This article is more than 5 years old. Information may no longer be current.
1 in 5 UK children presenting with persistent cough have pertussis
Click Here to Manage Email Alerts
Researchers in the United Kingdom reported that pertussis was diagnosed in one-fifth of school-age children who presented in primary care with persistent cough.
“Clinicians should be aware that whooping cough is still prevalent among school-age children with a persistent cough, even after the introduction of the preschool booster vaccination,” study researcher Kay Wang, DPhil, an academic clinical lecturer at the University of Oxford, told Infectious Disease News.
Kay Wang
In the United Kingdom, a primary course of pertussis vaccinations is administered at age 2, 3 and 4 months, followed by a preschool pertussis booster vaccination 3 years later. Before the preschool pertussis booster was introduced in 2001, pertussis infection was found in almost 40% of school-age children presenting in primary care with persistent cough, according to the researchers. Previous studies suggest that immunity following vaccination lasts 4 to 12 years, and immunity following infection lasts 7 to 20 years.
In a prospective cohort study, Wang and colleagues estimated the prevalence and clinical severity of pertussis in 279 children aged 5 to 15 years who presented in 22 primary care clinics in the United Kingdom with persistent cough lasting 2 to 8 weeks. Pertussis infection was confirmed by laboratory testing of oral fluid samples. Additionally, cough frequency was monitored through use of devices worn by six children with confirmed pertussis infection.
Results indicated that 20% (95% CI, 16-25) of children had evidence of recent pertussis infection, including 18% (95% CI, 13-24) of children who received the complete primary vaccination course plus the booster dose. Twenty-seven percent (95% CI, 16-41) of children who did not receive the booster had laboratory-confirmed pertussis infection.
According to the researchers, the risk for infection was more than three times higher in children who received the booster more than 7 years before presenting to the clinic (40%; 95% CI, 26%-54%) vs. children who received it less than 7 years previously (12%; 95% CI, 7%-17%). There was no significant difference in risk between children who received the three- and five-component pertussis booster vaccinations (RR=1.14; 95% CI, 0.64-2.03).
Four of the six children in whom cough frequency was measured coughed more than 400 times in the span of 24 hours, the researchers said.
Despite high vaccination coverage, the findings show a significant burden of illness associated with pertussis infection among children. According to Wang and colleagues, the results can be used to inform considerations of an additional booster during adolescence.
“If an adolescent pertussis booster vaccination is found to be cost effective, administering this alongside the routine meningococcus C and tetanus, diphtheria, and inactivated polio adolescent booster vaccinations, currently recommended at around 14 years of age, may be the most efficient way of ensuring high vaccination coverage,” they concluded. – John Schoen
Kay Wang, DPhil, can be reached at kay.wang@phc.ox.ac.uk.
Disclosure: See the study for a full list of financial disclosures.
Click Here to Manage Email Alerts