Whooping cough today
Grimprel, E.
Presse Medicale 28(30): 1671-1675
1999
ISSN/ISBN: 0755-4982 PMID: 10544703 Document Number: 511196
Vaccination has totally modified the epidemiology of pertussis in France. The classically described childhood forms have become quite exceptional compared with early cases in infants and later cases in older children, adolescents and adults. Whooping cough is often misdiagnosed in adults as the expression is less typical, largely contributing to further transmission. Pertussis should be envisaged as a possible diagnosis in adults with persistent or worsening cough for more than 7 days. Early vaccination should be encouraged with a late booster at 11-13 years as recommended in the 1998 guidelines. Bacterial isolates provide the diagnosis, requiring samples as early as possible in the disease course both in the primary patient and in persons in his/her contact. The PCR is reimbursed by the French health insurance system. Serology can be useful for retrospective diagnosis, particularly in children and adults even in case of vaccination, as well as in mothers of young infants due to the prepartum serum. Whole-cell vaccine has proven its excellent efficacy and remains the only vaccine indicated for infants. New acellular pertussis vaccines are well tolerated and are indicated for boosters at 18 months and at 11-13 years.