaluation. None of the 75 residents and 19 of 24 nonresident personnel had been vaccinated against
pertussis
. The overall attack rate of clinical
pertussis
, defined as
persistent cough
lasting at least 2 weeks, was 49%. In five subjects with clinical
pertussis
, either culture or polymerase chain reaction or both were positive for Bordetella
pertussis
. A significant (at least 4-fold) change in specific antibody titre was observed in 85% (41/48) and 20% (10/49) of subjects with and without clinical
pertussis
, respectively (P < 0.0001, chi-square 41.1). The attack rate of laboratory-confirmed
pertussis
was 42% (41/98). This rate was 5% (1/19), 20% (1/5), and 53% (39/74) in vaccinated personnel, nonvaccinated personnel, and nonvaccinated residents, respectively (not significant). Among residents aged between 55-74 years and 75-94 years, the attack rates were 47% (17/36) and 58% (22/38), respectively (relative risk=0.8; 95% confidence interval 0.5-1.3). Four of 75 residents (5%) died from intracranial bleeding, while they were symptomatic for
pertussis
. It is concluded that the attack rate of
pertussis
was high among nonvaccinated elderly and that
pertussis
tended to increase with age. There may be a considerable risk of mortality from
pertussis
in this population. Physicians should be alert to the diagnosis of
pertussis
in the elderly with nocturnal and prolonged periods of coughing.
...
PMID:An epidemic of pertussis among elderly people in a religious institution in The Netherlands. 1038 11
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