[Whooping cough in adults].

Within a period of four years the diagnosis of pertussis was made in 169 adults (105 women, 64 men; mean age 35.8 [18-79] years). based on symptoms, specific antibodies and bacteriological examination of nasopharyngeal swabs (in 53). The findings were compared with those obtained in a control group of 2,771 children (1,381 females, 1,390 males; mean age 4.3 years). In the adult the dominant symptom was persisting cough, at times convulsive, while the other symptoms, characteristic in children, of rib retraction and vomiting were significantly less common in adults (retraction: 3% vs 40%; vomiting 12% vs 59%). A history of contact was elicited in only 17% of adults (38% in children). Confirmation of the diagnosis was obtained by growing Bordetella pertussis from a nasopharyngeal swab (6 of 53 patients [11%]; in children 45%), or finding significantly elevated antibody concentration or titre rise of specific antibodies against B. pertussis (IgG: 81% vs 68%; IgA: 91% vs 73%; IgM: 44% vs 72%). Half the adult patients were aged between 20 and 35 years. Contrary to the sex distribution of pertussis in children, significantly more women than men contracted the infection (P less than 0.01). It is concluded that even in adults pertussis should be considered in the differential diagnosis of persisting cough.