REPLY
Pertussis in Adults
James D. Cherry, MD
15 June 1998 | Volume 128 Issue 12 Part 1 | Pages 1047-1048
IN RESPONSE:
The outbreak of pertussis in office personnel described by Dworkin and colleagues is of interest, and their advice is sound. In addition to polymerase chain reaction for diagnosis, single serum anti-pertussis toxin enzyme-linked immunosorbent assay can be useful in the diagnosis of adult pertussis [1].
Dr. Hyman asked about the type of vaccine (monocomponent versus DTaP) I would envision for adult use. My opinion, as well as the opinion of many of my colleagues, is that an adult-formulated dTap vaccine will be necessary for the routine immunization of adolescents and adults. However, it will also be useful to have an adult-formulated ap vaccine so that adults who have recently been immunized with dT can be vaccinated without the fear of significant local reactions. Dr. Hyman also inquires about the therapeutic usefulness of newer macrolide antibiotics. Because both azithromycin and clarithromycin are as active as erythromycin against B. pertussis, successful treatment is likely [2]. However, only minimal data on efficacy are available.
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Author and Article Information
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University of California, Los Angeles, School of Medicine; Los Angeles, CA 90095
1. Marchant CO, Loughlin AM, Lett SM, Todd CW, Wetterlow LH, Bicchieri R, et al. Pertussis in Massachusetts, 1981-1991: incidence, serologic diagnosis, and vaccine effectiveness. J Infect Dis. 1994; 169:1297-305.
2. Hoppe J. Update on epidemiology, diagnosis, and treatment of pertussis. Eur J Clin Microbiol Infect Dis. 1996; 15:189-93.
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