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Journal of Clinical Microbiology, August 2002, p. 2801-2805, Vol. 40, No. 8
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.8.2801-2805.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Issues Associated with and Recommendations for Using PCR To Detect Outbreaks of Pertussis

Fabio A. Lievano,1,2* Meredith A. Reynolds,1,3 Alfred L. Waring,4 Joel Ackelsberg,1,5 Kristine M. Bisgard,2 Gary N. Sanden,6 Dalya Guris,2 Anne Golaz,2 Dianna J. Bopp,4 Ronald J. Limberger,4 and Perry F. Smith5,7

Epidemic Intelligence Service, Epidemiology Program Office,1 Epidemiology and Surveillance Division, National Immunization Program,2 National Center for Chronic Disease Prevention and Health Promotion,3 Centers for Disease Control and Prevention, Atlanta, Georgia, and Wadsworth Center,4 and Division of Epidemiology,5 Division of Bacterial and Mycotic Diseases,National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia,6 New York State Department of Health, and Department of Epidemiology, School of Public Health, State University of New York at Albany7

Received 7 February 2002/ Returned for modification 22 March 2002/ Accepted 29 May 2002

Two outbreaks of respiratory tract illness associated with prolonged cough occurring in 1998 and 1999 in New York State were investigated. A PCR test for Bordetella pertussis was primarily used by a private laboratory to confirm 680 pertussis cases. Several clinical specimens had positive culture results for B. pertussis during both outbreaks, which confirmed that B. pertussis was circulating during the outbreaks. However, testing by the New York State Department of Health reference laboratory suggested that some of the PCR results may have been falsely positive. In addition, features of the outbreak that suggested that B. pertussis may not have been the primary agent of infection included a low attack rate among incompletely vaccinated children and a significant amount of illness among patients testing PCR negative for B. pertussis. These investigations highlight the importance of appropriate clinical laboratory quality assurance programs, of the limitations of the PCR test, and of interpreting laboratory results in context of clinical disease.

* Corresponding author. Mailing address: 1600 Clifton Rd. NE, Mailstop E-05, Atlanta, GA 30333. Phone: (404) 639 8904. Fax: (404) 639 8573. E-mail: flievano{at}cdc.gov.

Journal of Clinical Microbiology, August 2002, p. 2801-2805, Vol. 40, No. 8
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.8.2801-2805.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



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