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 journalArticlepeer-review

53 Scopus citations


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
Issue number4
StatePublished - Apr 2012


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

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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