Related Experiment Videos
Sensitivity and specificity of clinical case definitions for pertussis
P A Patriarca1, R J Biellik, G Sanden
1Division of Immunization, Centers for Disease Control, Atlanta, GA 30333.
Abstract:
We evaluated the diagnostic performance of 15 clinical case definitions for pertussis in 233 patients who developed acute respiratory illness during community outbreaks in Wisconsin and Delaware. Using results from culture (Regan-Lowe media) and serology (Ig-class-specific ELISA) as diagnostic standards, cough for greater than or equal to 14 days was both sensitive (84 per cent-92 per cent) and specific (63 percent-90 per cent) in identifying patients with pertussis. This definition may be useful in monitoring pertussis outbreaks and for investigating contacts of culture-positive cases.
Insights
Diagnosing pertussis (whooping cough) can be challenging. A cough lasting 14 days or more proved sensitive and specific for identifying pertussis during outbreaks.
Area of Science:
- Infectious Diseases
- Epidemiology
- Clinical Microbiology
Background:
- Pertussis, or whooping cough, remains a significant public health concern, particularly during community outbreaks.
- Accurate and timely diagnosis is crucial for effective disease control and patient management.
- Existing clinical case definitions for pertussis vary in their diagnostic utility.
Purpose of the Study:
- To evaluate the diagnostic performance of 15 distinct clinical case definitions for pertussis.
- To identify a reliable and practical case definition for use during pertussis outbreaks.
Main Methods:
- A cohort of 233 patients with acute respiratory illness during community outbreaks in Wisconsin and Delaware were assessed.
- Diagnostic standards included bacterial culture (Regan-Lowe media) and specific antibody serology (Ig-class-specific ELISA).
- The sensitivity and specificity of 15 different clinical case definitions were calculated.
Main Results:
- A clinical case definition of cough lasting greater than or equal to 14 days demonstrated high sensitivity (84%-92%).
- This definition also exhibited good specificity (63%-90%) in identifying pertussis cases.
- The performance was evaluated against established culture and serology diagnostic standards.
Conclusions:
- A clinical case definition of a cough lasting 14 days or more is a sensitive and specific indicator for pertussis.
- This definition can be a valuable tool for monitoring pertussis outbreaks.
- It may also aid in the investigation of contacts of culture-confirmed pertussis cases.