Morbidity of pertussis in adolescents and adults

The effect of age on the clinical presentation of pertussis was assessed in 664 adolescent and adult cases. Complications were more frequent in adults than in adolescents (28% vs. 16%), Pneumonia occurred in 2% of patients <3 0 years old but in 5%-9% of older patients. Urinary incontinence occurred i n 34% of women greater than or equal to 50 years old. Duration of cough, ri sk of sinusitis, and number of nights with disturbed sleep increased with s moking and asthma. The secondary attack rate in other household members gre ater than or equal to 12 years was 11%. Pertussis in secondary case patient s was less severe than in index case patients but presented with classic sy mptoms. The main source of infection in adolescents was schoolmates or frie nds; in adults it was workplace or their children. Teachers and health care workers had a greater risk of pertussis than did the general population. T he burden of disease appears to increase with age, with smoking, and with a sthma.