A boarding school outbreak of pertussis in adolescents: value of laboratory diagnostic methods
| Autor: | Gwendolyn L. Gilbert, M. Staff, C.R. MacIntyre, Cathy Bennett, L. G. Heron, Peter McIntyre, Peter Horby, M. Cagney, M. Hanlon |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
DNA
Bacterial Male Bordetella pertussis medicine.medical_specialty Adolescent Epidemiology Whooping Cough Pertussis toxin Asymptomatic Polymerase Chain Reaction Sensitivity and Specificity Serology Disease Outbreaks Reference Values Internal medicine Medicine Humans Serologic Tests Whooping cough Schools biology business.industry Outbreak biology.organism_classification medicine.disease Antibodies Bacterial Case definition Immunoglobulin A Vaccination Infectious Diseases Case-Control Studies Immunoglobulin G Immunology medicine.symptom business Research Article |
| Popis: | 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 |
| Databáze: | OpenAIRE |
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