Recently, a moderateincrease in the prevalenceof pertussis, possibly contractedfrom adults, has
beenobserved among unvaccinated children.
During a 3-year period,we prospectively enrolled 93index patients with apolymerase chain reaction
(PCR)and/or culture result positivefor
Bordetella pertussis. Among 63household contacts of
28index patients, PCR andculture for B.
pertussis identified25 B. pertussispositive persons. Nineteenof 25 B.
pertussispositive household
contacts were asymptomatic. Isolateswere available from
10families of both indexpatients and
household contactsfor molecular typing by
pulsed-field gel electrophoresis (PFGE)and for
genotyping ofpertactin and pertussis toxinby
sequence-specific PCR andsequencing. PFGE demonstrated
homogeneityamong the isolates recoveredfrom
within each familybut heterogeneity among the
isolates recovered from differentfamilies. B.
pertussis isolates recoveredfrom index patients andtheir household contacts wereindistinguishable by
molecular typing,demonstrating that identical strainscan cause full pertussisdisease in children andasymptomatic infection in adultsand adolescents.
Received 31 October 2002; accepted 6 February 2003;
electronically published 21 May 2003.
Financial support: Onderzoeksraad,Vrije
Universiteit Brussel, Brussels,Belgium (grant 624).
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