Do bullae and emphysema increase risk of pneumothorax in silicosis
Indian Journal of Occupational and Environmental Medicine Year : 2007 Volume : 11 Issue : 3 Page : 108-112
occurrence of occupational lung diseases is decreasing due to improvements in occupational health in recent years; however, silicosis and its complications remain important occupational health problems. We have studied the role of emphysema and bullae as predictive factors of secondary spontaneous pneumothorax in acute and accelerated silicosis.
01/12/2008
07:43 PM
Incidence of Respiratory Disorders in Neonates Born between 34 and 36 Weeks of Gestation Following Exposure to Antenatal Corticosteroids between 24 and 34 Weeks of Gestation
Amer J Perinatol : DOI: 10.1055/s-2007-1022470
We studied the effect of antenatal corticosteroids on the incidence of respiratory disorders in singleton neonates born between 34 and 36 weeks of gestation.
01/12/2008
07:42 PM
An overview of EPR3 Asthma Guidelines - What's different
Allergy and Asthma Proceedings, Volume 28, Number 6, November/December 2007 , pp. 620-627(8)
Updated asthma care guidelines have recently been released. This review will focus on several elements in the Expert Panel Report (EPR) 3 guidelines that reflect substantial differences compared with recommendations of the EPR2 guidelines, issued in 1997 and updated in 2002.
01/12/2008
07:40 PM
A reappraisal of the clinical efficacy of nebulized flunisolide in pediatric asthma - The Italian experience
Allergy and Asthma Proceedings, Volume 28, Number 6, November/December 2007 , pp. 671-687(17)
Flunisolide (FLU) is a synthetic corticosteroid with potent topical anti-inflammatory activity. Its oral bioavailability is poor (6.7%). After gastrointestinal and lung absorption, the drug undergoes rapid and extensive first-pass metabolism by the liver to an inactive 6Beta-hydroxylated metabolite. Plasma half-life is estimated to be 3.9 to 4.6 hours.
01/12/2008
07:40 PM
Factors impacting on length of stay and mortality of community-acquired pneumonia
Clinical Microbiology and Infection doi:10.1111/j.1469-0691.2007.01915.x
A 1-year retrospective multicentre study was performed to identify factors influencing hospital length of stay (LOS) and mortality of patients (n = 3233) admitted to hospital because of community-acquired pneumonia (CAP).
01/12/2008
07:38 PM
Influenza Vaccination Among Medical Residents in a Teaching Hospital
Infect Control Hosp Epidemiol 2008;29:89-91
We assessed the rates of influenza vaccine acceptance and the reasons for acceptance or refusal among medical residents in different disciplines during the 2004-2005 influenza season.
01/12/2008
07:34 PM
Development of an Algorithm for Surveillance of Ventilator-Associated Pneumonia With Electronic Data and Comparison of Algorithm Results With Clinician Diagnoses
Infect Control Hosp Epidemiol 2008;29:31-37
Surveillance for ventilator-associated pneumonia (VAP) using standard Centers for Disease Control and Prevention (CDC) criteria is labor intensive and involves many subjective assessments. We sought to improve the efficiency and objectivity of VAP surveillance by adapting the CDC criteria to make them amenable to evaluation with electronic data.
01/12/2008
07:33 PM
Continuous positive airway pressure increases heart rate variability in heart failure patients with obstructive sleep apnoea
Clinical Science (2008) 114, (243–249)
Patients with heart failure or OSA (obstructive sleep apnoea) have reduced HF-HRV (high-frequency heart rate variability), indicating reduced cardiac vagal modulation, a marker of poor prognosis. CPAP (continuous positive airway pressure) abolishes OSA in patients with heart failure, but effects on daytime HF-HRV have not been determined.
01/12/2008
07:32 PM
Association between exhaled nitric oxide and systemic inflammatory markers
Annals of Allergy, Asthma and Immunology, Volume 99, Number 6, December 2007 , pp. 534-539(6)
To determine if there is an association between exhaled nitric oxide and these systemic inflammatory markers.
01/12/2008
07:31 PM
Substitutive 'Hospital at Home' Versus Inpatient Care for Elderly Patients with Exacerbations of Chronic Obstructive Pulmonary Disease - A Prospective Randomized Controlled Trial
Journal of the American Geriatrics Society doi:10.1111/j.1532-5415.2007.01562.x
To evaluate hospital readmission rates and mortality at 6-month follow-up in selected elderly patients with acute exacerbation of chronic obstructive pulmonary disease (COPD).
01/12/2008
07:30 PM
The role of lung function in brain tissue oxygenation following traumatic brain injury
Journal of Neurosurgery January 2008 Volume 108, Number 1
Previous studies have demonstrated that periods of low brain tissue oxygen tension (PbtO2) are associated with poor outcome after head trauma but have primarily focused on cerebral and hemodynamic factors as causes of low PbtO2.
01/12/2008
07:29 PM
Angiotensin-Converting Enzyme Insertion/Deletion Polymorphism and Risk and Outcome of Pneumonia
Chest. 2008; 133:220-225
Recent studies have suggested involvement of the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism in the susceptibility to and severity of community-acquired pneumonia (CAP) in Asian populations. We have explored the hypothesis that the ACE I/D polymorphism affects the risk and outcome of CAP in a Dutch white population.
01/12/2008
07:28 PM
Severe Hemoptysis of Pulmonary Arterial Origin
Chest. 2008; 133:212-219
Hemoptysis of pulmonary arterial origin is a diagnostic challenge in patients admitted to a respiratory ICU (RICU) for treatment of hemoptysis. Its early accurate recognition and treatment reduce morbidity and prevent mortality. Multidetector row CT angiography (MDCTA) is an accurate method for imaging the systemic vascular network.
01/12/2008
07:27 PM
Pulmonary and Thrombotic Manifestations of Systemic Lupus Erythematosus
Chest. 2008; 133:271-280
Systemic lupus erythematosus (SLE) is considered the archetypal systemic autoimmune disease. Clinically characterized by multisystem involvement and varied serologic abnormalities, no two patients present or have disease that evolves in exactly the same way.
01/12/2008
07:26 PM
Long-term Follow-up of a Fenestrated Amplatzer Atrial Septal Occluder in Pulmonary Arterial Hypertension
Chest. 2008; 133:283-285
Pulmonary arterial hypertension (PAH) is a progressive disease, with right-heart failure being the main cause of death. In patients refractory to conventional drug therapy, atrial septostomy can serve as palliative treatment or as a bridge to transplantation.
01/12/2008
07:25 PM
Peripheral Muscle Alterations in Non-COPD Smokers
Chest. 2008; 133:13-18
Although tobacco smoke is the main cause of COPD, relatively little attention has been paid to its potential damage to skeletal muscle. This article addresses the effect of smoking on skeletal muscle.
01/12/2008
07:25 PM
Is Airway Smooth Muscle the 'Missing Link' Modulating Airway Inflammation in Asthma
Airway smooth muscle (ASM) plays a central role in regulating bronchomotor tone in patients with asthma. New evidence, however, suggests that ASM may also orchestrate and perpetuate airway inflammation by promoting the recruitment, activation, and trafficking of inflammatory cells in the airways.
01/12/2008
07:24 PM
Aging Dilates Atrium and Pulmonary Veins
Chest. 2008; 133:190-196
Aging plays a critical role in the pathophysiology of atrial fibrillation (AF). The left atrium (LA) and pulmonary veins (PVs) are essential components for the genesis and maintenance of AF. The purpose of this study was to investigate the effects of aging on the AF substrate and the initiator (PVs).
01/12/2008
07:23 PM
Fluid Therapy in Resuscitated Sepsis
Chest. 2008; 133:252-263
Fluid infusion may be lifesaving in patients with severe sepsis, especially in the earliest phases of treatment. Following initial resuscitation, however, fluid boluses often fail to augment perfusion and may be harmful.
01/12/2008
07:22 PM
Pulmonary Disease Due to Nontuberculous Mycobacteria
Chest. 2008; 133:243-251
Nontuberculous mycobacteria (NTM) are increasingly associated with pulmonary disease. This is a worldwide phenomenon and one that is not related just to better diagnostic techniques or HIV infection. The mode of transmission of NTM is not well defined, but environmental exposure may be the major factor.
01/12/2008
07:21 PM
Occult Traumatic Pneumothorax
Chest. 2008; 133:204-211
The role of chest ultrasonography (US) in the diagnosis of pneumothorax (PTX) has been established, but how it compares with lung CT scanning in the diagnosis of radiooccult PTX and in the determination of its topographic extension has not yet been completely evaluated.
01/12/2008
07:21 PM
Baseline BAL Neutrophilia Predicts Early Mortality in Idiopathic Pulmonary Fibrosis
Chest. 2008; 133:226-232
The prognostic value of BAL fluid cell count differential in patients with idiopathic pulmonary fibrosis (IPF) is unknown. We hypothesized that baseline BAL fluid cell count differential (ie, elevated levels of neutrophils and eosinophils, or reduced levels of lymphocytes) would predict higher mortality among persons with IPF.
01/12/2008
07:09 PM
Elevated Serum Aminotransferase Levels in Children at Risk for Obstructive Sleep Apnea
Chest. 2008; 133:92-99
Fatty liver disease (FLD) is a highly prevalent condition in obese (Ob) children, who are at increased risk for obstructive sleep apnea (OSA). However, the contribution of OSA to FLD remains unknown.
01/10/2008
07:13 PM
Advances in the understanding of allergic asthma
Allergy and Asthma Proceedings, Volume 28, Number 6, November/December 2007 , pp. 614-619(6)
This article reviews the concept of airway remodeling, through various inflammatory cells, the roles of angiogenesis, vascular endothelial cell growth factor, respiratory syncytial virus, and other biomarkers, including exhaled nitric oxide. Control of allergic asthma using immunomodulation and other strategies is addressed.
01/10/2008
07:12 PM
Association of progressive structural changes in the bronchial epithelium with subepithelial fibrous remodeling - A potential role for hypoxia
Virchows Archiv, Volume 451, Number 4, October 2007 , pp. 793-803(11)
In airway remodeling that occurs in association with chronic obstructive pulmonary disease (COPD), the relationship between the subepithelium and structural changes of the bronchial epithelium is not well defined.
01/10/2008
07:11 PM
Prevalence of pollen sensitization in younger children who have asthma
Allergy and Asthma Proceedings, Volume 28, Number 6, November/December 2007 , pp. 654-658(5)
It is commonly believed that young children are incapable of pollen sensitization; therefore, skin testing usually is not performed to these allergens. The purpose of this study was to identify the frequency of positive skin tests to outdoor allergens among younger children who have asthma. Patients who have asthma, aged 6 months to 10 years, were evaluated for pollen sensitization over a 10-year period.
01/10/2008
07:09 PM
Use of remifentanil in general anesthesia for emergency cesarean section in a patient with severe valvular heart disease and pulmonary hypertension
The Internet Journal of Anesthesiology. 2008. Volume 15 Number 2
Cardiac disease is an important cause of maternal mortality and morbidity in obstetric patients. Rheumatic heart disease resulting in valvular dysfunction is still relatively common in underdeveloped countries. Involvement of multiple valves poses a significant risk to patients requiring cesarean section.
01/10/2008
07:08 PM
Smooth Muscle-like Cells in Pulmonary Lymphangioleiomyomatosis
The Proceedings of the American Thoracic Society 5:119-126 (2008)
Proliferation, migration, and differentiation of smooth muscle (SM)-like lymphangioleiomyomatosis (LAM) cells in the lungs are pathologic manifestations of pulmonary LAM, a rare lung disease predominantly afflicting women and exacerbated by pregnancy. LAM cells form nodules throughout the lung without any predominant localization, but can also form small cell clusters dispersed within lung parenchyma.
01/10/2008
07:07 PM
Airway Myofibroblasts and Their Relationship with Airway Myocytes and Fibroblasts
The Proceedings of the American Thoracic Society 5:127-132 (2008)
Myofibroblasts are mesenchyme-derived cells responsible for tissue repair after injury. Resident populations of myofibroblasts are present throughout the lung. In addition, it is likely that myofibroblast progenitors (fibrocytes) can migrate to the lung from the circulation during injury.
01/10/2008
07:06 PM
Impaired Systemic Oxygen Extraction at Maximum Exercise in Pulmonary Hypertension
Medicine & Science in Sports & Exercise. 40(1):3-8, January 2008
To determine the relative contributions of the Fick principle variables to impaired exercise tolerance in pulmonary arterial hypertension compared with pulmonary venous hypertension.
01/10/2008
07:05 PM
Early enteral supplementation with key pharmaconutrients improves Sequential Organ Failure Assessment score in critically ill patients with sepsis - Outcome of a randomized, controlled double-blind trial
Critical Care Medicine. 36(1):131-144, January 2008
To assess the safety and efficacy of an early enteral pharmaconutrition supplement containing glutamine dipeptides, antioxidative vitamins and trace elements, and butyrate in critically ill, septic patients.
01/10/2008
07:04 PM
Use of a Pandemic Preparedness Drill to Increase Rates of Influenza Vaccination Among Healthcare Workers
Infect Control Hosp Epidemiol 2008;29:111-115
To determine the effect of a pandemic influenza preparedness drill on the rate of influenza vaccination among healthcare workers (HCWs).
01/10/2008
07:03 PM
Receptivity to Mandatory Influenza Vaccination Policies for Healthcare Workers Among Registered Nurses Working on Inpatient Units
Infect Control Hosp Epidemiol 2008;29:170-173
A survey that included questions about preferred methods of influenza prevention was completed by 513 registered nurses working on inpatient units. Vaccination was the preferred influenza prevention method among 83.0% of respondents.
01/10/2008
07:02 PM
House Staff Attitudes About Influenza Vaccination After Participation in a Clinical Trial to Improve Vaccination of Hospital Patients
Infect Control Hosp Epidemiol 2008;29:174-176
We surveyed house staff who had participated in a trial that compared influenza vaccination strategies for inpatients. House staff who were exposed to computer-generated vaccination orders were more likely to report that they recommended vaccination to their inpatients and outpatients, compared with house staff who were not exposed to a vaccination intervention.
01/10/2008
07:00 PM
An Evaluation of the Safety and Efficacy of an Anti-Inflammatory Pulmonary Enteral Formula in the Treatment of Pediatric Burn Patients With Respiratory Failure
Journal of Burn Care & Research. 29(1):82-88, January/February 2008
Respiratory failure is associated with a high mortality rate in burned children. Recently, a specialized pulmonary enteral formula (SPEF) was commercially introduced as an adjunct intervention in acute lung injury management. SPEF contains condition-specific nutrients to modulate the inflammatory response. The study examined SPEF impact in critically ill, pediatric burn patients with respiratory failure.
01/10/2008
06:59 PM
Evidence for a Heritable Predisposition to Death Due to Influenza
The Journal of Infectious Diseases 2008;197:18-24
Animal model studies and human epidemiological studies have shown that some infectious diseases develop primarily in individuals with an inherited predisposition. A heritable contribution to the development of severe influenza virus infection (i.e., that which results in death) has not previously been hypothesized or tested.
01/10/2008
06:58 PM
Syk Associates with Clathrin and Mediates Phosphatidylinositol 3-Kinase Activation during Human Rhinovirus Internalization
The Journal of Immunology, 2008, 180: 870-880
Human rhinovirus (HRV) causes the common cold. The most common acute infection in humans, HRV is a leading cause of exacerbations of asthma and chronic obstruction pulmonary disease because of its ability to exacerbate airway inflammation by altering epithelial cell biology upon binding to its receptor, ICAM-1. ICAM-1 regulates not only viral entry and replication but also signaling pathways that lead to inflammatory mediator production.
01/10/2008
06:57 PM
Surfactant Protein-D and Surfactant Inhibit Endotoxin-Induced Pulmonary Inflammation
Chest. 2007; 132:1447-1454
Acute lung injury is a common cause of morbidity and mortality following pulmonary or systemic infections. Surfactant protein-D is a member of the collectin family of proteins, which play important roles in innate host defense of the lung. In this study, the effect of exogenous recombinant human SP-D (rhSP-D) on protection of the adult mouse lung from lipopolysaccharide (LPS)-induced and lipoteichoic acid (LTA)-induced injury was assessed.
01/10/2008
06:56 PM
Expression and Regulation of CCR1 by Airway Smooth Muscle Cells in Asthma
The Journal of Immunology, 2008, 180: 1268-1275
C-C chemokines such as CCL11, CCL5, and CCL3 are central mediators in the pathogenesis of asthma. They are mainly associated with the recruitment and the activation of specific inflammatory cells, such as eosinophils, lymphocytes, and neutrophils.
01/10/2008
06:55 PM
Patients with coronary artery- or chronic obstructive pulmonary disease walk with mechanical inefficiency
Scandinavian Cardiovascular Journal, Volume 41, Issue 6 2007 , pages 405 - 410
Patients with chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) are associated with exercise intolerance. Whether exercise intolerance and reduced mechanical efficiency are due to inactivity alone or to disease related muscular abnormalities is not clear.
01/10/2008
06:54 PM
Severe Pneumonia Due to Adenovirus Serotype 14 - A New Respiratory Threat
Clinical Infectious Diseases 2008;46:421-425
Adenoviruses are associated with sporadic infection and community and institutional outbreaks; they can cause especially severe disease in infants, young children, immunocompromised persons, and transplant recipients.
01/10/2008
06:53 PM
Attenuation of Muscle Metaboreflex in Chronic Obstructive Pulmonary Disease
Medicine & Science in Sports & Exercise. 40(1):9-14, January 2008
Abnormal skeletal muscle function is well documented in chronic obstructive pulmonary disease, but there is no information about the activity of muscle metabosensitive afferents. In this study, we tested the hypothesis that patients with chronic obstructive pulmonary disease would have abnormal reflex responses to stimulation of metabosensitive afferents in skeletal muscle when compared with healthy, matched subjects.
01/10/2008
06:51 PM
Chloramphenicol versus ampicillin plus gentamicin for community acquired very severe pneumonia among children aged 2-59 months in low resource settings - multicentre randomised controlled trial SPEAR study
BMJ, doi:10.1136/bmj.39421.435949.BE
To evaluate whether five days’ treatment with injectable ampicillin plus gentamicin compared with chloramphenicol reduces treatment failure in children aged 2-59 months with community acquired very severe pneumonia in low resource settings.
01/10/2008
06:51 PM
Long-term safety study of levalbuterol administered via metered-dose inhaler in patients with asthma
Annals of Allergy, Asthma and Immunology, Volume 99, Number 6, December 2007 , pp. 540-548(9)
To examine the long-term safety of levalbuterol hydrofluoroalkane (HFA) vs racemic albuterol HFA administered via metered-dose inhaler (MDI) in patients with stable asthma.
01/10/2008
06:50 PM
Clinical profile health-related quality of life, and asthma control in children attending US asthma camps
als of Allergy, Asthma and Immunology, Volume 99, Number 6, December 2007 , pp. 496-501(6)
To create a standardized universal health history camp application that includes an assessment of health-related quality of life using the Child Asthma Short Form; to test a newly validated tool, the Childhood Asthma Control Test (C-ACT), to assess asthma control in children; to provide a clinical snapshot of the overall status of children with asthma in the United States; and to determine the benefit of children's asthma camps.
01/10/2008
06:48 PM
Epidemiology and Clinical Significance of Pneumocystis Colonization
The Journal of Infectious Diseases 2008;197:10-17
Pneumocystis pneumonia has long been recognized as a cause of morbidity and mortality in immunocompromised populations, particularly those with HIV infection.
01/10/2008
06:47 PM
Early Donor Management Increases the Retrieval Rate of Lungs for Transplantation
Ann Thorac Surg 2008;85:278-286
Lung transplantation activity is frustrated by donor lung availability. We sought to examine the effect of active donor management and hormone administration on pulmonary function and yield in cadaveric heart-beating potential lung donors.
01/10/2008
06:45 PM
Fine needle aspiration cytology of clear cell sugar tumor PEComa of the lung - Report of a case
Diagnostic Cytopathology Volume 36, Issue 2 , Pages 89 - 93
PEComa (clear cell sugar tumor) of the lung is a rare benign tumor of the lung probably arising from the perivascular epithelioid cells (PECs). We report a case of pulmonary PEComa arising from the periphery of the right lobe of a 64-year-old male.
01/10/2008
06:44 PM
Bacillus Calmette-Guerin Vaccine Scar Diameter and Asthma
Allergy & Clinical Immunology International September 2007 , Vol 19 , No. 5
The extent of T-helper cell type 1/type 2 (Th1/Th2) balance during the neonatal period may be the key determinant of how the genetic predisposition to asthma is modulated and may be useful in predicting its subsequent development.
01/10/2008
06:43 PM
Association of TNF polymorphisms with sarcoidosis, its prognosis and tumour necrosis factor TNF-alpha levels in Asian Indians
Clinical & Experimental Immunology, Volume 151, Number 2, February 2008 , pp. 251-259(9)
Tumour necrosis factor (TNF)-alpha, an important proinflammatory cytokine, has been implicated in the pathogenesis of sarcoidosis, a multi-systemic granulomatous disorder of unknown aetiology. Here, we report for the first time the association of TNF haplotypes and genotypes with sarcoidosis and its prognosis in the Indian population.
01/10/2008
06:42 PM
Persistent of respiratory syncytial virus in human dendritic cells and influence of nitric oxide
Clinical & Experimental Immunology, Volume 151, Number 2, February 2008 , pp. 359-366(8)
The annual epidemics of respiratory syncytial virus (RSV) infection are probably explained by poor herd immunity and the existence of a dormant reservoir of virus that is activated by an unknown trigger. The virus causes particular problems in infants, the elderly and patients with chronic obstructive airways disease (COPD).
01/10/2008
06:41 PM
Comparison of traditional and abbreviated salbutamol aerosol therapy using a new spacer mouth mask
Allergy and Asthma Proceedings, Volume 28, Number 6, November/December 2007 , pp. 688-690(3)
Abbreviated aerosol therapy has been suggested to increase compliance by delivering the same therapeutic dose, but more rapidly than traditional aerosol therapy. A new spacer mouth mask, which is recommended for use in abbreviated aerosol therapy, is now available in Italy.
01/10/2008
06:39 PM
Randomized Controlled Trial and Meta-analysis of Oral Decontamination with 2 percent Chlorhexidine Solution for the Prevention of Ventilator-Associated Pneumonia
Infect Control Hosp Epidemiol 2008;29:131-136
To determine the effectiveness of oral decontamination with 2% chlorhexidine solution for the prevention of ventilator-associated pneumonia (VAP).
01/10/2008
06:37 PM
Measuring Acceptable Treatment Failure Rates for Community-Acquired Pneumonia - Potential for Reducing Duration of Treatment and Antimicrobial Resistance
Infect Control Hosp Epidemiol 2008;29:137-142
This study was designed to establish the rates of treatment failure for community-acquired pneumonia that are acceptable to knowledgeable and experienced physicians, in order to facilitate the interpretation of existing studies and the design of new studies aimed at optimizing the duration of antibiotic therapy.
01/10/2008
06:36 PM
Prevention and control of silicosis - A national challenge
Indian Journal of Occupational and Environmental Medicine Year : 2007 Volume : 11 Issue : 3 Page : 95-96
Pneumoconiosis is resulting from exposure to free silica may be the commonest and most extensively studied occupational disease of the lung and even today, it continues to be among the most serious occupational diseases. The problem of silicosis is confined not only to the developing nations, but is also not uncommon in industrialized nations.
01/10/2008
06:35 PM
Vanadium pentoxide inhalation
Indian Journal of Occupational and Environmental Medicine Year : 2007 Volume : 11 Issue : 3 Page : 97-102
This mini-review describes the toxic effects of vanadium pentoxide inhalation principally in the workplace and associated complications with breathing and respiration. Although there are some material safety data sheets available detailing the handling, hazards and toxicity of vanadium pentoxide, there are only two reviews listed in PubMed detailing its toxicity.
01/10/2008
06:32 PM
Thrombolysis for Pulmonary Embolism and Venous Thrombosis - Is It Worthwhile
Semin Thromb Hemost 2007; 33: 821-828
Venous thromboembolism is a frequently occurring and potentially fatal disease characterized by short-term and long-term sequelae.
01/10/2008
06:31 PM
IL13 gene polymorphisms modify the effect of exposure to tobacco smoke on persistent wheeze and asthma of childhood, a longitudinal study
Respiratory Research 2008, 9:2
Tobacco smoke and genetic susceptibility are risk factors for asthma and wheezing. The aim of this study was to investigate whether there is a combined effect of interleukin-13 gene (IL13) polymorphisms and tobacco smoke on persistent childhood wheezing and asthma.
01/10/2008
06:30 PM
A Countywide Outbreak of Pertussis
Arch Pediatr Adolesc Med. 2008;162(1):79-85
To describe a large communitywide pertussis outbreak where aggressive diagnostic and treatment measures were used to control the outbreak.