Pertussis (Bordetella pertussis) (Whooping Cough)

1995 Case Definition

Clinical case definition

A cough illness lasting at least 2 weeks with one of the following: paroxysms of coughing, inspiratory "whoop," or post-tussive vomiting, without other apparent cause (as reported by a health professional)

Laboratory criteria for diagnosis

Case classification

Probable: meets the clinical case definition, is not laboratory confirmed, and is not epidemiologically linked to a laboratory-confirmed case

Confirmed: a case that is laboratory confirmed or that meets the clinical case definition and is epidemiologically linked to a laboratory-confirmed case. A laboratory confirmed case in a person who has cough does not need to meet the clinical case definition.

Comment

The clinical case definition above is appropriate for endemic or sporadic cases. In outbreak settings, a case may be defined as a cough illness lasting at least 2 weeks (as reported by a health professional). Because direct fluorescent antibody testing of nasopharyngeal secretions has been demonstrated in some studies to have low sensitivity and variable specificity (9,10), such testing should not be relied on as a criterion for laboratory confirmation. Serologic testing for pertussis is available in some areas but is not standardized and, therefore, should not be relied on as a criterion for laboratory confirmation. Both probable and confirmed cases should be reported nationally.

References

  9. Broome CV, Fraser DW, English WJ. Pertussis--diagnostic methods and surveillance. In: Manclark CR, Hill JC, eds. International Symposium on Pertussis. Bethesda, MD: US Department of Health, Education, and Welfare, Public Health Service, National Institutes of Health, 1979; DHEW publication no. (NIH)79-1830:19-22.

10. Halperin SA, Bortolussi R, Wort AJ. Evaluation of culture, immunofluorescence, and serology for the diagnosis of pertussis. J Clin Microbiol 1989;27:752-7.

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