Increased risk of pertussis in patients with asthma

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Background: The recent pertussis outbreak in California highlights the effect of pertussis on public health. In 2004, a pertussis outbreak occurred in Olmsted County, Minnesota, despite a high vaccine uptake. This outbreak provided a natural experiment to assess the relationship between asthma and pertussis. Objective: We sought to determine whether asthmatic subjects have a higher risk of pertussis than nonasthmatic subjects. Methods: We conducted a population-based case-control study. There were 223 pertussis cases identified by means of PCR in 2004 and 2005. We identified age- and sex-matched control subjects from 5537 patients with negative test results for pertussis. We conducted a comprehensive medical record review and applied predetermined criteria to ascertain asthma status. Conditional logistic regression was fit to assess the effect of asthma status on the risk of pertussis. Results: Of the 223 subjects, 164 were eligible for the study, and 328 matched control subjects (1:2 matching) were enrolled. Of these 164 subjects, 50% were male, and 82% were white. The median age at the index date of pertussis was 14 years. Sixty-two (38%) of the 164 cases had asthma before the index date of pertussis compared with 85 (26%) of the 328 control subjects (odds ratio, 1.73; 95% CI, 1.12-2.67; P =.013). The population attributable risk percentage of asthma for risk of pertussis was 17%. Conclusions: Given the high prevalence of asthma and the ongoing risk of pertussis throughout the United States, consideration of defining asthmatic subjects as a target group for pertussis vaccination (eg, replacing decennial tetanus-diphtheria booster with tetanus, diphtheria, and acellular pertussis vaccine for adolescents and adults) should be given. © 2012 American Academy of Allergy, Asthma & Immunology.




Capili, C. R., Hettinger, A., Rigelman-Hedberg, N., Fink, L., Boyce, T., Lahr, B., & Juhn, Y. J. (2012). Increased risk of pertussis in patients with asthma. Journal of Allergy and Clinical Immunology, 129(4), 957–963.

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