Abstract
BackgroundPertussis is believed to be widely underreported and under-recognized, particularly among adults. The aim of this study was to estimate the incidence of private practitioner-attended cough illness that could be attributed to Bordetella pertussis in adults aged ≥50 years in the US.MethodsMultiple linear regressions were employed to estimate the overall incidence of pertussis. Data were extracted from IMS’ private practice database of longitudinal, patient-level claims and IMS’ commercial laboratory database during 4/1/2006–12/31/2010. Patients were ≥50 years old and had ≥1 ICD-9-CM claim for cough illness relating to pertussis, cough, or acute bronchitis. Pertussis positive laboratory tests, seasonal and secular variables were used for estimating the B. pertussis attributable fraction of cough illness.ResultsDuring the study period, there were 20.7 million cases of cough illness among people aged 50–64 and 27.5 million cases among those ≥65; of which the model attributed 2.5 and 1.7 %, respectively, to B. pertussis. The estimated incidences of cough illness attributed to B. pertussis during the study period were on average 202 and 257/100,000 among people aged 50–64 and ≥65 years, respectively, and increased over the years in both age groups. Depending on the year, estimated pertussis incidences were 42 to 105 times higher than medically attended ones in the same database.ConclusionsThese findings indicate that the B. pertussis disease incidence in adults aged ≥50 years is significantly higher than generally estimated. Additional research regarding pertussis reporting and diagnosis in the adult populations is needed to validate these findings.
Highlights
Pertussis is believed to be widely underreported and under-recognized, among adults
8398 laboratory tests were positive for B. pertussis among individuals aged 50–64 years corresponding to 37 % of the total tests performed, and 4029 among those aged ≥65 years corresponding to 33 % of total tests performed
Pertussis incidence by International Classification of Diseases (ICD-9) codes Between April 2006 and December 2010, 8763 pertussis cases were diagnosed in outpatient settings (ICD9: 033.0, 033.9 and 484.3) among people aged 50–64 and 6369 among people 65 and older (Table 1)
Summary
Pertussis is believed to be widely underreported and under-recognized, among adults. The aim of this study was to estimate the incidence of private practitioner-attended cough illness that could be attributed to Bordetella pertussis in adults aged ≥50 years in the US. Pertussis (whooping cough), caused by Bordetella pertussis (B. pertussis), is a highly contagious respiratory tract illness [1]. Pertussis generally results in a prolonged cough, and can cause pharyngeal discomfort, influenza-like symptoms, hoarseness, sinus. In 2006 ACIP recommended the administration of a reduced antigen content tetanus toxoid, diphtheria toxoid, and acellular pertussis (Tdap) vaccine to all adolescents and adults 19 through 64 years of age [3]. In February 2012, the ACIP extended the Tdap recommendation to adults aged 65 years and older [10].
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