BMJ  2006;333:174-177 (22 July), doi:10.1136/bmj.38870.655405.AE (published 7 July 2006)

Research

Whooping cough in school age children with persistent cough: prospective cohort study in primary care

¹ Department of Primary Health Care, University of Oxford, Oxford OX3 7LF, ² Department of Paediatrics, University of Auckland, Starship Children's Hospital, Auckland, New Zealand, ³ Respiratory and Systematic Infection Laboratory, Health Protection Agency, Centre for Infections, London NW9 5HT

Abstract

Objective To estimate the proportion of school age children with a persistent cough who have evidence of a recent Bordetella pertussis infection.

Design Prospective cohort study (October 2001 to March 2005).

Setting General practices in Oxfordshire, England.

Participants 172 children aged 5-16 years who presented to their general practitioner with a cough lasting 14 days or more who consented to have a blood test.

Main outcome measures Serological evidence of a recent Bordetella pertussis infection; symptoms at presentation; duration and severity of cough; sleep disturbance (parents and child).

Results 64 (37.2%, 95% confidence interval 30.0% to 44.4%) children had serological evidence of a recent Bordetella pertussis infection; 55 (85.9%) of these children had been fully immunised. At presentation, children with whooping cough were more likely than others to have whooping (odds ratio 2.85, 95% confidence interval 1.39 to 5.82), vomiting (4.35, 2.04 to 9.25), and sputum production (2.39, 1.14 to 5.02). Children with whooping cough were also more likely to still be coughing two months after the start of their illness (85% v 48%; P = 0.001), continue to have more than five coughing episodes a day (P = 0.049), and cause sleep disturbance for their parents (P = 0.003).

Conclusions For school age children presenting to primary care with a cough lasting two weeks or more, a diagnosis of whooping cough should be considered even if the child has been immunised. Making a secure diagnosis of whooping cough may prevent inappropriate investigations and treatment.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Articles

Test of time

Susanna C Almond and Nick Summerton
BMJ 2009 338: b1878. [Extract] [Full Text]

Whooping cough

Anthony Harnden
BMJ 2009 338: b1772. [Extract] [Full Text]

News
BMJ 2007 334: 1186. [Extract] [Full Text] [PDF]

Whooping cough is quite common and can be diagnosed clinically

Doug Jenkinson
BMJ 2006 333: 352. [Extract] [Full Text] [PDF]

Is public health action worth while if many cases are being missed?

Peter M English
BMJ 2006 333: 304. [Extract] [Full Text]

Consider whooping cough even if a child has been immunised
BMJ 2006 333: 0. [Full Text]

Whooping cough in general practice

Chris Butler, Nick Francis, and Geert-Jan Dinant
BMJ 2006 333: 159-160. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Fry, N. K., Duncan, J., Wagner, K., Tzivra, O., Doshi, N., Litt, D. J., Crowcroft, N., Miller, E., George, R. C., Harrison, T. G. (2009). Role of PCR in the diagnosis of pertussis infection in infants: 5 years' experience of provision of a same-day real-time PCR service in England and Wales from 2002 to 2007. J Med Microbiol 58: 1023-1029 [Abstract] [Full text]  
• Almond, S. C, Summerton, N. (2009). Test of time. BMJ 338: b1878-b1878 [Full text]  
• Harnden, A. (2009). Whooping cough. BMJ 338: b1772-b1772 [Full text]  
• Shields, M D, Bush, A, Everard, M L, McKenzie, S, Primhak, R, on behalf of the British Thoracic Society Cough Gu, (2008). Recommendations for the assessment and management of cough in children. Thorax 63: iii1-iii15 [Full text]  
• Surridge, J., Segedin, E. R, Grant, C. C (2007). Pertussis requiring intensive care. Arch. Dis. Child. 92: 970-975 [Abstract] [Full text]  
• Jefferson, T (2007). Why the MRC randomized trials of whooping cough (pertussis) vaccines remain important more than half a century after they were done. JRSM 100: 343-345 [Full text]  
• (2006). Lucina. Arch. Dis. Child. 91: 1048-1048 [Full text]  
• Rathore, M. H. (2006). Persistent Cough Points to Pertussis. AAP Grand Rounds 16: 37-38 [Full text]  
• Jenkinson, D. (2006). Whooping cough is quite common and can be diagnosed clinically. BMJ 333: 352-352 [Full text]  
• (2006). Children Who Keep On Coughing. JWatch Emergency Med. 2006: 2-2 [Full text]  
• English, P. M (2006). Is public health action worth while if many cases are being missed?. BMJ 333: 304-304 [Full text]  
• Butler, C., Francis, N., Dinant, G.-J. (2006). Whooping cough in general practice. BMJ 333: 159-160 [Full text]  

Rapid Responses:

Read all Rapid Responses

Whooping cough

Ada Majd
bmj.com, 10 Jul 2006 [Full text]

whooping cough prevalance in schoolchildren

Stan Bloxham
bmj.com, 10 Jul 2006 [Full text]

Is public health action worth-while if we are we missing lots of cases?

Peter M English
bmj.com, 21 Jul 2006 [Full text]

In practice, how are we to assess this?

Mary G Gibbs, et al.
bmj.com, 22 Jul 2006 [Full text]

Persistent cough – a persisting problem.

Mark Tighe
bmj.com, 23 Jul 2006 [Full text]

What about IgM and PCR?

Mick A Tarry
bmj.com, 25 Jul 2006 [Full text]

Cohort was selected

Wilfrid Treasure
bmj.com, 27 Jul 2006 [Full text]

Whooping cough and vulnerable adults

Judith H Harvey
bmj.com, 30 Jul 2006 [Full text]

Whooping cough – adolescents and adults as preventive targets.

Patricia GM Bezerra
bmj.com, 31 Jul 2006 [Full text]

Whooping cough is quite common and can be diagnosed clinically

Doug Jenkinson
bmj.com, 31 Jul 2006 [Full text]

Online poll

Find out more >>