Assessment of clinical symptoms in household contacts of confirmed pertussis cases

Angela Domínguez, Núria Soldevila, Joan A. Caylà, Manuel García-Cenoz, Glòria Ferrús, Maria Rosa Sala-Farré, Josep Álvarez, Mònica Carol, Irene Barrabeig, Neus Camps, Lorena Coronas, Carmen Muñoz-Almagro, Pere Godoy

Research output: Contribution to journalArticle

Abstract

Objectives: We assessed the value of the clinical symptoms included in the case definition of pertussis in household contacts of laboratory-confirmed cases. Methods: A prospective epidemiological study was made in two Spanish regions. Household contacts were identified for each confirmed case reported during 2012 and 2013. Two clinical samples were taken to determine the presence or absence of Bordetella pertussis by culture or real-time PCR. Clinical variables, age and vaccination status were recorded. Positive and negative likelihood ratios (PLR, NLR) were estimated for each symptom. Results: 2852 household contacts of 688 confirmed cases were reported. 178 household contacts with clinical symptoms were analyzed: 150 were laboratory confirmed and 28 were not. The clinical symptom with the highest PLR in comparison with the NLR was paroxysmal cough (PLR 4.76; 95% CI 1.91-11.87 and NLR 0.37; 95% CI 0.28-0.49). The contrast between the PLR and NLR was especially important for persons aged <18 years (PLR 7.08; 95% CI 1.10-45.74 and NLR 0.32; 95% CI 0.21-0.49). Conclusions: The clinical symptoms of pertussis are poor predictors of pertussis disease, independently of the vaccination status. Differences were observed between persons aged <18 years and adults. To adopt the appropriate treatment and control measures, rapid laboratory confirmation by PCR of all household contacts of confirmed cases who present any clinical symptoms compatible with pertussis should be recommended.

Original languageEnglish (US)
JournalJournal of Infection
DOIs
StateAccepted/In press - 2017
Externally publishedYes

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Symptom Assessment
Whooping Cough
Vaccination
Bordetella pertussis
Cough
Real-Time Polymerase Chain Reaction
Epidemiologic Studies
Prospective Studies
Polymerase Chain Reaction

Keywords

  • Clinical symptoms
  • Household contacts
  • Pertussis
  • Sensitivity
  • Specificity

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Domínguez, A., Soldevila, N., Caylà, J. A., García-Cenoz, M., Ferrús, G., Sala-Farré, M. R., ... Godoy, P. (Accepted/In press). Assessment of clinical symptoms in household contacts of confirmed pertussis cases. Journal of Infection. https://doi.org/10.1016/j.jinf.2017.08.008

Assessment of clinical symptoms in household contacts of confirmed pertussis cases. / Domínguez, Angela; Soldevila, Núria; Caylà, Joan A.; García-Cenoz, Manuel; Ferrús, Glòria; Sala-Farré, Maria Rosa; Álvarez, Josep; Carol, Mònica; Barrabeig, Irene; Camps, Neus; Coronas, Lorena; Muñoz-Almagro, Carmen; Godoy, Pere.

In: Journal of Infection, 2017.

Research output: Contribution to journalArticle

Domínguez, A, Soldevila, N, Caylà, JA, García-Cenoz, M, Ferrús, G, Sala-Farré, MR, Álvarez, J, Carol, M, Barrabeig, I, Camps, N, Coronas, L, Muñoz-Almagro, C & Godoy, P 2017, 'Assessment of clinical symptoms in household contacts of confirmed pertussis cases', Journal of Infection. https://doi.org/10.1016/j.jinf.2017.08.008
Domínguez A, Soldevila N, Caylà JA, García-Cenoz M, Ferrús G, Sala-Farré MR et al. Assessment of clinical symptoms in household contacts of confirmed pertussis cases. Journal of Infection. 2017. https://doi.org/10.1016/j.jinf.2017.08.008
Domínguez, Angela ; Soldevila, Núria ; Caylà, Joan A. ; García-Cenoz, Manuel ; Ferrús, Glòria ; Sala-Farré, Maria Rosa ; Álvarez, Josep ; Carol, Mònica ; Barrabeig, Irene ; Camps, Neus ; Coronas, Lorena ; Muñoz-Almagro, Carmen ; Godoy, Pere. / Assessment of clinical symptoms in household contacts of confirmed pertussis cases. In: Journal of Infection. 2017.
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abstract = "Objectives: We assessed the value of the clinical symptoms included in the case definition of pertussis in household contacts of laboratory-confirmed cases. Methods: A prospective epidemiological study was made in two Spanish regions. Household contacts were identified for each confirmed case reported during 2012 and 2013. Two clinical samples were taken to determine the presence or absence of Bordetella pertussis by culture or real-time PCR. Clinical variables, age and vaccination status were recorded. Positive and negative likelihood ratios (PLR, NLR) were estimated for each symptom. Results: 2852 household contacts of 688 confirmed cases were reported. 178 household contacts with clinical symptoms were analyzed: 150 were laboratory confirmed and 28 were not. The clinical symptom with the highest PLR in comparison with the NLR was paroxysmal cough (PLR 4.76; 95{\%} CI 1.91-11.87 and NLR 0.37; 95{\%} CI 0.28-0.49). The contrast between the PLR and NLR was especially important for persons aged <18 years (PLR 7.08; 95{\%} CI 1.10-45.74 and NLR 0.32; 95{\%} CI 0.21-0.49). Conclusions: The clinical symptoms of pertussis are poor predictors of pertussis disease, independently of the vaccination status. Differences were observed between persons aged <18 years and adults. To adopt the appropriate treatment and control measures, rapid laboratory confirmation by PCR of all household contacts of confirmed cases who present any clinical symptoms compatible with pertussis should be recommended.",
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AU - Domínguez, Angela

AU - Soldevila, Núria

AU - Caylà, Joan A.

AU - García-Cenoz, Manuel

AU - Ferrús, Glòria

AU - Sala-Farré, Maria Rosa

AU - Álvarez, Josep

AU - Carol, Mònica

AU - Barrabeig, Irene

AU - Camps, Neus

AU - Coronas, Lorena

AU - Muñoz-Almagro, Carmen

AU - Godoy, Pere

PY - 2017

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N2 - Objectives: We assessed the value of the clinical symptoms included in the case definition of pertussis in household contacts of laboratory-confirmed cases. Methods: A prospective epidemiological study was made in two Spanish regions. Household contacts were identified for each confirmed case reported during 2012 and 2013. Two clinical samples were taken to determine the presence or absence of Bordetella pertussis by culture or real-time PCR. Clinical variables, age and vaccination status were recorded. Positive and negative likelihood ratios (PLR, NLR) were estimated for each symptom. Results: 2852 household contacts of 688 confirmed cases were reported. 178 household contacts with clinical symptoms were analyzed: 150 were laboratory confirmed and 28 were not. The clinical symptom with the highest PLR in comparison with the NLR was paroxysmal cough (PLR 4.76; 95% CI 1.91-11.87 and NLR 0.37; 95% CI 0.28-0.49). The contrast between the PLR and NLR was especially important for persons aged <18 years (PLR 7.08; 95% CI 1.10-45.74 and NLR 0.32; 95% CI 0.21-0.49). Conclusions: The clinical symptoms of pertussis are poor predictors of pertussis disease, independently of the vaccination status. Differences were observed between persons aged <18 years and adults. To adopt the appropriate treatment and control measures, rapid laboratory confirmation by PCR of all household contacts of confirmed cases who present any clinical symptoms compatible with pertussis should be recommended.

AB - Objectives: We assessed the value of the clinical symptoms included in the case definition of pertussis in household contacts of laboratory-confirmed cases. Methods: A prospective epidemiological study was made in two Spanish regions. Household contacts were identified for each confirmed case reported during 2012 and 2013. Two clinical samples were taken to determine the presence or absence of Bordetella pertussis by culture or real-time PCR. Clinical variables, age and vaccination status were recorded. Positive and negative likelihood ratios (PLR, NLR) were estimated for each symptom. Results: 2852 household contacts of 688 confirmed cases were reported. 178 household contacts with clinical symptoms were analyzed: 150 were laboratory confirmed and 28 were not. The clinical symptom with the highest PLR in comparison with the NLR was paroxysmal cough (PLR 4.76; 95% CI 1.91-11.87 and NLR 0.37; 95% CI 0.28-0.49). The contrast between the PLR and NLR was especially important for persons aged <18 years (PLR 7.08; 95% CI 1.10-45.74 and NLR 0.32; 95% CI 0.21-0.49). Conclusions: The clinical symptoms of pertussis are poor predictors of pertussis disease, independently of the vaccination status. Differences were observed between persons aged <18 years and adults. To adopt the appropriate treatment and control measures, rapid laboratory confirmation by PCR of all household contacts of confirmed cases who present any clinical symptoms compatible with pertussis should be recommended.

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KW - Sensitivity

KW - Specificity

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