Journal Article

Failure of Physicians to Consider the Diagnosis of Pertussis in Children

Shelley Deeks, Gaston De Serres, Nicole Boulianne, Bernard Duval, Louis Rochette, Pierre Déry and Scott Halperin

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 28, issue 4, pages 840-846
Published in print April 1999 | ISSN: 1058-4838
Published online April 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/515203
Failure of Physicians to Consider the Diagnosis of Pertussis in Children

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To determine the ability of physicians to make a diagnosis of pertussis and factors associated with improved diagnosis, 8,235 children from 88 child care centers and 14 elementary schools from Quebec City, Quebec, Canada, were evaluated by using a questionnaire completed by parents and a medical record review. Children must have consulted a physician to be included in the evaluation. There were 558 children meeting the surveillance case definition and 416 meeting a modified World Health Organization case definition who consulted a physician. A diagnosis of pertussis was considered in 24%–26% of children meeting either case definition, made in 12%–14%, and reported for 6%. Pertussis diagnosis was significantly associated with having a history of pertussis exposure (P ⩽ .003), four pertussis-related symptoms (P ⩽ .001), and a cough for ⩾5 weeks (P ⩽ .05) and consulting in a hospital setting (P ⩽ .03). The proportion of cases of pertussis diagnosed and reported is low even when children present with classical symptoms.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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