December 27, 2006

Health Officials Puzzled By Whooping Cough Outbreak

What city health officials at first thought was an outbreak of whooping cough among employees at Children’s Hospital Boston may have been

something else entirely.

But exactly what is still in question.

It started when a 19-month-old patient came down with the classic symptoms of whooping cough, a respiratory disease also known as pertussis.

Symptoms include a runny nose, sneezing, slight fever, and mild cough, which can develop into a violent and persistent cough.

A laboratory test confirmed he had the disease.

Three dozen hospital employees and one other patient tested positive for whooping cough from late September through early November.

But further testing, different from the initial tests, could find little evidence of the highly contagious bacteria. Now no one can say for sure what

made the workers sick, but pertussis hasn’t been ruled out.

Federal and state health officials joined the city in trying to figure out exactly what ailed the workers, all of whom recovered.

The Children’s Hospital cases were at first confirmed through a test called polymerase chain reaction, or PCR.

Based on the tests, Children’s moved to contain the outbreak.

“Children’s, much like we do at the local health department, really relies on laboratory tests to guide us on what the diagnosis is, especially

illnesses that can look like a lot of different things,” said Dr. Anita Barry of the Boston Public Health Commission. “Having accurate test results early

on, particularly when they’re consistent with the clinical symptoms, really launches us into control steps.”

State lab workers then performed other tests, including the laborious task of culturing samples and taking blood samples from hospital workers.

The additional tests were almost uniformly negative for pertussis.

Samples were sent to the federal Centers for Disease Control.

“The results were inconclusive,” said Dr. Amanda Cohn, a medical epidemiologist for the federal agency.

There are competing theories, ranging from a cold virus to a bacterial relative of pertussis to the virus that causes the condition commonly known as

walking pneumonia.

It’s unlikely that the causes of all the respiratory illnesses will ever be fully known.

“What I can say is that whatever it was, it went away,” Barry said. “And that’s the good news.”

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