Concurrent Outbreaks of Pertussis and Mycoplasma pneumoniae Infection: Clinical and Epidemiological Characteristics of Illnesses Manifested by Cough

Abstract

Concurrent outbreaks of illnesses that were manifested by cough and that were suspected to be due to Bordetella pertussis and Mycoplasma pneumoniae infection were investigated in a midwestern town in Illinois. Three studies were conducted: questionnaires on the clinical and epidemiological characteristics of illness were administered to patients; serological tests were performed to confirm the presence of each pathogen and to develop case definitions for each illness; and case definitions were applied to responses to a mail-in questionnaire for estimating the magnitude of both outbreaks. In 135 cases of suspected pertussis and 42 cases of suspected mycoplasmal infection, subjects had a cough for > or = 14 days (the pertussis outbreak case definition). Among 20 laboratory-confirmed cases, a cough for > or = 14 days had a specificity of 20% for pertussis, and a cough for > or = 28 days plus whoop and/or vomiting had a specificity of 90% for pertussis. Six hundred-seventeen pertussis cases per 100,000 population and 1,179 cases of M. pneumoniae infection per 100,000 population occurred. In this setting, the standard outbreak case definition for pertussis lacked adequate specificity to distinguish pertussis from mycoplasmal infection. The magnitude of each outbreak was greater than the number of reported cases suggested.

Seasonal variation of Mycoplasma infections in Iceland and Israel: different associations with meteorological variables

“…Thus, during the winter months when most of the Mycoplasma infections occur, temperature is low and precipitation is relatively high. Our findings are in agreement with other reports showing that Mycoplasma infections are most common during autumn and winter [3][4][5]7]. We conclude that Mycoplasma infections in Iceland show a definite seasonal variation with peak incidence in autumn and winter, when temperature is low and precipitation high.…”

“…The Mycoplasma antigen used in the test was supplied by Behringwerke AG (OTHI 04/05; Mycoplasma pneumoniae antigen, Marburg, Germany). In our study, seropositivity was defined as a titre of ≥1:64 in a single sample or a fourfold increase of Mycoplasma titre in paired samples as reported in some other studies [2][3][4][5]. Statistical significance was evaluated with the Chi-squared test and the level of significance set at p<0.05.…”

Molecular Pathogenesis, Epidemiology, and Clinical Manifestations of Respiratory Infections Due toBordetella pertussisand OtherBordetellaSubspecies

“…Many other infectious agents cause illnesses with cough that can be confused with Bordetella infections. Most important in this regard are Mycoplasma pneumoniae, Chlamydia pneumoniae, adenoviruses, and other respiratory viruses (33,136,147,161,166,196,314,584,829). In addition, spasmodic attacks of coughing may be observed in children with bronchiolitis, bacterial pneumonia, cystic fibrosis, or tuberculosis.…”

Human parainfluenza virus type 3 (HPIV 3) community-acquired pneumonia (CAP) mimicking pertussis in an adult: The diagnostic importance of hoarseness and monocytosis

“…The protracted course of nonproductive paroxysmal coughing with pertussis is longer than with any other acute infectious disease; for this reason, pertussis is also known as the "100-day cough." [7][8][9][10] We present the case of a young woman who presented during the winter of the H1N1 pandemic. She was admitted with ILI and fever, sore throat, hoarseness, and a persistent paroxysmal pertussis-like cough.…”