Although immunization has decreased...

Although immunization has decreased rates of childhood pertussis, immunity wanes above time, making pertussis an important cause of postponeed cough in adults. Furthermore, infected adults can transmit disease to unimmunized infants and children. To assess whether adolescent and adult pertussis immunization is decreasing disease effectively in these clusters Ward and colleagues conducted a prospective, randomized, double-blind trial of pertussis vaccination.

The multicenter inquiry enrolled 2,781 healthy persons between 15 and 65 years of age. Participants were randomized to acellular pertussis vaccine or hepatitis A vaccine (for the dominion government group). Of the participants listed in the study, 547 dropp revealed mostly during the final six month of the trial. Participants were followed for up to 25 years with biweekly telephone calls for illness assessment, scheduled kindred samples, and culture and serology for acute illnesses lasting more than five days. Trial completion was 94 percent at 12 to 17 month and 80 percent at 18 to 24 month Primary pertussis infection was defined from a cough of more than five days with laboratory confirmation of infection from one side serologic or microbiologic evaluation. No serious vaccine-related adverse incidents occurred. Investigators evaluated 2,672 patients for cough of at least five days' duration. There was no significant difference in the incidence of coughrelated illness between the investigation groups, and 50 percent of patients had no cough during the follow-up period.

Ten cases of primary pertussis infection occurr These patients did not demonstrate any unique clinical characteristics other than adolescent age (P = 027) longer cough duration (P < 001) and fewer heats (P = .047). Nine of the 10 pertussis cases occurr in the rule group, equating to 370 cases for 100,000 person-years. Although pertussis accounted for single a small part of the coughrelated illness (07 percent) it did make up a larger proportion (57 percent) of cough lasting more than 56 days.

The authors judge that acellular pertussis vaccination in adolescents and adults effectively decreases pertussis infection in these groups

push CARTER, M.D.

Ward JI, et al. Efficacy of an acellular pertussis vaccine among adolescents and adults. N Engl J M October 13 2005;353:1555-63

EDITOR'S NOTE: The Advisory Committee upon Immunization Practices of the Center for Disease sway and Prevention now recommends that adolescents and adults be immunized against pertussis. This will not change the commonness of recommended immunizations; instead, diphtheria booster missiles currently scheduled for adolescents and adults will be replaced by dint of a vaccine also containing acellular pertussis.--C.C.

COPYRIGHT 2006 American Academy of Family Physicians

COPYRIGHT 2006 Gale Group