FREQUENCY OF UNRECOGNIZED BORDETELLA-PERTUSSIS INFECTIONS IN ADULTS

To investigate the frequency of unrecognized Bordetella pertussis infe ctions in adults, we performed IgA and IgG ELISA antibody studies with four B. pertussis antigens - i.e., lymphocytosis-promoting factor, fi lamentous hemagglutinin, pertactin, and fimbriae-2 - in 51 health care workers from whom six consecutive yearly serum samples (from 1984 to 1989) were available. Overall, 90% of the subjects had a significant i ncrease in antibody (IgA or IgG) to one or more antigens between 2 con secutive years during the 5-year study period; 55% of subjects had evi dence of two infections, 17% had three infections, and 4% had four inf ections, Infections occurred in all study years, with the following ra tes: 1984-1985, 32%; 1985-1986, 24%; 1986-1987, 40%; 1987-1988, 29%; a nd 1988-1989, 43% (P = .12). Some antibody rises may have been due to responses to cross-reacting antigens (Bordetella parapertussis, nontyp able Haemophilus influenzae), but overall these data suggest that B. p ertussis infections in adults are common, endemic, and usually unrecog nized.