Department of Microbiology, University of Tartu, Tartu, Estonia.
Children's Clinic of Tartu University Hospital, Tartu, Estonia.
Infection. 2018 Feb;46(1):83-91. doi: 10.1007/s15010-017-1095-z. Epub 2017 Nov 1.
We aimed to determine the prevalence, symptoms and course of pertussis and parapertussis among patients at any age with a cough of unknown aetiology that had lasted for ≥ 7 days and to assess the diagnostic value of the symptoms included in the World Health Organisations' (WHO) clinical case definition of pertussis.
Patients were enrolled between the 23 April 2012 and 31 December 2014 at 25 general practitioner (GP) centres and three paediatric hospitals. Pertussis was confirmed by culture and/or polymerase chain reaction (PCR) and/or quantitative serology. Parapertussis was confirmed by culture and/or PCR.
Altogether, 549 patients were recruited. Of them, 22 (4.0%; 95% CI 2.5-6.0) had pertussis (predominately diagnosed by positive serology 17/22) and 7 (1.3%; 95% CI 0.5-2.6) had parapertussis. Patients with pertussis were more likely to have inspiratory whooping and posttussive emesis than those with a cough of another/unknown aetiology. However, the presence or absence of these two symptoms did not definitively confirm or exclude pertussis. The sensitivity and specificity of the WHO's clinical definition was 0.77 and 0.38, respectively.
The prevalence of pertussis and parapertussis among patients with a persistent cough of unknown aetiology in Estonia is low. As clinical symptoms alone cannot be used to distinguish pertussis, we recommend that laboratory testing for pertussis is performed in all patients with a persistent cough regardless of age.
我们旨在确定任何年龄的、持续时间≥7 天的不明病因咳嗽患者中百日咳和副百日咳的流行率、症状和病程，并评估世界卫生组织（WHO）百日咳临床病例定义中包含的症状的诊断价值。
2012 年 4 月 23 日至 2014 年 12 月 31 日期间，在 25 家全科医生（GP）中心和 3 家儿科医院招募了患者。通过培养和/或聚合酶链反应（PCR）和/或定量血清学来确认百日咳。通过培养和/或 PCR 来确认副百日咳。
共招募了 549 名患者。其中，22 名（4.0%；95%CI 2.5-6.0）患有百日咳（主要通过 17/22 例阳性血清学诊断），7 名（1.3%；95%CI 0.5-2.6）患有副百日咳。与其他/不明病因咳嗽患者相比，百日咳患者更有可能出现吸气性哮鸣和咳嗽后呕吐。然而，这些两个症状的存在与否并不能明确地确定或排除百日咳。WHO 临床定义的敏感性和特异性分别为 0.77 和 0.38。
在爱沙尼亚，不明病因持续咳嗽患者中百日咳和副百日咳的流行率较低。由于仅凭临床症状无法区分百日咳，我们建议对所有持续咳嗽的患者，无论年龄大小，均进行百日咳实验室检测。
