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 or audible whoop sound during inhalation or vomiting after a coughing spell. Infants, particularly those under 6 months, can present differently with apnea (pauses in breathing), feeding difficulties, vomiting after coughing, or cyanosis (bluish discoloration of skin, lips, or nails due to lack of oxygen). In some infants, struggling to breathe or apnea may be the only symptom.
Treatment is with antibiotics and symptom management. Antibiotics administered during the first one to two weeks of an illness may reduce the severity and the duration of symptoms. An infected person is no longer contagious after approximately five days of appropriate antibiotic treatment.
Sources: Humans are the only known host. People with pertussis are contagious as soon as they have cold-like symptoms and can transmit disease for up to 3 weeks after they start coughing paroxysms. Transmission is through respiratory droplets or direct contact with secretions. Those with mild symptoms may go undiagnosed, although they can transmit disease to unvaccinated infants and others who are at high risk for severe disease and complications.
Additional risks: Pertussis rarely leads to severe complications among healthy people who have been appropriately vaccinated. Severe complications can occasionally occur in older children and adults who have significant underlying health issues. Pneumonia is the most common complication across all age groups, while seizures and encephalopathy are rare and typically affect very young infants. Complications are more common in infants and young children. Although death from pertussis is uncommon, it is most likely to happen in unvaccinated infants or in infants whose mothers did not receive vaccination during pregnancy.
Prevention: Vaccination is the most effective way to reduce transmission, prevent pertussis illness, particularly in those at high risk for severe disease, and severe complications associated with disease. Vaccinated people who get pertussis usually have milder symptoms. One pertussis-containing vaccine during the third trimester of each pregnancy helps protect newborns who are at high risk for severe complications from pertussis. 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
- Pertussis Weekly Update (PDF)
- 2024 Annual Pertussis Update (Final) (PDF)
- Pertussis FAQ
- Case Definition (PDF)
- Pertussis Notifiable Conditions Page
Surveillance Data
Reporting Forms
Resources for Public Health
- Surveillance and Reporting Guideline (PDF)
- Pertussis Investigation Algorithm for Local Health Jurisdictions (PDF)
- School and Childcare Reporting to Public Health (PDF)
- Form Letter from Schools to Parent of Coughing Child (Word)
- Estimated Duration of Immunity from DTaP – CDC