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Pertussis

(Whooping Cough)
DOHMH Health Alert # 29: Pertussis in New York City (PDF)
What is pertussis?
Pertussis, also known as whooping cough, is a highly contagious bacterial illness that causes a cough lasting several weeks to months. In New York City, from 2008-2010, there has been an average of 107 cases of pertussis per year reported to the Health Department.
Who gets pertussis?
Pertussis can occur at any age. Children who are too young to be fully vaccinated and those who have not yet completed the primary vaccination series are at highest risk for severe illness. Since the 1980s, the number of reported pertussis cases has gradually increased in the United States. In 2005, over 25,000 cases of pertussis cases were reported in the United States, the highest number of reported cases since 1959. Approximately 60 percent of the cases were in adolescents and adults and may be a result of decreasing immunity in this population.
How is pertussis spread?
Pertussis is primarily spread when a person coughs or sneezes, by direct contact with the mucus or saliva of an infected person, or it can be spread by droplets.
What are the symptoms of pertussis?

Pertussis can occur at any age. Children who are too young to be fully vaccinated and those who have not yet completed the primary vaccination series are at highest risk for severe illness. Since the 1980s, the number of reported pertussis cases has gradually increased in the United States. In 2005, over 25,000 cases of pertussis cases were reported in the United States, the highest number of reported cases since 1959. Approximately 60 percent of the cases were in adolescents and adults and may be a result of decreasing immunity in this population.

How soon after infection do symptoms appear?
Symptoms usually appear 7-10 days after exposure to an infected person, but can be as long as 21 days or even up to 6 weeks.
When and for how long is a person able to spread pertussis?
A person is contagious for up to 3 weeks after the onset of coughing fits or until 5 days after appropriate antibiotic treatment has begun. People are most contagious during the early, "cold-like" stage.
Does past infection with pertussis make a person immune?

Neither vaccination nor natural infection with pertussis guarantees lifelong protective immunity against pertussis. Since immunity decreases after five to ten years from the last pertussis vaccine dose, older children, adolescents and adults are at risk of becoming infected with pertussis and need vaccination.

What are the complications associated with pertussis?
Complications of pertussis are most common in young infants and can include pneumonia, ear infections, seizures, problems of the nervous system and brain, and death.
What is the vaccine for pertussis?

The vaccine for pertussis is usually given in combination with diphtheria and tetanus. There are two vaccines to protect against pertussis: 1 for children <7 years of age (diphtheria-tetanus-acellular pertussis vaccine or DTaP) and the second for persons aged 7 years and older (tetanus-diphtheria-acellular pertussis vaccine or Tdap).

The primary DTaP series should be given at 2, 4, and 6 months, a fourth dose should be given between 15 -18 months of age, and a fifth booster dose prior to school entry between 4 – 6 years of age. If a 7-10 year old child has not received all of the recommended DTaP vaccine doses, a dose of Tdap should be given before the 11-12 year old checkup.

Adolescents attending 6th through 10th grades are required to receive a Tdap booster dose for school entry.

Adults should also receive the Tdap vaccine; it is especially important for those in close contact with infants less than 12 months of age such as parents, caregivers, and health care personnel. Tdap vaccine should be administered to women who are pregnant, preferably during the late second or third trimester (after 20 weeks gestation). If not administered during pregnancy, Tdap should be administered immediately postpartum.

What can be done to prevent the spread of pertussis?
The single most effective control measure is maintaining the highest possible vaccination levels in the community. Treatment of patients with certain antibiotics, such as a macrolide (erythromycin or azithromycin) , can shorten the time they are contagious. People who have pertussis should stay away from young children and infants until they have been treated. People in close contact with a person with pertussis may require antibiotics (post-exposure prophylaxis) to prevent them from becoming ill and spreading the disease.

For more information on where your child can be vaccinated, call 311.

Last Updated: December 18, 2012