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Pertussis (Whooping Cough)

What is it?

Pertussis (also called “whooping cough”) is a highly contagious bacterial infection that causes a severe cough.

Symptoms

  • Symptoms appear 6 to 21 (average 7-10) days after exposure to an infected person.
  • Pertussis may start with cold symptoms or simply a dry cough followed by episodes of severe coughing. Fever is absent or mild.
  • Gagging or vomiting may occur after severe coughing spells. Cough may be worse at night.
  • The person may look and feel healthy between coughing episodes.
  • Immunized school children, adolescents, and adults often have milder illness than young children.
  • Infants with pertussis may not develop a severe cough. They may only have a mild cough, decreased feeding, and may have difficulty breathing or turn bluish.

How is it spread?

  • Pertussis is spread through droplets from the mouth and nose when a person with pertussis coughs, sneezes, or talks.
  • Untreated, persons with pertussis can spread the infection for several weeks.
  • Adults and older children with unrecognized pertussis often spread the infection to others, including young children.

Who gets it?

  • Anyone who is exposed to the bacteria can get pertussis.
  • Pertussis vaccine prevents severe disease in young infants, but even a vaccinated person can get pertussis infection.
  • Pertussis occurs in older children and adults because protection from the vaccine (DTP or DTaP) lasts only 5-10 years after the last dose.

Who is at greatest risk?

  • Infants less than one year old are considered at high risk for complications of pertussis, including hospitalization, pneumonia, convulsions, and rarely, brain damage or death.
  • Unimmunized or partly immunized children are also at higher risk for pertussis infection and severe disease.
  • Pregnant women with pertussis near the time of delivery may spread it to their newborns.
  • Persons who have close contact with pregnant women, infants, or health care workers can spread pertussis to these high risk individuals.
  • Health care workers with pertussis who have face-to-face patient contact can spread pertussis to their patients and other health care staff.

Treatment

  • Treatment is most effective early in the disease. A health care provider must prescribe an antibiotic active against pertussis.
  • Persons treated with antibiotics are no longer contagious after the first 5 days of appropriate antibiotic treatment have been completed.

Prevention

  • Pertussis vaccine is included in DTaP and the new Tdap vaccine for adolescents and adults (available since 2006).
    • Before age 7, children should get 5 doses of the DTaP vaccine.
    • Doses are usually given at 2, 4, 6, and 15-18 months of age and 4 - 6 years of age.
    • The 4th dose may be given as early as 12 months of age.
    • Tdap should be given as a single booster dose to 11-64 year old individuals.
  • Persons with cough illnesses should avoid contact with infants and expectant mothers, including visiting or working in labor, delivery, and nursery areas of hospitals and in child care settings.
  • If you live or have close contact with someone who has pertussis, you should take antibiotics to prevent pertussis – contact your health care provider.
Report all King County cases to Public Health by calling 206-296-4774.

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