Pertussis in adults.

A survey was conducted of 89 households in each of which at least one patient with culture-confirmed pertussis had been detected. The source of infection was found to be an adult in 10 (11.2%) of the 89 households, and the rate of secondary attack was 19 (10.3%) of 185. Furthermore, a laboratory study disclosed 17 adults with subclinical pertussis; the subclinical infection rate was 17 (25.0%) of 68. When compared with pertussis in young children, the adult illness was generally less severe and had different clinical features. Adult pertussis showed neither leukocytosis nor lymphocytosis, but it produced anti-pertussis toxin antibody more quickly and higher levels of anti-filamentous hemagglutinin and agglutinin antibodies, and showed stronger growth inhibition of Bordetella pertussis. Although adult pertussis is usually unrecognized because of its different clinical and laboratory features, it is a significant health threat that requires some measures for disease control.