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Pertussis / Whooping Cough (Bordetella pertussis)

1997 Case Definition Revised May 2, 1997

Clinical Description

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

  • Isolation of Bordetella pertussis from clinical specimen
  • Polymerase chain reaction (PCR) positive for pertussis

Case Classification

Probable

In the absence of a more likely diagnosis, a cough illness lasting ≥2 weeks, with at least one of the following symptoms:
  • Paroxysms of coughing, OR
  • Inspiratory "whoop", OR
  • Post-tussive vomiting; AND
  • Absence of laboratory confirmation, AND
  • No epidemiologic linkage to a laboratory-confirmed case of pertussis

Confirmed

  • Acute cough illness of any duration, with isolation of Bordetella pertussis from a clinical specimen, OR
  • Cough illness lasting ≥2 weeks, with at least one of the following symptoms:
    • Paroxysms of coughing, OR
    • Inspiratory "whoop", OR
    • Post-tussive vomiting
AND, at least one of the following
  • Polymerase chain reaction (PCR) positive for pertussis, OR
  • Contact with a laboratory-confirmed case of pertussis

Comments

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, such testing should not be relied on as a criterion for laboratory confirmation1, 2. 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.

The 19973 case definition appearing on this page was re-published in the 2009 CSTE position statement 09-ID-51. Thus, the 1997 and 2010 versions of the case definition are identical.

In 2010, the wording of the case classification was reformatted for clarification, but does not represent any substantive change to the case definition.

Reference(s)

  1. 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.
  2. Halperin SA, Bortolussi R, Wort AJ. Evaluation of culture, immunofluorescence, and serology for the diagnosis of pertussis. J Clin Microbiol 1989;27:752-7.
  3. CDC. (1997). Case Definitions for Infectious Conditions Under Public Health Surveillance. MMWR, 46(RR-10), 1-55. http://www.cdc.gov/mmwr/preview/mmwrhtml/00047449.htm

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