Monday, January 22, 2007

Deja vu all over again: "pertussis" in NH

Today's (22 January 2007) NY Times includes an intriguing piece on the pertussis "epidemic that wasn't" at Dartmouth Hitchcock Medical Center.

Another case of the "allure of the new." So many of the DHMC healthcare workers were coughing. And there've been all these recent articles on the prevalence of whooping cough (pertussis) among persons who've coughed for protracted periods. So the folks at Dartmouth used PCR to test for this fastidious bug. Result: over 1000 workers furloughed for some period of time.

It reminds one of the advent of bacteriology, in the late 19th and early 20th century. Back in the day--back in that day--there was such allure-of-the-new that diseases like beri-beri, pellagra, and even psychiatric illness were ascribed to causative bacterial organisms.

Which were present, no doubt, in some of those non-infectious cases.

But it was--and is--the age old problem of the false positive. None of this indicts the good folks at DHMC, one of the best in the nation. But this episode illustrates beautifully the need for continued emphasis on EBM in our curricula and our thought processes. And real skepticism about the allure of the latest and greatest in high technology methods, until we have adequately "tested the test."

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