Pertussis (Whooping Cough)

Cause: Bacterium Bordetella pertussis.

Illness and treatment: Classic pertussis symptoms include initial cold-like manifestations followed by an extended cough illness lasting for weeks with spasms of severe coughing (paroxysms) ending in a gasp, whoop, or vomiting. Infants may have feeding difficulties, and often become apneic. Treatment is with antibiotics and supportive care.

Sources: Humans, often older adolescents and adults with mild symptoms not recognized as pertussis, are the reservoir and transmit pertussis through respiratory droplets or direct contact.

Additional risks: Complications, which include pneumonia, seizures, encephalopathy, and rarely death, occur most often in very young infants.

Prevention: Universal immunization including booster doses can reduce the risk of infection and generally prevents severe illness. Respiratory and hand hygiene can prevent transmission.

Recent Washington trends: The number of cases reported each year varies considerably, ranging from 184 to 1026 cases a year since 1995. There is also variation in the rate of reported disease among health jurisdictions, reflecting local outbreaks.

Purpose of Reporting and Surveillance

To prevent illness and death among high-risk persons and among persons who may transmit pertussis to high-risk persons
To identify and evaluate contacts and recommend appropriate preventive measures, including exclusion, antibiotic prophylaxis and/or immunization
To educate exposed persons about signs and symptoms of disease, thereby facilitating early diagnosis and treatment and preventing further spread
To vaccinate exposed, underimmunized children
To monitor the epidemiology of pertussis in Washington state

Legal Reporting Requirements

Health care providers and Health care facilities: notifiable to local health jurisdiction within 24 hours
Laboratories: notifiable to local health jurisdiction within 24 hours; submission required – isolate, within 2 business days; submission on request – if no isolate available, specimen associated with positive result, within 2 business days.
Local health jurisdictions: notifiable to the Washington State Department of Health (DOH) Communicable Disease Epidemiology (CDE) within 7 days of case investigation completion or summary information required within 21 days