MMWR

Morbidity and Mortality Weekly Report

Outbreaks of Respiratory Illness Mistakenly Attributed to Pertussis — New Hampshire, Massachusetts, and Tennessee, 2004–2006

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Culture for Bordetella pertussis should be routinely used as part of investigations of outbreaks that are suspected to be pertussis. Pertussis is a serious cough illness that can be fatal in infants. Pertussis is highly contagious, and waning vaccine-induced immunity in adolescents and adults may facilitate its spread. Pertussis outbreaks can occur, and may require significant investment of public health resources to control. However, not all outbreaks of cough illness are pertussis. Further, diagnostic testing for pertussis is problematic. As in the instances in this MMWR, overreliance on pertussis PCR testing during a suspected pertussis outbreak may lead to implementation of unnecessary control measures. Epidemiologic, clinical and laboratory factors should all be considered when responding to outbreaks of cough illness, and culture-confirmation of Bordetella pertussis, the cause of pertussis, is important for confirming pertussis as the cause of outbreaks of cough illness.

Norovirus Activity — United States, 2006–2007

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You can decrease your chance of coming in contact with noroviruses by frequently washing your hands, especially after toilet visits, and by thoroughly cleaning and disinfecting contaminated surfaces immediately after an episode of illness using a bleach-based household cleaner. During late 2006 and early 2007 there was a widespread increase in the frequency of outbreaks and emergency room visits for vomiting and diarrhea in the United States. This increase was associated with the emergence of two new norovirus strains, named Minerva and Laurens. A large proportion of these outbreaks occurred among residents of long-term care facilities, a population which suffers higher morbidity from gastroenteritis than non-institutionalized populations. Deaths were also reported in association with norovirus outbreaks in long-term-care facilities providing evidence that norovirus illness may be associated with mortality in this vulnerable group.