Physicians at MIT and Boston Medical Center (BMC) have started a two-year study of the incidence of pertussis or whooping cough on campus, in an effort to track and treat a disease that is more common than once believed.
The study is being undertaken because pertussis is on the increase. In 1996, there were 1,076 cases diagnosed in Massachusetts-almost 20 percent of the 5,000 in the United States and a significant increase over previous years, according to Dr. Mark Goldstein, chief of pediatrics and Student Health Services in the MIT Medical Department and one of the principal investigators for the study. The other is Dr. Jo Anne Harris from the BMC's Pediatric Infectious Disease Division.
Pertussis is caused by a bacterium and characterized by a persistent cough, which can last for weeks or months if left untreated. It is life-threatening only to young children or elderly people, or those with other health problems, but those who have the illness have difficulty studying or working, and they also pose a health hazard to people around them, who could catch the airborne disease.
In one portion of the study, doctors will try to learn about the epidemiology of pertussis, or how prevalent it is in the community. They will ask patients who come to MIT medical with a cough lasting more than six days for a voluntary nasopharyngeal culture as well as a blood test to see if they are infected with pertussis.
"We suspect it's a lot more common than people think. We don't usually culture people for pertussis," Dr. Goldstein said.
Patients who test positive for the disease will be offered one of two treatments: the standard 14-day regimen of erythromycin, or a new antibiotic called azithromycin, which needs to be taken for only five days. Another advantage of the new treatment is the absence of upset stomach commonly associated with erythromycin, Dr. Goldstein said.
Those who test positive for pertussis will be asked for names of others who might have caught the illness from them-roommates, office mates, family members or teammates. MIT Medical, in conjunction with the state Department of Public Health, will contact those people and offer testing and treatment. Because of the risk of contagion, "there's an importance to the campus as a whole in trying to control this," Dr. Goldstein said.
Diseases like pertussis can spread rapidly in a community like MIT, where people live and work in close proximity and come from many different backgrounds, Dr. Goldstein said. While Americans are immunized against pertussis in infancy, the vaccine often wears off by the time they are 15, and proof of immunization is not required for college entrance in any case, he noted. Though a new vaccine is being developed, the existing one can't be administered after the age of seven.
The other part of the study will try to determine the prevalence of two other causes of persistent cough-mycoplasma pneumonia and chlamydia pneumonia. Patients who have a cough but test negative for pertussis will be asked for a second voluntary blood donation to test for these conditions.
A version of this article appeared in MIT Tech Talk on January 29, 1997.
