Failure of physicians to consider the diagnosis of pertussis in children

To determine the ability of physicians to make a diagnosis of pertussis and factors associated with improved diagnosis, 8,235 children from 88 child c are centers and 14 elementary schools from Quebec City, Quebec, Canada, ser e evaluated by using a questionnaire completed by parents and a medical rec ord review, Children must have consulted a physician to be included in the evaluation, There were 558 children meeting the surveillance case definitio n and 416 meeting a modified World Health Organization case definition who consulted a physician. A diagnosis of pertussis was considered in 24%-26% o f children meeting either case definition, made in 12%-14%, and reported fo r 6%. Pertussis diagnosis was significantly associated with having a histor y of pertussis exposure (P less than or equal to .003), four pertussis-rela ted symptoms (P < .001), and a cough for greater than or equal to 5 weeks ( P less than or equal to .05) and consulting in a hospital setting (P less t han or equal to .03), The proportion of cases of pertussis diagnosed and re ported is low even when children present with classical symptoms..