title: Pertussis Outbreak Among Soldiers During Basic Training: The Need for Updated Protocols.
abstract: Pertussis is a highly contagious, vaccine preventable upper respiratory disease. The incidence of the disease has been rising in the past few decades. During the winter of 2015, an upper respiratory outbreak occurred in one of Israel Defense Forces basic training bases in northern Israel. Following the detection of the first primary cases, a suspected outbreak investigation was initiated in conjunction with more rigorous clinical and laboratory testing efforts to include specific antibody enzyme-linked immunosorbent assay assays and polymerase chain reaction to diagnose pertussis. Initially, 1,596 soldiers were surveyed clinically using a questionnaire and physicians' interviews for upper respiratory disease symptoms. A total of 158 soldiers were further evaluated and 38.6% (61) of those were diagnosed as having pertussis (with laboratory evidence). Based on the protocol that we developed during the course of this outbreak, a postexposure prophylaxis was given to every soldier for whom there was a high level of suspicion for infection and met the inclusion criteria for the postexposure prophylaxis protocol. The effects of the postvaccination waning immunity among a vaccinated population were demonstrated, thus the need of maintaining a high index of suspicion of Brodetella pertussis as a causative agent during respiratory diseases outbreaks in young soldiers.
authors.affiliation: Israel Defense Forces Medical Corps, Surgeon General's Headquarters, Military P.O. Box 02149, Tel HaShomer, Ramat Gan, Israel.
authors.forename: Basheer
authors.initials: B
authors.lastname: Halhal
authors.affiliation: Israel Defense Forces Medical Corps, Surgeon General's Headquarters, Military P.O. Box 02149, Tel HaShomer, Ramat Gan, Israel.
authors.forename: Yuval
authors.initials: Y
authors.lastname: Glick
authors.affiliation: Israel Defense Forces Medical Corps, Surgeon General's Headquarters, Military P.O. Box 02149, Tel HaShomer, Ramat Gan, Israel.
authors.forename: Inbal
authors.initials: I
authors.lastname: Galor
authors.affiliation: Israel Defense Forces Medical Corps, Surgeon General's Headquarters, Military P.O. Box 02149, Tel HaShomer, Ramat Gan, Israel.
authors.forename: Ankory
authors.initials: A
authors.lastname: Ran
authors.affiliation: Military Infectious Disease Research Program, 504 Scott Street, Fort Detrick, MD 21702-5012.
authors.forename: David J
authors.initials: DJ
authors.lastname: Bacon
authors.affiliation: Israel Defense Forces Medical Corps, Surgeon General's Headquarters, Military P.O. Box 02149, Tel HaShomer, Ramat Gan, Israel.
authors.forename: Elon
authors.initials: E
authors.lastname: Glassberg
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017963:Azithromycin / Q000627:therapeutic use; D004196:Disease Outbreaks / Q000517:prevention & control*; D004493:Education / Q000379:methods / Q000458:organization & administration; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D017408:Guidelines as Topic / Q000592:standards*; D007557:Israel; D008889:Military Personnel; D016133:Polymerase Chain Reaction / Q000379:methods; D011795:Surveys and Questionnaires; D014917:Whooping Cough / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin