Abstract
Pertussis is underdiagnosed and underreported in adults and patients with underlying conditions. Patients with chronic obstructive pulmonary disease (COPD) may be at increased risk of severe pertussis. Understanding the true prevalence of pertussis infections in such patients is important. We therefore evaluated the seroprevalence of anti-pertussis toxin (PT) antibodies in a cohort of 40–85-year-old patients diagnosed with moderate, severe or very severe COPD enrolled (between June 2011 and June 2012) in the prospective, observational “Acute Exacerbation and Respiratory InfectionS in COPD” (AERIS; NCT01360398) study, conducted in England. Serum anti-PT antibodies were measured in 104 patients using an enzyme-linked immunosorbent assay on samples collected 12 months (M12) and 24 months (M24) after enrollment. Overall, 14/104 (13.5%) patients had anti-PT concentrations ≥50 IU/mL at M12 or M24, indicative of exposure to Bordetella pertussis during the preceding 2–3 years. Of these, 6/104 (5.8%) had anti-PT ≥70 IU/mL, of whom 3/104 (2.9%) had anti-PT ≥120 IU/mL, indicative of exposure within 12 and 6 months, respectively. These results show a high circulation of B. pertussis in 40–85-year-old patients with moderate, severe or very severe COPD in England between 2012 and 2014, and call for enhanced immunization to prevent pertussis infections in such patients.
Highlights
Pertussis, or whooping cough, is a highly contagious respiratory disease caused by Bordetella pertussis
The study enrolled women and men 40–85 years of age with a confirmed diagnosis of chronic obstructive pulmonary disease (COPD) based on postbronchodilator spirometry, classified as moderate, severe or very severe according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) staging [24,25,32]
As part of one of the study’s tertiary objectives, the analyses described here aimed to evaluate the seroprevalence of B. pertussis in the study population at two timepoints 1 year apart: 12 and 24 months after enrollment (M12 and M24)
Summary
Whooping cough, is a highly contagious respiratory disease caused by Bordetella pertussis. Symptoms in adults are often atypical (and may overlap with those of chronic respiratory diseases): they include persistent paroxysmal coughing without fever with an average duration of 6 weeks and often lack the characteristic inspiratory whooping [6,7]. This leads to mis- and underdiagnosis of pertussis and an underestimation of the burden of disease in adults [1,4]. The link between pertussis and COPD and whether pertussis plays a role in AECOPD remains to be better characterized
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