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AFHSC Surveillance Case Definitions
Case Definition and Incidence Rules
For surveillance purposes, a case of pertussis is defined as:
One record of a reportable medical of pertussis infection; laboratory confirmation not required.
For surveillance purposes, a probable case of pertussis is defined as:
One hospitalization or outpatient medical encounter with any of the defining diagnoses of pertussis (see ICD9 and ICD10 code lists below) in the primary diagnostic position.
Incidence rules:
For individuals who meet the case definition:
The incidence date is considered the date of onset documented in a reportable medical event report, or the first hospitalization or outpatient medical encounter that includes a defining diagnosis of pertussis.
An individual is considered an incident case only once per lifetime.
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PERTUSSIS
Includes Probable Cases
Background
This case definition was developed by the Armed Forces Health Surveillance Center (AFHSC) for the purpose of epidemiological surveillance of a condition important to military-associated populations.
Clinical Description
Pertussis or “whooping cough” is a highly infectious respiratory disease most commonly considered a disease of childhood. It is caused by the bacterium Bordetella pertussis. Clinically pertussis begins with upper respiratory tract symptoms (i.e., cough, runny nose, mild fever) lasting one to two weeks; this stage is followed by the development of severe coughing episodes (paroxysms) that typically involve a characteristic “whoop” upon inspiration. Recovery can be prolonged and affected individuals may experience a persistent cough that takes weeks to months to resolve. Pertussis is vaccine preventable; yet many outbreaks are reported each year in the United States.^1
(^1) Armed Forces Health Surveillance Center. Pertussis diagnosis among service members and other
beneficiaries of the U.S. Health System, January 2005-June 2012. Medical Surveillance Monthly Report (MSMR); 2012 August; Vol 98(8): 14-17.
AFHSC Surveillance Case Definitions
Case Definition and Incidence Rules (continued)
Exclusions: (applies to probable cases of pertussis only):
Cases with one medical encounter with evidence of pertussis immunization within 7 days before or after the case-defining encounter; as indicated by the following vaccine administered (CVX) codes: 001 (DTP), 011 (pertussis), 020 (DTaP), 050 (DTaP-Hib), 102 (DTaP/DTP-Hib-HepB), 106 (DTaP,5 pertussis antigens), 107 (DTaP, unspecified formulation), 110 (DTap-HepB-IPV), 115 (Tdap), 120 (DTap-Hib-IPV), 130 (DTaP-IPV)
Individuals with evidence of a positive test for serologic immunity to pertussis within 7 days before or after the case defining encounter.
Cases with one Current Procedure Code (CPT) or one ICD9/ICD10 procedure code indicating pertussis vaccination or antibody testing recorded during the same medical encounter; as indicated by the following codes.
- ICD9 codes: V03.6 (pertussis alone), V06.1 (DTP, DTaP], V06.2 (DTP TAB), V06. (DPT+polio), 99.37 (vaccination against pertussis), 99.39 (administration of diphtheria- tetanus-pertussis, combined). In ICD10 use Z23 (encounter for immunization) plus procedure code for type of immunization.
- CPT codes: 90698 (DTap-Hib-IPV), 90700 (DTaP), 90701 (DTP), 90715 (Tdap), 90720 (DTP-Hib), 90721 (DtaP-Hib), 90723 (DtaP-HipB-IPV)
Codes
The following ICD9 and ICD10 codes are included in the case definition:
Condition ICD-10-CM Codes ICD-9-CM Codes
- Pertussis
- (Whooping cough)
A37 (whooping cough) 033 (whooping cough)
A37.0 (whooping cough due to Bordetella pertussis )
- 033.0 ( Bordetella pertussis [B.pertussis])
- A37.00 (whooping cough due to Bordetella pertussis without pneumonia)
- A37.01 (whooping cough due to Bordetella pertussis with pneumonia)
484.3 (pneumonia in whooping cough)
A37.1 (whooping cough due to Bordetella parapertussis )
- 033.1 ( Bordetella parapertussis [B. parapertussis])
- A37.10 (whooping cough due to Bordetella parapertussis without pneumonia)
AFHSC Surveillance Case Definitions
Reports
AFHSC reports on pertussis in the following reports:
Monthly: AFHSC Reportable Events Monthly Report. Available on the AFHSC website at: http://www.afhsc.mil; see “Reports and Publications”.
Weekly: DoD Communicable Disease Weekly Report; Summary of Communicable Reportable Events by Service; Available on the AFHSC website at: http://www.afhsc.mil; see “Reports and Publications”.
Review
Jun 2015 Case definition reviewed and adopted by the AFHSC Surveillance Methods and Standards (SMS) working group.
Feb 2012 Case definition developed by AFHSC MSMR staff.
Comments
Armed Forces Reportable Events: Pertussis is a reportable medical event in the Armed Forces Reportable Events surveillance system under “Vaccine Preventable” disease.
