Openly accessible

A boarding school outbreak of pertussis in adolescents : value of laboratory diagnostic methods

Horby, P., Macintyre, C. R., McIntyre, P. B., Gilbert, G. L., Staff, M., Hanlon, M., Heron, L. G., Cagney, M. and Bennett, C. M. 2005, A boarding school outbreak of pertussis in adolescents : value of laboratory diagnostic methods, Epidemiology and infection, vol. 133, no. 2, pp. 229-236.

Attached Files
Name Description MIMEType Size Downloads
bennett-aboardingschool-2005.pdf Published version application/pdf 134.53KB 87

Title A boarding school outbreak of pertussis in adolescents : value of laboratory diagnostic methods
Author(s) Horby, P.
Macintyre, C. R.
McIntyre, P. B.
Gilbert, G. L.
Staff, M.
Hanlon, M.
Heron, L. G.
Cagney, M.
Bennett, C. M.
Journal name Epidemiology and infection
Volume number 133
Issue number 2
Start page 229
End page 236
Publisher Cambridge University Press
Place of publication Cambridge, England
Publication date 2005-04
ISSN 0950-2688
1469-4409
Summary Culture for Bordetella pertussis (B. pertussis) is the traditional gold standard for laboratory diagnosis of pertussis but is insensitive, especially later in the course of illness and in vaccinated persons. Interpretation of serology is limited by the lack of an appropriate reference standard. An outbreak of pertussis in a crowded boarding-school dormitory allowed evaluation of laboratory correlates of infection. Questionnaires, serum samples and throat swabs were collected from members of the exposed group. Serum samples from unexposed controls of a similar age group were used for comparison. B. pertussis PCR was performed on throat swabs, and sera were tested for IgA antibodies against whole-cell (WC) B. pertussis antigen and IgG antibodies to pertussis toxin (PT). The Centers for Disease Control and Prevention definition for pertussis was used to define clinical cases. We evaluated the use of a previously published cut-off for PT IgG of 125 EIA units (EU)/ml. Completed questionnaires were obtained from 115 students, of whom 85 (74%) reported coughing symptoms, including 32 (28%) who met the clinical case definition for pertussis. B. pertussis was detected by PCR in 17 (15%) and WC IgA in 22 (19%) students; neither correlated with symptoms, but dormitory of residence strongly predicted PCR status. The mean PT IgG geometric mean concentration, in this situation of high pertussis exposure, correlated with severity of symptoms and was significantly higher in both symptomatic and asymptomatic children exposed during the outbreak (P<0·001) than in control children. A cut-off for PT IgG of 125 EU/ml was too high in an outbreak situation to be sensitive enough to identify pertussis cases. A case of pertussis in a crowded boarding-school dormitory resulted rapidly in an outbreak. Serology and PCR were useful in identifying the outbreak and commencing disease control measures. The use of serology has mostly been evaluated in community serosurveys, where it is not possible to determine if immunity reflects vaccination, asymptomatic disease or symptomatic disease. This outbreak gave us the opportunity to evaluate the value of serology and PCR in the presence of confirmed exposure to pertussis.
Notes Reproduced with the specific permission of the copyright owner.
Language eng
Field of Research 111799 Public Health and Health Services not elsewhere classified
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2004, Cambridge University Press
Persistent URL http://hdl.handle.net/10536/DRO/DU:30021964

Connect to link resolver
 
Unless expressly stated otherwise, the copyright for items in DRO is owned by the author, with all rights reserved.

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.

Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 19 times in TR Web of Science
Scopus Citation Count Cited 19 times in Scopus
Google Scholar Search Google Scholar
Access Statistics: 470 Abstract Views, 87 File Downloads  -  Detailed Statistics
Created: Mon, 18 Jan 2010, 11:02:31 EST

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.