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GPs should be considered for pertussis vaccination, say researchers

Pertussis infection is a frequent cause of persistent cough in patients presenting in primary care, raising the question whether GPs should be immunised against infection, say researchers.

The small study took oral swabs from all patients presenting to their GP with a persistent cough for two weeks or more and found 10% had a current pertussis infection.

They also found 22% of the adults with acute persistent cough worked with in the health sector.

The study – published in this month’s edition of the British Journal of General Practice – looked at 226 patients with chronic cough and asked them to complete a questionnaire and complete a cough diary as part of the investigation.

Pertussis infection was then determined by measuring the concentration of IgG antibodies to the pertussis toxin from an oral swab.

The researchers from the University of Auckland in New Zealand found that the frequency of B. pertussis infection in adults working in the health sector was three times higher than for other adults.

They concluded: ‘This highlights the need both for access to high quality laboratory testing from primary care, and for the consideration of other immunisation strategies such as cocooning for population subgroups more likely to come in contact with young infants.’

The Joint Committee on Vaccination and Immunisation recently recommended healthcare workers caring for preterm and young infants should be immunised against whooping cough, yet ‘the limited supplies of vaccine priority had been given to the immunisation programme for pregnant women, so that suggestion could not currently be taken forward’.

Dr Anthony Harnden, chair of the adolescent sub-committee of the JCVI and a GP in Oxford, said: ‘The data in this NZ study are consistent with our understanding that neither natural infection nor vaccination offer life-long immunity against pertussis.

‘Extension of the UK immunisation schedule to include an adolescent booster is under review.’