Oral fluid testing for pertussis, England and wales, june 2007-august 2009

Area of Science:

• * Public Health
• * Epidemiology
• * Infectious Diseases

Background:

• * Current pertussis (whooping cough) surveillance systems often miss less severe infections in older children and adults.
• * Improved diagnostic methods are needed to accurately capture the full spectrum of pertussis epidemiology.

Purpose of the Study:

• * To evaluate the effectiveness of oral fluid testing for routine follow-up of clinically diagnosed pertussis cases.
• * To assess the impact of oral fluid testing on overall pertussis ascertainment and case identification.

Main Methods:

• * Pilot study conducted in England and Wales from June 2007 to August 2009.
• * Oral fluid testing was used for routine follow-up of notified, nonconfirmed, clinically diagnosed pertussis cases.
• * Comparison of case ascertainment with established laboratory methods and serologic testing.

Main Results:

• * Oral fluid testing confirmed an additional 591 pertussis cases, increasing laboratory ascertainment by 32% overall.
• * A maximal increase of 124% in case detection was observed among children aged 5-9 years.
• * Cases confirmed by oral fluid testing were less likely to be hospitalized, indicating detection of milder community cases.

Conclusions:

• * Oral fluid testing is a valuable, noninvasive tool for enhancing pertussis surveillance.
• * This method improves the identification of pertussis cases, particularly milder infections.
• * Findings support the use of oral fluid testing to inform pertussis vaccination strategies.