Assessment of clinical symptoms in household contacts of confirmed pertussis cases
Por:
Dominguez, A, Soldevila, N, Cayla, JA, Garcia-Cenoz, M, Ferrus, G, Sala-Farre, MR, Alvarez, J, Carol, M, Barrabeig, I, Camps, N, Coronas, L, Munoz-Almagro, C, Godoy, P
Publicada:
1 nov 2017
Resumen:
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. (C) 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
Filiaciones:
Dominguez, A:
Univ Barcelona, Dept Med, C Casanova,143, E-08036 Barcelona, Spain
Inst Salud Carlos III, CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Soldevila, N:
Univ Barcelona, Dept Med, C Casanova,143, E-08036 Barcelona, Spain
Inst Salud Carlos III, CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Cayla, JA:
Inst Salud Carlos III, CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Agencia Salut Publ Barcelona, Barcelona, Spain
Garcia-Cenoz, M:
Inst Salud Carlos III, CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Inst Salud Publ Navarra IdiSNA, Pamplona, Spain
Univ Publ Navarra, Navarra, Spain
Ferrus, G:
Agencia Salut Publ Catalunya, Barcelona, Spain
Sala-Farre, MR:
Agencia Salut Publ Catalunya, Barcelona, Spain
Alvarez, J:
Agencia Salut Publ Catalunya, Barcelona, Spain
Carol, M:
Agencia Salut Publ Catalunya, Barcelona, Spain
Barrabeig, I:
Agencia Salut Publ Catalunya, Barcelona, Spain
Camps, N:
Agencia Salut Publ Catalunya, Barcelona, Spain
Coronas, L:
Univ Barcelona, Dept Med, C Casanova,143, E-08036 Barcelona, Spain
Munoz-Almagro, C:
Inst Salud Carlos III, CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Hosp St Joan Deu, Barcelona, Spain
Univ Internac Catalunya, Dept Med, Barcelona, Spain
Godoy, P:
Inst Salud Carlos III, CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Agencia Salut Publ Catalunya, Barcelona, Spain
Inst Recerca Biomed Lleida IRBLLeida, Lleida, Spain
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