title: Outbreak of pertussis in a university laboratory.
abstract: OBJECTIVE
  Analysis of an outbreak of Bordetella pertussis infection in a university laboratory. To prevent and control the outbreak, we conducted a survey of the laboratory staff and their family members, and we investigated the clinical features of adult pertussis.
  
  
  METHODS
  During the outbreak, four out of the 10 laboratory staff and five out of 16 family members had a primary complaint of cough. Seven of nine patients were diagnosed as definitive B. pertussis infection using serology and PCR.
  
  
  RESULTS
  Clinical findings and laboratory data in adult patients with B. pertussis infection demonstrated non-specific cough and normal WBC and lymphocyte count. The patients who received clarithromycin prior to 14 days after clinical onset demonstrated a shorter duration of cough symptoms than patients who received clarithromycin at 14 days or more after clinical onset (duration of cough after administration of clarithromycin: 17.8 ± 6.48 days versus 35.3 ± 5.38 days; duration of total cough after clinical onset: 24.8 ± 6.65 days versus 56.8 ± 6.50 days).
  
  
  CONCLUSIONS
  The clinical findings of adult pertussis are different from pertussis in children. The efficacy of macrolide therapy clearly differed between the catarrhal phase and paroxysmal phase. Physicians should consider B. pertussis in the differential diagnosis of an outbreak of non-specific respiratory infection even in adult populations.
authors.affiliation: Department of Internal Medicine 1, Kawasaki Medical School, Japan. nao@med.kawasaki-m.ac.jp
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Miyashita
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kawai
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Ouchi
authors.forename: Koji
authors.initials: K
authors.lastname: Kurose
authors.forename: Mikio
authors.initials: M
authors.lastname: Oka
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001886:Bordetella pertussis / Q000302:isolation & purification / Q000472:pathogenicity; D017291:Clarithromycin / Q000627:therapeutic use; D003371:Cough / Q000209:etiology; D003937:Diagnosis, Differential; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D017056:Medical Laboratory Personnel; D008875:Middle Aged; D014495:Universities; D010566:Virulence Factors, Bordetella / Q000097:blood; D014917:Whooping Cough / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D010566:Virulence Factors, Bordetella; D017291:Clarithromycin