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Defining pertussis epidemiology: clinical, microbiologic and serologic perspectives
James D Cherry1, Emmanuel Grimprel, Nicole Guiso
1David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA. jcherry@mednet.ucla.edu
The Pediatric Infectious Disease Journal
|May 7, 2005
Summary
Pertussis (whooping cough) is rising in vaccinated populations, especially among adults and adolescents who spread it to infants. Better diagnosis and standardized definitions are needed.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Background:
- Pertussis (whooping cough) incidence is increasing in highly immunized populations.
- Adolescents and adults are now the primary source of pertussis infection for infants.
- Underdiagnosis is common in adults due to varied symptoms and low physician suspicion.
Purpose of the Study:
- To highlight challenges in pertussis epidemiology and diagnosis.
- To advocate for standardized clinical case definitions.
- To recommend improved laboratory diagnostic methods.
Main Methods:
- Review of pertussis epidemiology and diagnostic challenges.
- Analysis of limitations in current case definitions (WHO, CDC).
- Evaluation of laboratory diagnostic test performance and availability.
Main Results:
- Reported pertussis cases underestimate actual infections.
- Inconsistent case definitions hinder global comparisons.
- Suboptimal laboratory tests limit accurate Bordetella pertussis confirmation.
Conclusions:
- Standardized clinical case definitions are crucial for outbreak and endemic settings.
- Widespread implementation of rapid, accessible diagnostic techniques is necessary.
- Polymerase chain reaction and single serum serology should be more widely adopted.