Fuente de infección de Bordetella pertussis en lactantes hospitalizados por coqueluche / Source of infection in young infants hospitalized with Bordetella pertussis

Background: Despite pertussis vaccination, very young infants have the highest rates of morbidity and mortality caused by the microorganism. Aim: To determine the source of Pertussis infection in infants aged six months or less in Chile. Material and Methods: Twenty six household contacts of 10 young infants hospitalized with confirmed Pertussis were studied for the presence of Bordetella Pertussis by polyme-rase chain reaction (PCR). Clinical and demographic data were analyzed. Results: Respiratory symptoms were present in 20 (77 percent) contacts, being cough the most common. Pertussis cases were identifed in every household and in 18 (72 percent) of the household members. four members with B.pertussis were asymptomatic. Source of infection was identifed in 80 percent (8/10) of the infant cases with ages ranging from 6 to 62 years. Half of primary cases had positive PCR and their cough duration was significantly shorter compared to primary cases with negative PCR. Conclusions: B. pertussis transmission to young infants occurred mainly within the household where adults are generally the source of the infection. Risk factors for infant infection are the same as in developed countries. Therefore, the same strategies, such as routine vaccination in adolescents and adults or cocoon strategy, will help to prevent this disease in infants.

Coqueluche em paciente adulto: relato de caso e revisão da literatura / Pertussis in adult patient: case report and literature review

Relato de caso de coqueluche em adulto de 55 anos, diagnosticado pelo quadro clínico compatível, pela cultura e reação em cadeia da polimerase (PCR) de material coletado com swab alginatado do nasofaringe. Conclui-se, após revisão da literatura médica, que este caso serve de alerta para o fato de que a proteção vacinal da infância se perde após alguns anos, sendo importantes os reforços durante a idade adulta, já que esta é uma doença considerada reemergente, que provoca grande sofrimento e complicações sérias, principalmente em adultos e nas crianças pequenas

Care report of a 55 years old patient diagnosed with pertussis by a consistent clinical picture and by culture and polymerase chain reaction (PCR) in material collected with alginate swabs from the nasopharynx. It is concluded, after a literature review, that this case is an alert to the fact that childhood vaccinal protection wears off after a few years, and reinforcements in adulthood are important, as this is considered a re-emerging disease that causes great suffering and serious complications, especially in adults and young children

Infección por Bordetella pertussis: una causa emergente de tos prolongada en adolescentes y adultos / Bordetella pertussis infection: an emerging cause of prolonged cough illness in adolescents and adults

Whooping cough is increasingly recognized as a cause of prolonged cough illness in adolescents and adults. Systematic vaccination has changed its epidemiology, with the majority of cases now primarily affecting adolescents and adults. A 45-year-old female, active smoker, nurse, who works in a dialysis service, presented with a 6-week history of bothersome cough and malaise. Thorax x-ray was normal and direct immunofuorescence of nasopharyngeal swab was positive for Bordetella pertussis. This case illustrates pertussis infection in adulthood. We review the main causes of chronic cough in adults: asthma, chronic rhinosinusitis and gastroesophageal refux; the clinical features, prevalence, diagnostic tools, and management of adult patients with B. pertussis infection to increase awareness of this highly contagious disease.

La tos convulsiva o coqueluche está siendo reconocida cada vez con mayor frecuencia como causa de tos prolongada en adolescentes y adultos. La vacunación sistemática de la población pediátrica ha determinado un cambio en el perfl epidemiológico de la enfermedad, aumentando su prevalencia en la población adulta. Se presenta el caso clínico de una paciente de 45 años, fumadora, enfermera de unidad de hemodiálisis, que consulta por malestar general y tos seca de seis semanas de evolución. La radiografía de tórax era normal y la inmunofuorescencia directa de hisopado nasofaríngeo fue positiva para Bordetella pertussis. A propósito de este caso clínico, revisamos las principales causas de tos crónica: asma bronquial, enfermedad rinosinusal y refujo gastroesofágico; el cuadro clínico, evaluación diagnóstica y tratamiento de la infección por B. pertussis en población adulta.