{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:26:18Z","timestamp":1787840778686,"version":"build-2784847793"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,2]]},"abstract":"\n A\n BSTRACT<\/jats:sc>\n <\/jats:title>\n \n Pertussis<\/jats:italic>\n , caused by\n Bordetella pertussis<\/jats:italic>\n , is a highly contagious respiratory illness experiencing a resurgence globally, particularly in adolescents, and adults. General practitioners (GPs) in primary care settings are crucial for early detection and control, yet often face challenges in diagnosing atypical presentations. This case series describes a family cluster of atypical\n pertussis<\/jats:italic>\n managed by a community health service center in Shenzhen, China. A 42-year-old male (Case 1) initially presented with a 10-day history of persistent, dry cough, lacking characteristic paroxysmal coughing and fever, leading to initial misdiagnosis. Subsequent targeted respiratory pathogen testing revealed\n Bordetella pertussis<\/jats:italic>\n . Prompt investigation identified two additional family members with confirmed\n pertussis<\/jats:italic>\n : his 43-year-old wife (Case 2) and 14-year-old son (Case 3), both exhibiting atypical cough symptoms. Two other asymptomatic family members (Cases 4 and 5) showed positive\n pertussis<\/jats:italic>\n antibodies, suggesting prior subclinical infection. Initial symptomatic treatments were ineffective. Following confirmed\n pertussis<\/jats:italic>\n diagnoses, Cases 1 and 2 were treated with compound sulfamethoxazole (800 mg per dose, administered twice daily for a total duration of 5 days), leading to significant symptom alleviation. Case 3 received azithromycin (400 mg on the first day, 200 mg\/d on days 2 to 5, with a total course of treatment of 5 days), also resulting in substantial symptom relief. All confirmed cases eventually tested negative for\n pertussis<\/jats:italic>\n nucleic acid upon re-examination. This family cluster highlights the diagnostic challenges posed by atypical\n pertussis<\/jats:italic>\n in adults and adolescents, emphasizing the need for increased awareness among GPs. Early identification, aggressive family member screening, and appropriate antibiotic therapy (considering local resistance patterns) are crucial for effective management and prevention of further transmission within communities. Strengthening primary care\u2019s capacity for recognizing and managing\n pertussis<\/jats:italic>\n is paramount to combating its resurgence.\n <\/jats:p>","DOI":"10.4103\/jfmpc.jfmpc_444_25","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T12:01:34Z","timestamp":1774008094000},"page":"992-995","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Atypical pertussis: Family cluster case series and primary care management strategies"],"prefix":"10.4103","volume":"15","author":[{"given":"Ling","family":"Ouyang","sequence":"first","affiliation":[{"name":"Tangwei Community Health Service Center, Guangming District People\u2019s Hospital, Shenzhen, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhucheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of General Practice, Hong Kong University - Shenzhen Hospital, China, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Wang","sequence":"additional","affiliation":[{"name":"Tangwei Community Health Service Center, Guangming District People\u2019s Hospital, Shenzhen, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangdong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Shenzhen University General Hospital, Shenzhen, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"R1-20260325","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.pop.2018.05.003","article-title":"Pertussis: The whooping cough","volume":"45","author":"Nguyen","year":"2018","journal-title":"Prim Care"},{"key":"R2-20260325","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1038\/s41579-024-01064-8","article-title":"Pertussis vaccines, epidemiology 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care clinics","volume":"97","author":"Rodr\u00edguez","year":"2022","journal-title":"An Pediatr (Engl Ed)"},{"key":"R11-20260325","doi-asserted-by":"crossref","first-page":"E872","DOI":"10.9778\/cmajo.20170072","article-title":"Case-control study of household contacts to examine immunological protection from Bordetella pertussis transmission-study protocol","volume":"5","author":"Bolotin","year":"2017","journal-title":"CMAJ Open"},{"key":"R12-20260325","doi-asserted-by":"crossref","first-page":"106322","DOI":"10.1016\/j.jinf.2024.106322","article-title":"Household transmission patterns and serial interval of pertussis in China","volume":"89","author":"Su","year":"2024","journal-title":"J Infect"},{"key":"R13-20260325","doi-asserted-by":"crossref","first-page":"2475841","DOI":"10.1080\/22221751.2025.2475841","article-title":"Sharp rise in high-virulence Bordetella pertussis with macrolides resistance in Northern China","volume":"14","author":"Hu","year":"2025","journal-title":"Emerg Microbes Infect"},{"key":"R14-20260325","doi-asserted-by":"crossref","first-page":"106373","DOI":"10.1016\/j.jinf.2024.106373","article-title":"Resurgence of pertussis in China: Evaluating the efficacy of sulfamethoxazole-trimethoprim as an alternative treatment","volume":"90","author":"Zhu","year":"2025","journal-title":"J Infect"},{"key":"R15-20260325","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1007\/s12519-024-00848-5","article-title":"Expert consensus for pertussis in children: New concepts in diagnosis and treatment","volume":"20","author":"Mi","year":"2024","journal-title":"World J Pediatr"},{"key":"R16-20260325","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.chest.2018.09.027","article-title":"Clinically diagnosing pertussis-associated cough in adults and children: CHEST guideline and expert panel 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