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Bordetella pertussis, Bordetella parapertussis, Mycoplasma pneumoniae, Chlamydia pneumoniae and persistent cough in children.

Scand J Infect Dis 1999;31(3):281-6 ISSN: 0036-5548)

Hallander HO; Gnarpe J; Gnarpe H; Olin P
Swedish Institute for Infectious Disease Control, Stockholm.

Material collected during a prospective pertussis vaccine trial in 1992-95 was examined for Bordetella pertussis (culture and serology), Bordetella parapertussis (culture), Mycoplasma pneumoniae and Chlamydia pneumoniae (PCR). From 64% (99/155) of episodes with cough for less than 100 d, 115 aetiological agents were identified in one southern and one northern subset of DT-recipients. The most common single agent was B. pertussis, representing 56%(64/115), with a median cough period of 51 d, followed by M. pneumoniae 26%(30/115), 23 d, C. pneumoniae 17% (19/115), 26 d, and B. parapertussis 2% (2/115). For co-infections, the median duration of cough was about 60 d. Spasmodic cough for 21 d or more (clinical WHO criteria for pertussis) was present in 82% (41/50) of infections with B. pertussis as single agent, 38% (17/45) with B. parapertussis, 38% (5/13) with C. pneumoniae, 26% (5/19) with M. pneumoniae and 30%(17/56) in cases where no aetiology was found. In children with cough for more than 100 d (n = 78) using all vaccine arms, B. pertussis was responsible in 83% (65/78), in 21%(16/78) together with other agents. Acellular vaccines were more efficient against serious disease than whole cell vaccine. Antibiotic treatment was more common at the southern (34%) study site than at the northern one (12%). The findings indicate that diagnosis should rely on laboratory confirmation, both for rational treatment of an individual case and for monitoring outbreaks.

Major Subject Heading(s) Minor Subject Heading(s) CAS Registry / EC Numbers
  • Bordetella pertussis [isolation & purification]
  • Bordetella [isolation & purification]
  • Chlamydophila pneumoniae [isolation & purification]
  • Cough [microbiology]
  • Mycoplasma pneumoniae [isolation & purification]
  • Antibodies, Bacterial [blood]
  • Bordetella Infections [complications] [microbiology]
  • Bordetella pertussis [immunology]
  • Child, Preschool
  • Chlamydia Infections [microbiology]
  • Chlamydophila pneumoniae [genetics]
  • Chronic Disease
  • Diphtheria-Tetanus-Pertussis Vaccine [administration & dosage] [immunology]
  • Infant
  • Mycoplasma Infections [complications] [microbiology]
  • Mycoplasma pneumoniae [genetics]
  • Nasopharynx [microbiology]
  • Polymerase Chain Reaction [methods]
  • Prospective Studies
  • Whooping Cough [complications] [microbiology]
  • 0 (Antibodies, Bacterial)
  • 0 (Diphtheria-Tetanus-Pertussis Vaccine)

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