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Enhanced Pertussis Surveillance

Enhanced Pertussis Surveillance (EPS) builds on the existing National Notifiable Diseases Surveillance System for pertussis in seven states participating in the Emerging Infections Programs. Improved completeness and quality of data, augmented data collection, and routine isolate collection characterize EPS activities. Following the identification of a pertussis case, states complete a standardized case report form using information collected during patient and physician interviews. States collect isolates, when available, and routinely ship them to CDC for further laboratory characterization. Because the number of pertussis isolates available for laboratory characterization has declined nationally, EPS sites use various methods to increase isolate collection in their catchment areas. These methods range from establishing sentinel clinics to promoting free, centralized testing at state public health laboratories.

The primary EPS objective is to collect epidemiologic data and isolates from cases of Bordetella pertussis. However, EPS also captures case data and isolates for other Bordetella species, including B. parapertussis, B. bronchiseptica, and B. holmesii. States incorporate epidemiologic information, when available, on these other Bordetella species into the enhanced pertussis surveillance dataset and submit isolates to CDC.

ABCs encourages sites to incorporate methods to increase the yield of identified pertussis cases in the catchment area. For example, sites can encourage providers to submit specimens directly to state public health laboratories for centralized testing. Sites can also educate providers and public health personnel within the catchment area about pertussis and the goals of EPS.

Case Definition

  • Clinical Case Definition
    • In the absence of a more likely diagnosis a cough illness lasting ≥2 weeks with one of the following symptoms:
      • Paroxysms of coughing, OR
      • Inspiratory “whoop,” OR
      • Posttussive vomiting, OR
      • Apnea (with or without cyanosis) (FOR INFANTS AGED < 1 YEAR ONLY)
  • Confirmed Case
    • Acute cough illness of any duration, with isolation of B. pertussis from a clinical specimen, OR
    • A case that meets the clinical case definition AND is polymerase chain reaction (PCR) positive for pertussis, OR
    • A case that meets the clinical definition AND had contact with a laboratory-confirmed case of pertussis
  • Probable Case
    • Meets the clinical case definition, is not laboratory confirmed, and is not epidemiologically linked to a laboratory-confirmed case, OR
    • FOR INFANTS AGED < 1 YEAR ONLY:
      • Acute cough illness of any duration with at least one of the following signs or symptoms:
        • Paroxysms of coughing, OR
        • Inspiratory “whoop”, OR
        • Posttussive vomiting, OR
        • Apnea (with or without cyanosis)

        AND

      • PCR positive for pertussis, OR
    • FOR INFANTS AGED < 1 YEAR ONLY:
      • Acute cough illness of any duration with at least one of the following signs or symptoms:
        • Paroxysms of coughing, OR
        • Inspiratory “whoop”, OR
        • Posttussive vomiting, OR
        • Apnea (with or without cyanosis)

        AND

      • Contact with a laboratory-confirmed case of pertussis

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Program Objectives

  • To determine the incidence and epidemiologic characteristics of B. pertussis
  • To characterize the molecular epidemiology of circulating strains of B. pertussis
  • To determine epidemiologic and molecular characteristics of other Bordetella species (B. parapertussis, B. bronchiseptica, and B. holmesii)
  • To monitor the impact of pertussis vaccines
  • To provide an infrastructure for additional special studies including those aimed at evaluating B. pertussis prevention and control strategies

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