Bordetella pertussis and chronic cough in adults

To evaluate Bordetella pertussis as a cause of persistent cough in adults, we examined 201 patients who had a cough for 2-12 weeks and no pulmonary di sease. We obtained the following at presentation: medical history, chest ra diograph, respiratory function measurement, nasopharyngeal aspirate for pol ymerase chain reaction (PCR), nasopharyngeal swab specimen for culture, and a blood sample (acute serum). Four weeks later a second blood sample (conv alescent serum) was obtained. Control sera were obtained from 164 age-match ed healthy blood donors with no history of cough during the previous 12 wee ks, Four patients were B. pertussis culture-positive; 11 (including the cul ture-positive patients) were B. pertussis PCR-positive; and 33, including 1 0 of the 11 PCR-positive patients,had serological evidence of recent B, per tussis infection. Pertussis-positive and -negative patients could not be di scriminated by a history of cough. We conclude that B. pertussis infection is a common cause of persistent cough in adults. This is of concern, becaus e these patients may be B, pertussis reservoirs from which transmission may occur to infants, in whom the disease can be devastating.