Pertussis (whooping cough) is a highly contagious bacterial disease caused by Bordetella pertussis (a small, aerobic, Gram-negative pleomorphic bacillus). Transmission occurs via respiratory secretions on the hands or in aerosolized form. Among vaccine-preventable diseases, Pertussis is one of the most commonly occurring ones in the United States and it remains a cause of high morbidity and mortality among children worldwide.
The vaccine currently used in the United States consists of heat-killed organisms and is combined with the diphtheria and tetanus vaccine, combined form is Tdap.Individuals are vaccinated at 2, 4, 6, and 15-18 months of age. The vaccine provides immunity for approximately 15 years and this waning immunity increases susceptibility among adolescents and adults, unless re-vaccinated. Reinfection is also common in both previously vaccinated and non-vaccinated individuals.
Pertussis can cause serious illness in infants, children and adults. The disease starts like the common cold, with runny nose or congestion, sneezing, and maybe mild cough or fever. Then after 1 to 2 weeks sever coughing can begin. It can cause violent and rapid coughing, over and over, until the air is gone from the lungs and the person is forced to inhale with a loud "whooping" sound.
Pertussis is typically spread when an infected person coughs or sneezes while in close contact with others who then breathe in the pertussis bacteria. Infants, particularly those younger than 6 months of age are at the highest risk for infection and many infants who develop pertussis are infected by parents, older siblings, or other caregivers.However, pertussis is not just a childhood disease, outbreaks among adolescents and adults (including healthcare workers) are increasingly reported. This reinforces the need for healthcare providers to recognize that asymptomatic and subclinical infections are common in adolescents and adults as exposure to unrecognized cases of pertussis in this population may provide an explanation as to the increase of pertussis in susceptible children and infants.
Transmission occurs through direct contact with respiratory secretions or large aerosol droplets from the respiratory tract of infected individuals. Due to the highly contagious nature of the disease, patients who have pertussis need to be placed under droplet precautions. Droplet precautions for pertussis means:
- Private room with private toilet and bathing facilities required (may cohort patients if necessary)
- Regular air ventilation adequate and door may remain open
- Standard procedure/ surgical mask is adequate to enter the room and remove mask when leaving room
- Visitors to follow disease-specific visitor guidelines and screen visitors for sign or symptoms consistent with the patient's illness
- Patients may be transported outside the room only for essential tests and procedures that cannot be completed inside the isolation room.
- Take the patient immediately into the examination/ procedure room
- Mask the patient (a standard mask is adequate)
- If patient cannot be masked then providers must wear standard masks in addition to following standard precautions
- Follow the respiratory hygiene/cough etiquette policy
- Visitors must follow standard precautions and must be screened for signs and symptoms consistent with pertussis
For more information, check out the following policies and procedures: