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Pertussis (Whooping Cough) (Bordetella pertussis)
2020 Case Definition

NOTE: A surveillance case definition is a set of uniform criteria used to define a disease for public health surveillance. Surveillance case definitions enable public health officials to classify and count cases consistently across reporting jurisdictions. Surveillance case definitions are not intended to be used by healthcare providers for making a clinical diagnosis or determining how to meet an individual patient’s health needs.

CSTE Position Statement(s)

  • 19-ID-08

Background

Bordetella pertussis is among the most poorly controlled bacterial vaccine-preventable diseases in the U.S. Pertussis vaccine was introduced in the 1940s, and the routine childhood immunization program has resulted in substantial reductions of disease. However, the number of reported pertussis cases has increased steadily since the late 1980s, with a considerable resurgence observed over the last 10 years. The most notable peak was in 2012 when more than 48,000 cases and 18 deaths were reported, the largest number of cases in the U.S. since the mid-1950s. Significant numbers of cases were also reported in 2004, 2010 and 2014, ranging from 25,000–32,000 cases. Reasons for the increase in reported disease are likely multifactorial, with improved provider recognition and reporting of pertussis disease, changing diagnostic practices, molecular changes in the organism, and waning immunity from acellular pertussis vaccines potentially responsible.

Clinical Criteria

In the absence of a more likely diagnosis, a cough illness lasting ≥2 weeks, with at least one of the following signs or symptoms:

  • Paroxysms of coughing; OR
  • Inspiratory whoop; OR
  • Post-tussive vomiting; OR
  • Apnea (with or without cyanosis)

Laboratory Criteria

Confirmatory laboratory evidence:

  • Isolation of B. pertussis from a clinical specimen
  • Positive Polymerase Chain Reaction (PCR) for B. pertussis

Epidemiologic Linkage

  • Contact with a laboratory-confirmed case of pertussis

Case Classification

Probable

  • In the absence of a more likely diagnosis, illness meeting the clinical criteria
OR
  • Illness with cough of any duration, with
    • At least one of the following signs or symptoms:
      • Paroxysms of coughing; or
      • Inspiratory whoop; or
      • Post-tussive vomiting; or
      • Apnea (with or without cyanosis)
    AND
    • Contact with a laboratory confirmed case (epidemiologic linkage)

Confirmed

Acute cough illness of any duration, with

  • Isolation of B. pertussis from a clinical specimen OR
  • PCR positive for B. pertussis



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