Ulrich Heininger, MD
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Heininger U. Uncomplicated Acute Bronchitis. Ann Intern Med. 2001;135:839. doi: 10.7326/0003-4819-135-9-200111060-00015
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Published: Ann Intern Med. 2001;135(9):839.
TO THE EDITOR:
I would like to comment on the pertussis section of the interesting article by Gonzales and Sande (1) on uncomplicated acute bronchitis. When discussing the role of Bordetella pertussis (and B. parapertussis) as a cause of uncomplicated acute bronchitis, the authors cite a paper from 1985 (2) to claim that “immunity after natural infection with pertussis appears to be lifelong.” This view is not valid anymore. My group performed a large pertussis vaccine efficacy trial in infants in Germany from 1991 to 1994 (3). We had the opportunity to study B. pertussis infections in 64 adult household members (4). To our surprise, approximately 50% had a history of pertussis, and serologic data suggested previous pertussis in 100%. This led us to conclude that the widely held belief that infection with B. pertussis confers lifelong immunity is probably wrong. In the meantime, our view has been substantiated by numerous similar observations of other groups. It is important to note that evidence of previous pertussis by history or serologic examination does not rule out B. pertussis as the cause of a cough illness and should not lead to withholding specific diagnostic tests. I believe that this information is useful to anyone caring for adolescents and adults with cough illnesses.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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