Whooping cough caused by Bordetella pertussis and Bordetella parapertussis in an immunized population

JAMA. 1998 Aug 19;280(7):635-7. doi: 10.1001/jama.280.7.635.


Context: The prevalence of Bordetella pertussis and Bordetella parapertussis infections among outpatients in an immunized population is not known.

Objective: To study the prevalence of these infections in outpatients with paroxysmal cough in Finland, where the pertussis vaccine coverage of 4 doses is 98%.

Design: Prospective cohort study.

Setting: Thirty-two health centers in southwestern Finland.

Patients: A total of 584 patients with paroxysmal cough seen at local health centers from October 1994 through March 1997 from whom nasopharyngeal swabs were collected.

Main outcome measures: Prevalence of positive cultures for B pertussis or B parapertussis and/or positive polymerase chain reaction (PCR) results and frequency of symptoms in those with pertussis and parapertussis.

Results: A total of 153 subjects (26.2%) had Bordetella infection by culture or PCR: 93 (60.8%) had B pertussis infection, 49 (32.0%) had B parapertussis infection, and 1 1 (7.2%) had both. Of these cases, 39 (25.5%) had positive cultures and 95 (62.1%) had positive PCR results for B pertussis, and 19 (12.4%) had positive cultures and 55 (35.9%) had positive PCR results for B parapertussis. At the time of diagnosis, no difference was found in the frequency of symptoms between patients with B parapertussis infection and those with B pertussis infection. Bordetella parapertussis infection was as common as B pertussis infection in children before school entry, whereas in schoolchildren and adults, B pertussis infection was more common than B parapertussis infection (P<.001).

Conclusion: Bordetella infections are common in an immunized population, and B parapertussis infections apparently are more prevalent than previously documented.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bordetella / isolation & purification
  • Bordetella Infections / diagnosis
  • Bordetella Infections / epidemiology
  • Bordetella Infections / prevention & control
  • Bordetella pertussis / isolation & purification
  • Child
  • Child, Preschool
  • DNA, Bacterial / analysis
  • Female
  • Finland / epidemiology
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Pertussis Vaccine* / immunology
  • Polymerase Chain Reaction
  • Prevalence
  • Prospective Studies
  • Whooping Cough / diagnosis
  • Whooping Cough / epidemiology*
  • Whooping Cough / prevention & control*


  • DNA, Bacterial
  • Pertussis Vaccine