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Updated: Jun 2, 2026

Remote Laboratory Management: Respiratory Virus Diagnostics
Published on: April 6, 2019
Outbreak of pertussis in a university laboratory
Naoyuki Miyashita1, Yasuhiro Kawai, Tetsuya Yamaguchi
1Department of Internal Medicine 1, Kawasaki Medical School, Japan. nao@med.kawasaki-m.ac.jp
Objective:
Analysis of an outbreak of Bordetella pertussis infection in a university laboratory. To prevent and control the outbreak, we conducted a survey of the laboratory staff and their family members, and we investigated the clinical features of adult pertussis.
Patients And Methods:
During the outbreak, four out of the 10 laboratory staff and five out of 16 family members had a primary complaint of cough. Seven of nine patients were diagnosed as definitive B. pertussis infection using serology and PCR.
Results:
Clinical findings and laboratory data in adult patients with B. pertussis infection demonstrated non-specific cough and normal WBC and lymphocyte count. The patients who received clarithromycin prior to 14 days after clinical onset demonstrated a shorter duration of cough symptoms than patients who received clarithromycin at 14 days or more after clinical onset (duration of cough after administration of clarithromycin: 17.8 ± 6.48 days versus 35.3 ± 5.38 days; duration of total cough after clinical onset: 24.8 ± 6.65 days versus 56.8 ± 6.50 days).
Conclusion:
The clinical findings of adult pertussis are different from pertussis in children. The efficacy of macrolide therapy clearly differed between the catarrhal phase and paroxysmal phase. Physicians should consider B. pertussis in the differential diagnosis of an outbreak of non-specific respiratory infection even in adult populations.
Insights
An outbreak of Bordetella pertussis occurred in a university lab. Early macrolide treatment significantly shortened cough duration in adults, differing from pediatric pertussis symptoms.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Pertussis, caused by Bordetella pertussis, can present atypically in adults.
- Outbreaks in institutional settings necessitate rapid identification and control measures.
Purpose of the Study:
- To analyze a Bordetella pertussis outbreak in a university laboratory.
- To investigate the clinical characteristics of pertussis in adults.
- To evaluate the effectiveness of early antibiotic intervention.
Main Methods:
- Case identification through symptom surveys and contact tracing.
- Diagnostic confirmation using serology and Polymerase Chain Reaction (PCR).
- Retrospective analysis of clinical data and treatment outcomes.
Main Results:
- Seven out of nine suspected cases were confirmed as B. pertussis.
- Adult patients exhibited non-specific cough and normal white blood cell counts.
- Early clarithromycin treatment (before 14 days of onset) significantly reduced cough duration compared to later treatment.
Conclusions:
- Adult pertussis clinical presentation differs from that in children.
- Macrolide therapy is more effective when initiated during the catarrhal phase.
- Bordetella pertussis should be considered in adult respiratory infections, especially during outbreaks.
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