Increased risk of pertussis in patients with asthma

Conrad R. Capili, Allison Hettinger, Natalie Rigelman-Hedberg, Lisa Fink, Thomas Boyce, Brian Lahr, Young J Juhn

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)957-963
Number of pages7
JournalJournal of Allergy and Clinical Immunology
Volume129
Issue number4
DOIs
StatePublished - Apr 2012

Fingerprint

Whooping Cough
Asthma
Disease Outbreaks
Diphtheria-Tetanus-acellular Pertussis Vaccines
Diphtheria
Tetanus
Population
Medical Records
Case-Control Studies
Vaccination
Vaccines
Public Health
Logistic Models

Keywords

  • adolescents
  • Asthma
  • Bordetella pertussis
  • children
  • epidemiology
  • immunity
  • outbreak
  • population
  • risk
  • susceptibility

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

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. https://doi.org/10.1016/j.jaci.2011.11.020

Increased risk of pertussis in patients with asthma. / Capili, Conrad R.; Hettinger, Allison; Rigelman-Hedberg, Natalie; Fink, Lisa; Boyce, Thomas; Lahr, Brian; Juhn, Young J.

In: Journal of Allergy and Clinical Immunology, Vol. 129, No. 4, 04.2012, p. 957-963.

Research output: Contribution to journalArticle

Capili, CR, Hettinger, A, Rigelman-Hedberg, N, Fink, L, Boyce, T, Lahr, B & Juhn, YJ 2012, 'Increased risk of pertussis in patients with asthma', Journal of Allergy and Clinical Immunology, vol. 129, no. 4, pp. 957-963. https://doi.org/10.1016/j.jaci.2011.11.020
Capili CR, Hettinger A, Rigelman-Hedberg N, Fink L, Boyce T, Lahr B et al. Increased risk of pertussis in patients with asthma. Journal of Allergy and Clinical Immunology. 2012 Apr;129(4):957-963. https://doi.org/10.1016/j.jaci.2011.11.020
Capili, Conrad R. ; Hettinger, Allison ; Rigelman-Hedberg, Natalie ; Fink, Lisa ; Boyce, Thomas ; Lahr, Brian ; Juhn, Young J. / Increased risk of pertussis in patients with asthma. In: Journal of Allergy and Clinical Immunology. 2012 ; Vol. 129, No. 4. pp. 957-963.
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abstract = "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.",
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