Knowledge, attitude, and practices with regard to adult pertussis vaccine booster in travelers.

Introduction: Pertussis is a worldwide, highly communicable, vaccine-preventable respiratory disease and is a frequent but often underestimated cause of prolonged cough illness in adults. Immunity from childhood pertussis immunization is thought to last only up to 10 years. The incidence of adult pertussis has been estimated to be 200 to 500 per 100,000 persons-years. Acellular pertussis vaccines have been evaluated in adults and confer safe and effective protection and now exist as combination vaccine together with tetanus and diphtheria.

Methods: We did a questionnaire survey to assess the knowledge, attitude, and practices toward pertussis in adult travelers. We consecutively enrolled all travelers who presented at the Travellers' Health & Vaccination Centre in Singapore in 1 month.

Results: Of 218 consecutively enrolled travelers, 184 (84.4%) completed the questionnaire; of which 80% were Singaporeans. Seventy persons (38%) did not know or gave a wrong answer for the mode of transmission of pertussis, 147 (83%) had never heard of a pertussis vaccine for adults, and almost none had received an adult pertussis vaccine booster. Travelers from Western countries were seven times [95% confidence interval (CI): 2-27] more likely than Asians to have knowledge about pertussis; women were 4.27 times (95% CI: 1.59-11.53) more likely than men to be aware of the booster vaccine, after adjusting for nationality ( p= 0.004).

Conclusions: Knowledge about pertussis was poor among adult travelers. Although pertussis was viewed as a serious illness by the majority of participants, and 38% expressed the desire to be vaccinated, almost no one had received the pertussis vaccine booster. Awareness about pertussis, its risks, and prevention via vaccination need to be increased among adult travelers. Studies are needed to quantify the risk of pertussis in adult travelers.