Outbreaks of Respiratory Illness Mistakenly Attributed to Pertussis — New Hampshire, Massachusetts, and Tennessee, 2004–2006

Pertussis, or whooping cough, is a highly infectious, nationally notifiable respiratory disease associated with prolonged cough illness and paroxysms of coughing, inspiratory "whoop," or posttussive vomiting. Reported pertussis cases have tripled in the United States since 2001, with 25,61...

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Bibliographic Details
Published in:	MMWR. Morbidity and mortality weekly report Vol. 56; no. 33; pp. 837 - 842
Main Authors:	Kirkland, K.B, Talbot, E.A, Lasky, R.A, McLellan, R.K, Montero, J.T, Barry, M.A, McCarthy, T.A, Gunn, J.E, Pendarvis, J.L, Han, L.L, Devasia, R.A, Edwards, K.M, Jones, T.F, Kretsinger, K, Tondella, M.L, Tatti, K.M, Brown, K.H, Slade, B.A, Wu, K-H, Lu, X, Patel, M
Format:	Journal Article Newsletter
Language:	English
Published:	United States Centers for Disease Control and Prevention 24-08-2007 U.S. Government Printing Office
Subjects:	Bordetella - isolation & purification Bordetella pertussis Community-Acquired Infections Cough Cross Infection Development and progression Diagnosis, Differential Diagnostic Errors Disease Outbreaks Diseases Dosage and administration DPT vaccine Epidemiology Evaluation Humans Massachusetts - epidemiology New Hampshire - epidemiology Notifiable diseases Polymerase Chain Reaction Prevention Public health Respiratory Tract Diseases - diagnosis Respiratory Tract Diseases - epidemiology Statistics Symptoms Tennessee - epidemiology Vaccination Whooping cough Whooping Cough - diagnosis Whooping Cough - epidemiology Massachusetts Tennessee New Hampshire United States
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Summary:	Pertussis, or whooping cough, is a highly infectious, nationally notifiable respiratory disease associated with prolonged cough illness and paroxysms of coughing, inspiratory "whoop," or posttussive vomiting. Reported pertussis cases have tripled in the United States since 2001, with 25,616 probable or confirmed cases reported in 2005. This increase has been attributed to increased circulation of Bordetella pertussis, waning vaccine-induced immunity among adults and adolescents, heightened awareness of pertussis among health-care providers, increased public health reporting, and increased use of polymerase chain reaction (PCR) testing for diagnosis. To minimize the spread of pertussis, control measures must be implemented early in the course of illness when the risk for transmission is highest. However, diagnosis of pertussis is complicated by nonspecific signs and symptoms, particularly in the early catarrhal stage of disease. In addition, the lack of rapid, sensitive, and specific laboratory tests makes early and accurate identification of pertussis challenging. This report describes two hospital outbreaks and one community outbreak of respiratory illness during 2004-2006 in New Hampshire, Massachusetts, and Tennessee that were attributed initially to pertussis. However, subsequent investigations revealed negative or equivocal laboratory results and epidemiologic and clinical features atypical of pertussis, suggesting that pertussis was not the cause of these outbreaks. The findings in this report underscore the need for thorough epidemiologic and laboratory investigation of suspected pertussis outbreaks when considering extensive control measures.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0149-2195 1545-861X