Information on Pertussis

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Pertussis, more commonly known as whooping cough, is caused by a bacterium, Bordatella pertussis, that lives in the mouth, nose and throat. The germ is highly contagious and is easily spread from person to person. In the early to mid-1900s, pertussis was one of the most common childhood diseases and a major cause of childhood mortality in the United States.

Symptoms of Pertussis

Symptoms usually appear five to 10 days after exposure, but can take as long as 21 days. The first symptoms are similar to those of a common cold: a runny nose, sneezing, low-grade fever and a mild, occasional cough. The cough gradually becomes severe and, after one to two weeks, the patient has spasmodic bursts of numerous, rapid coughs. The characteristic high-pitched "whoop" comes from breathing in after a coughing episode. During such an attack, the patient may turn blue, vomit and become exhausted. Between coughing attacks, the patient usually appears normal.

Coughing attacks occur more frequently at night. The attacks increase in frequency for a couple of weeks, then remain at the same level for two to three weeks, and then gradually decrease. Coughing may last as long as 10 weeks. Recovery is gradual, and coughing episodes can recur with subsequent respiratory infections for months after the onset of pertussis.

How Pertussis Spreads

The bacteria are shed in discharges from the nose and throat and then spread to others through coughing and sneezing. An infected person is contagious from just before onset of symptoms until up to three weeks after symptoms start. Treatment with antibiotics shortens the contagious period to about five days.

Anyone who has not had pertussis previously or who was not vaccinated as a child can get the disease. Half of the cases occur in children younger than 1 year of age. Older children and adults can carry the germ and spread it but have only mild symptoms. The current pertussis vaccine is not administered after age 7.

Management of Students or Faculty Potentially Exposed to Pertussis

The medical management of pertussis cases is primarily supportive, although antibiotics are of some value. Erythromycin is the drug of choice. This therapy eradicates the organism from secretions, there- by decreasing communicability and, if initiated early, may modify the course of the illness. Erythromycin or trimethoprim-sulfamethoxazole prophylaxis should be administered for 14 days to all household and other close contacts of persons with pertussis, regardless of age and vaccination status. Although data from controlled clinical trials are lacking, prophylaxis of all household members and other close contacts may prevent or minimize transmission. All close contacts <7 years of age who have not completed the four-dose primary series should complete the series with the minimal intervals. Close contacts <7 years of age who have completed a primary series but have not received a dose of DTP or DTaP within 3 year's of exposure, should be given a booster dose.

Infection Control Recommendations

• Student or faculty member should stay home: no work, school, day care, public areas for 10 days after fever stops.
• Cover mouth and nose with tissue/mask when coughing/sneezing and wash hands with soap and friction or use waterless hand hygiene products every time you touch your nose or mouth.
• Household/dormitory contacts: hand washing or waterless hand hygiene products (gloves for fluids if possible).
• No sharing of eating/drinking utensils, sport bottles, sandwiches, towels or bedding.
• Routine cleaning with soap and hot water, Use household disinfectant (Lysol® or 1:100 diluted bleach) for environmental surfaces.
• Household/dormitory waste (e.g. body fluids, tissues, gloves) may be discarded as normal waste.

Note: if you live in a dormitory, please report your illness to the residency hall director.

Web Sites for More Information

• U.S. Centers for Disease Control and Prevention
• Illinois Department of Public Health