Pertussis / Whooping Cough (Bordetella pertussis) Revised May 2, 1997

NOTE: A surveillance case definition is a set of uniform criteria used to define a disease for public health surveillance. Surveillance case definitions enable public health officials to classify and count cases consistently across reporting jurisdictions. Surveillance case definitions are not intended to be used by healthcare providers for making a clinical diagnosis or determining how to meet an individual patient’s health needs.

Clinical Description

A cough illness lasting at least 2 weeks with one of the following: paroxysms of coughing, inspiratory "whoop," or post-tussive vomiting, without other apparent cause (as reported by a health professional)

Laboratory Criteria For Diagnosis

Isolation of Bordetella pertussis from clinical specimen
Polymerase chain reaction (PCR) positive for pertussis

Case Classification

Probable

In the absence of a more likely diagnosis, a cough illness lasting ≥2 weeks, with at least one of the following symptoms:

Paroxysms of coughing, OR
Inspiratory "whoop", OR
Post-tussive vomiting; AND
Absence of laboratory confirmation, AND
No epidemiologic linkage to a laboratory-confirmed case of pertussis

Confirmed

Acute cough illness of any duration, with isolation of Bordetella pertussis from a clinical specimen, OR
Cough illness lasting ≥2 weeks, with at least one of the following symptoms:
- Paroxysms of coughing, OR
- Inspiratory "whoop", OR
- Post-tussive vomiting

AND, at least one of the following

Polymerase chain reaction (PCR) positive for pertussis, OR
Contact with a laboratory-confirmed case of pertussis

Comments

The clinical case definition above is appropriate for endemic or sporadic cases. In outbreak settings, a case may be defined as a cough illness lasting at least 2 weeks (as reported by a health professional). Because direct fluorescent antibody testing of nasopharyngeal secretions has been demonstrated in some studies to have low sensitivity and variable specificity, such testing should not be relied on as a criterion for laboratory confirmation^{1, 2}. Serologic testing for pertussis is available in some areas but is not standardized and, therefore, should not be relied on as a criterion for laboratory confirmation.

The 1997³ case definition appearing on this page was re-published in the 2009 CSTE position statement 09-ID-51. Thus, the 1997 and 2010 versions of the case definition are identical.

In 2010, the wording of the case classification was reformatted for clarification, but does not represent any substantive change to the case definition.

References

Broome CV, Fraser DW, English WJ. Pertussis--diagnostic methods and surveillance. In: Manclark CR, Hill JC, eds. International Symposium on Pertussis. Bethesda, MD: US Department of Health, Education, and Welfare, Public Health Service, National Institutes of Health, 1979; DHEW publication no. (NIH)79-1830:19-22.
Halperin SA, Bortolussi R, Wort AJ. Evaluation of culture, immunofluorescence, and serology for the diagnosis of pertussis. J Clin Microbiol 1989;27:752-7.
CDC. (1997). Case Definitions for Infectious Conditions Under Public Health Surveillance. MMWR, 46(RR-10), 1-55. https://www.cdc.gov/mmwr/preview/mmwrhtml/00047449.htm

Related Case Definition(s)

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Last Reviewed: April 16, 2021

Source: Office of Public Health Data, Surveillance, and Technology