Attitude of Italian physicians toward pertussis diagnosis

Michaela Veronika Gonfiantini, Alberto Villani, Francesco Gesualdo, Elisabetta Pandolfi, Eleonora Agricola, Elena Bozzola, Raffaele Arigliani, Alberto Eugenio Tozzi

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Resurgence of pertussis has been observed in several countries whereas Italy continues to be a low incidence country. We hypothesize that the low reported incidence of pertussis in Italy could be biased by the attitude of physicians to suspect and diagnose pertussis in different age groups. We investigated the attitude of Italian physicians toward pertussis diagnosis through clinical scenarios. A cross-sectional study was conducted in June 2012 sending online questionnaires to pediatricians and general practitioners (GPs) involved in ambulatory primary care. The questionnaire included five clinical scenarios of patients of different ages (45 d, 5 y, 11 y, 24 y, 58 y) with prolonged cough of at least 2 weeks. Respondents were asked to choose a diagnosis among a list of 14. We observed a decreasing trend of suspected pertussis diagnosis with increasing age of the patient (from 46% at 45 d to 0 at 58 y). In Italy pertussis is seldom suspected in the differential diagnosis of cough particularly in adults. This may cause a significant under-notification of pertussis, with a higher impact in older age groups. Educational programs should be reinforced to consider the differential diagnosis of pertussis in individuals with atypical presentation and in older age groups.

Original languageEnglish
Pages (from-to)1485-1488
Number of pages4
JournalHuman Vaccines and Immunotherapeutics
Issue number7
Publication statusPublished - Jul 2013


  • Chronic cough
  • General practitioners
  • Pediatricians
  • Pertussis
  • Under-notification

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pharmacology


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