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.

Resources

Notifiable Conditions Directory