Pediatr Infect Vaccine. 2017 Apr;24(1):37-43. Korean.
Published online Apr 18, 2017.
Copyright © 2017 The Korean Society of Pediatric Infectious Diseases
Original Article

Clinical Characteristics of Pertussis Epidemic in Changwon

Joon Weon Jang,1 Jin Han Kang,1 Jae Won Choi,2 Hak Sung Lee,2 and Sang Hyuk Ma2
    • 1Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, the Republic of Korea.
    • 2Department of Pediatrics, Changwon Fatima Hospital, Changwon, the Republic of Korea.
Received August 10, 2016; Revised October 19, 2016; Accepted October 27, 2016.

Abstract

Purpose

Pertussis can be prevented with a vaccine. Despite this, there have been an increasing number of cases worldwide, and also in Korea. This study aimed to investigate the epidemiology and clinical characteristics of the recent outbreak in the Changwon area.

Methods

Patients who visited Changwon Fatima Hospital from July 2015 to March 2016 with respiratory symptoms, including spasmodic cough, cough induced vomiting, inspiratory ‘intake’ sound (whooping), and a night-time cough for >1 week were included in this study. Respiratory specimens were collected from patients and a polymerase chain reaction (PCR) and detected anti-pertussis immunoglobulin G enzyme-linked immunosorbent assay kit test were performed. Patients with underlying diseases, or those who had received a DTaP or Tdap vaccination in recent 1 year were excluded.

Results

Pertussis was diagnosed in 37 of 50 patients, two patients were positive according to the PCR, and 37 patients were positive according to serologic tests. The age distribution of the patients was 1 month to 15 years. After administering antibiotics, all patients recovered without complications.

Conclusions

A pertussis outbreak occurred in Changwon in 2015 and 2016. This data can provide the basis for further study on the epidemiology of pertussis in Korea.

Keywords
Whooping cough; Polymerase chain reaction; Enzyme-linked immunosorbent assay

Figures

Fig. 1
Age and sex distribution of patients.

Fig. 2
Monthly distribution of patients with pertussis.

Tables

Table 1
Clinical Manifestations of Patients

References

    1. Mattoo S, Cherry JD. Molecular pathogenesis, epidemiology, and clinical manifestations of respiratory infections due to Bordetella pertussis and other Bordetella subspecies. Clin Microbiol Rev 2005;18:326–382.
    1. World Health Organization. Immunization, vaccines and biologicals: pertussis [Internet]. Geneva: World Health Organization; 2016 [cited 2016 Dec 23].
    1. Choe YJ, Kim JW, Park YJ, Jung C, Bae GR. Burden of pertussis is underestimated in South Korea: a result from an active sentinel surveillance system. Jpn J Infect Dis 2014;67:230–232.
    1. Korea Centers for Disease Control and Prevention. Increased whooping cough, proper vaccination is important [Internet]. Cheongju: Korea Centers for Disease Control and Prevention; 2012 [cited 2016 Dec 23].
    1. Zhang Q, Zheng H, Liu M, Han K, Shu J, Wu C, et al. The seroepidemiology of immunoglobulin G antibodies against pertussis toxin in China: a cross sectional study. BMC Infect Dis 2012;12:138.
    1. Regan J, Lowe F. Enrichment medium for the isolation of Bordetella. J Clin Microbiol 1977;6:303–309.
    1. IBL International GmbH. Bordetella pertussis IgG ELISA [Internet]. Hamburg: IBL International GmbH; c2015 [cited Dec 23].
    1. European Centre for Disease Prevention and Control. Guidance and protocol for the use of real-time PCR in laboratory diagnosis of human infection with Bordetella pertussis or Bordetella parapertussis. Stockholm: ECDC; 2012.
    1. Souder E, Long SS. Pertussis in the era of new strains of Bordetella pertussis. Infect Dis Clin North Am 2015;29:699–713.
    1. Centers for Disease Control and Prevention (CDC). Pertussis epidemic: Washington, 2012. MMWR Morb Mortal Wkly Rep 2012;61:517–522.
    1. Martin SW, Pawloski L, Williams M, Weening K, DeBolt C, Qin X, et al. Pertactin-negative Bordetella pertussis strains: evidence for a possible selective advantage. Clin Infect Dis 2015;60:223–227.
    1. Winter K, Glaser C, Watt J, Harriman K. Centers for Disease Control and Prevention (CDC). Pertussis epidemic: California, 2014. MMWR Morb Mortal Wkly Rep 2014;63:1129–1132.
    1. Choe YJ, Park YJ, Jung C, Bae GR, Lee DH. National pertussis surveillance in South Korea 1955-2011: epidemiological and clinical trends. Int J Infect Dis 2012;16:e850–e854.
    1. Jung SW. Epidemiologic properties of pertussis confirmed from pharyngitis patients. Public Health Wkly Rep 2011;4:237–240.
    1. Park S, Lee SH, Seo KH, Shin KC, Park YB, Lee MG, et al. Epidemiological aspects of pertussis among adults and adolescents in a Korean outpatient setting: a multicenter, PCRbased study. J Korean Med Sci 2014;29:1232–1239.
    1. Lee SY, Han SB, Kang JH, Kim JS. Pertussis prevalence in Korean adolescents and adults with persistent cough. J Korean Med Sci 2015;30:988–990.
    1. Cherry JD. The epidemiology of pertussis and pertussis immunization in the United Kingdom and the United States: a comparative study. Curr Probl Pediatr 1984;14:1–78.
    1. Solano R, Crespo I, Fernandez MI, Valero C, Alvarez MI, Godoy P, et al. Underdetection and underreporting of pertussis in children attended in primary health care centers: Do surveillance systems require improvement. Am J Infect Control 2016;44:e251–e256.
    1. Cherry JD, Tan T, Wirsing von, Forsyth KD, Thisyakorn U, Greenberg D, et al. Clinical definitions of pertussis: summary of a Global Pertussis Initiative roundtable meeting, February 2011. Clin Infect Dis 2012;54:1756–1764.
    1. Campins-Marti M, Cheng HK, Forsyth K, Guiso N, Halperin S, Huang LM, et al. Recommendations are needed for adolescent and adult pertussis immunisation: rationale and strategies for consideration. Vaccine 2001;20:641–646.
    1. Cherry JD, Grimprel E, Guiso N, Heininger U, Mertsola J. Defining pertussis epidemiology: clinical, microbiologic and serologic perspectives. Pediatr Infect Dis J 2005;24 5 Suppl:S25–S34.
    1. Rendi-Wagner P, Tobias J, Moerman L, Goren S, Bassal R, Green M, et al. The seroepidemiology of Bordetella pertussis in Israel: estimate of incidence of infection. Vaccine 2010;28:3285–3290.
    1. Narkeviciute I, Kavaliunaite E, Bernatoniene G, Eidukevicius R. Clinical presentation of pertussis in fully immunized children in Lithuania. BMC Infect Dis 2005;5:40.
    1. Bodilis H, Guiso N. Virulence of pertactin-negative Bordetella pertussis isolates from infants, France. Emerg Infect Dis 2013;19:471–474.
    1. Brotons P, de Paz HD, Toledo D, Villanova M, Plans P, Jordan I, et al. Differences in Bordetella pertussis DNA load according to clinical and epidemiological characteristics of patients with whooping cough. J Infect 2016;72:460–467.
    1. Crowcroft NS, Booy R, Harrison T, Spicer L, Britto J, Mok Q, et al. Severe and unrecognised: pertussis in UK infants. Arch Dis Child 2003;88:802–806.
    1. Halperin SA, Wang EE, Law B, Mills E, Morris R, Dery P, et al. Epidemiological features of pertussis in hospitalized patients in Canada, 1991-1997: report of the Immunization Monitoring Program: Active (IMPACT). Clin Infect Dis 1999;28:1238–1243.
    1. Pierce C, Klein N, Peters M. Is leukocytosis a predictor of mortality in severe pertussis infection. Intensive Care Med 2000;26:1512–1514.
    1. Centers for Disease Control and Prevention. Diagnosis confirmation [Internet]. Atlanta: Centers for Disease Control and Prevention; 2015 [cited Dec 23].
    1. Andre P, Caro V, Njamkepo E, Wendelboe AM, Van Rie A, Guiso N. Comparison of serological and real-time PCR assays to diagnose Bordetella pertussis infection in 2007. J Clin Microbiol 2008;46:1672–1677.
    1. Riffelmann M, Thiel K, Schmetz J, Wirsing von. Performance of commercial enzyme-linked immunosorbent assays for detection of antibodies to Bordetella pertussis. J Clin Microbiol 2010;48:4459–4463.
    1. Altunaiji S, Kukuruzovic R, Curtis N, Massie J. Antibiotics for whooping cough (pertussis). Cochrane Database Syst Rev 2007;(3):CD004404.
    1. Langley JM, Halperin SA, Boucher FD, Smith B;. PICNIC). Azithromycin is as effective as and better tolerated than erythromycin estolate for the treatment of pertussis. Pediatrics 2004;114:e96–e101.
    1. Wood N, McIntyre P. Pertussis: review of epidemiology, diagnosis, management and prevention. Paediatr Respir Rev 2008;9:201–211.

Metrics
Share
Figures

1 / 2

Tables

1 / 1

PERMALINK