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Specialists Mystified by Coughing Cases

The 2d tests for pertussis have put the outbreak in doubt. The mystery began Sept. 18, when a Child was treated with symptoms of whooping cough, typically heralded by a runny// nose, sneezing, slight fever, and mild cough in the Children’s Hospital in Boston.

Then in last September through early November, about three dozen hospital employees of the same ward, developed coughs and other symptoms suggesting that they, too, were stricken with the same disease.

The disease is said to be developing far more severe manifestations; most notably spasmodic coughing that can last for months and be ferocious enough to shatter ribs.

But now, more than three months after the child fell ill, disease investigators are no longer certain that the respiratory illnesses that struck workers and one other patient at Children's Hospital were caused by whooping cough, also known as pertussis. Additional testing, using approaches different from the first round, could find little evidence of the highly contagious germ.

This episode at the Children's Hospital is a caution stating the limits of science, particularly the ability of laboratories to produce absolute, unimpeachable results when disease strikes.

While symptoms can provide strong clues about whether a patient has the disease, laboratory tests provide far more robust proof -- especially for pertussis, with early symptoms similar to the common cold. To collect a specimen for testing, a cotton swab- like probe is threaded through the nose and into the back of the throat.

But Dr. Alfred DeMaria, director of communicable disease control for the state, said: "People generally don't like it much when you do that, but you can't get to that area through the mouth."

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