Incidence ofBordetella pertussisInfection in Adolescents and Adults

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Abstract
TO THE EDITOR—Ward et al. [1] analyzed serologic data from a large group of subjects who were followed-up prospectively, had known vaccination status, and were tested for all major pertussis antigens. The authors concluded that the Bordetella pertussis infection rate among 1228 subjects aged 15–65 years who had not been recently vaccinated was ∼1% over an 11-month period on the basis of significant increases in serum antibody titers to pertussis toxin (PT). The reported range in estimates (0.4%–2.7%) was based on increases in titers of antibodies to other pertussis antigens. The PT-based rate of ∼1% is at the low end of the range of PT-based incidence estimates reported in the 4 other serologic studies referenced in the article by Ward et al. [1]. These studies reported PT-based annual incidence estimates of ∼1% [2, 3], 2.2% [4], 3.3% [5], and 8% [6]. However, the studies used different sample populations, sample sizes, and laboratory methodology, all of which could influence the magnitude of the annual estimates.

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