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Pertussis / Whooping Cough (Bordetella pertussis)
1996 Case Definition

Clinical Description

A cough illness lasting greater than or equal to 2 weeks with one of the following: paroxysms of coughing, inspiratory "whoop," or post-tussive vomiting, without other apparent cause

Laboratory Criteria for Diagnosis

  • Isolation of Bordetella pertussis from clinical specimen, OR
  • Positive polymerase chain reaction for B. pertussis

Case Classification

Probable

A case that 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 one that meets the clinical case definition and is either laboratory confirmed or epidemiologically linked to a laboratory-confirmed case

Comments

The clinical case definition is appropriate for endemic or sporadic cases. In outbreak settings, a case may be defined as a cough illness lasting greater than or equal to 2 weeks. Because some studies have documented that direct fluorescent antibody testing of nasopharyngeal secretions has low sensitivity and variable specificity, it 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 for national reporting purposes. Both probable and confirmed cases should be reported to NNDSS.

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.


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