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Pertussis in Adults
- Mark S. Dworkin, MD, MPHTM;
- Christopher Spitters, MD; and
- John M. Kobayashi, MD, MPH
- Centers for Disease Control and Prevention; Atlanta, GA 30333 Snohomish Health District; Everett, WA 98201 Washington State Department of Health; Seattle, WA 98155
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
TO THE EDITOR:
Dr. Cherry's editorial [1] was a wake-up call to internists about the importance of pertussis in adults. Pertussis is “highly communicable,” and immunity from available vaccines is not long lasting [2]. Outbreaks continue to occur, consuming scarce public health resources [3]. These outbreaks may be exacerbated by physicians' delays in diagnosing the disease in adults. A recent study suggests that internists' knowledge of pertussis is incomplete [4].
We investigated an outbreak of pertussis among 89 office personnel in Washington State. The index case occurred in a 31-year-old woman with paroxysms of coughing, inspiratory whoop, post-tussive vomiting, and serologic evidence of recent infection. We interviewed 61 (68.5%) of 89 employees (including the index case-patient) by using a standardized questionnaire. We defined a clinical case-patient as an employee who had had a cough illness for 2 weeks or longer and at least one of the following symptoms: inspiratory whoop, post-tussive vomiting, or paroxysmal cough. A probable case-patient was defined as an employee who had had a cough illness for at least 2 weeks that occurred during the outbreak period.
Including the index case-patient, we identified 16 case-patients (26%) (7 clinical, 9 probable) with onset within a 4-month period. An inspiratory whoop was present in 3 case-patients (19%); 12 case-patients (75%) stated that they had been vaccinated for pertussis. Although patients were tested late in their illnesses, two of three nasopharyngeal swabs collected from 3 case-patients were positive for Bordetella pertussis by polymerase chain reaction performed in the Pertussis Laboratory at the Centers for Disease Control and Prevention.
This outbreak of pertussis reaffirms the susceptibility of adults to pertussis despite a history of vaccination. We encourage physicians to consult their local public health departments for assistance with testing for B. pertussis when such diagnostic expertise is not readily available at their own medical facilities.
Mark S. Dworkin, MD, MPHTM
Centers for Disease Control and Prevention; Atlanta, GA 30333
John M. Kobayashi, MD, MPH
Washington State Department of Health; Seattle, WA 98155
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
