Criteria
Diagnostic criteria for clinically suspected and confirmed cases of pertussis
Case definitions for pertussis, primarily used for surveillance and reporting, have been developed in several countries. US, UK, and World Health Organization case definitions are similar and are based on clinical and laboratory criteria and epidemiologic linkage with a laboratory-confirmed case.[24][31][32]
Centers for Disease Control and Prevention case definition[31]
The US Centers for Disease Control defines probable cases as:
Illness meeting clinical criteria (cough lasting ≥2 weeks with at least either paroxysms of coughing, inspiratory whoop, posttussive vomiting, or apnea with or without cyanosis) without a more likely cause; or
Illness with cough of any duration and at least either paroxysms of coughing, inspiratory whoop, posttussive vomiting, or apnea with or without cyanosis, and contact with a laboratory-confirmed case.
Confirmed cases are those with a cough of any duration and isolation of Bordetella pertussis from a clinical specimen or a positive B pertussis nucleic amplification assay.
UK Health Security Agency (formerly Public Health England) case definition[24]
The UK defines suspected cases as:
Cough lasting ≥2 weeks in a person of any age with at least either paroxysms of coughing, inspiratory whoop, or posttussive vomiting, without a more likely cause; or
Clinical suspicion of pertussis.
Confirmed cases are those with signs and symptoms consistent with pertussis and laboratory confirmation (isolation of B pertussis from a clinical specimen, a positive B pertussis nucleic amplification assay, or elevated immunoglobulin G [IgG] antibodies to pertussis toxin [at least 1 year after last vaccine dose]) or close contact with a laboratory-confirmed case.
World Health Organization (WHO) case definition[32]
The WHO defines suspected cases as:
Cough lasting ≥2 weeks in a person of any age (or of any duration in an infant or any person in an outbreak setting), with at least either paroxysms of coughing, inspiratory whoop, posttussive vomiting, or apnea (only in patients <1 year old) without a more likely cause; or
Clinical suspicion of pertussis.
Confirmed cases are those who meet the suspected case definition and have laboratory confirmation (isolation of B pertussis from a clinical specimen, a positive B pertussis nucleic amplification assay, or elevated IgG antibodies to pertussis toxin [in those ≥11 years old, at least 1 year after last vaccine dose]) or close contact with a laboratory-confirmed case. Those who meet the suspected case definition but do not meet confirmed classification are considered to be possible cases.
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