FastMed North Carolina Health Advisory - Pertussis (Whooping Cough)

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Pertussis

Pertussis is a highly contagious bacterial disease causing uncontrollable, violent coughing making it hard to breathe causing a deep "whooping" sound often heard when the patient tries to take a breath.

Over the past few weeks, FastMed has been seeing an increase in the number of suspected and confirmed cases of pertussis in the County. Several of these cases have been in unvaccinated children.

If you suspect you have Pertussis based upon the descriptions of symptoms, immediately visit your nearest FastMed Urgent Care for evaluation. If we suspect pertussis, FastMed will call the Health Department the same day.

Symptoms of Pertussis

Persons with the following symptoms should be suspected of having pertussis:

  • Cough lasting for >2 weeks PLUS 1 of the following
  • Paroxysms (violent fits of coughing)
  • Inspiratory whooping
  • Posttussive (cough induced) vomiting

Keep in mind that infants under 6 months of age, partially vaccinated children, adolescents and adults frequently do not have the characteristic whoop.

Testing for Pertussis

Persons suspected of having pertussis  may have the following 2 tests:

  1. Culture of nasopharyngeal secretions for pertussis – This culture is a sample of secretions from the uppermost part of the throat, behind the nose, collected to test and detect the pertussis bacteria
  2. PCR testing of nasopharyngeal secretions for pertussis - "molecular photocopying" the polymerase chain reaction (PCR) is used copy small segments of DNA for testing and detection of the pertussis viruses

Communicability

Pertussis is highly contagious in the first 2 weeks; negligible by 3 weeks. Patients are no longer contagious after 5 days of treatment with appropriate antibiotics.

Treatment

The following medications may be administered in treatment of pertussis:

  • Azithromyci
  • Clarithromycin
  • Erythromycin

Stay Home and Limit Exposure to Infants & Young Children

Until antibiotic course medication treatment has been completed, stay home. Do not go to school, work, after school activities, other activities outside the home. Suspected or known cases should stay away from infants & young children, especially unvaccinated infants, until they have completed 5 days of appropriate antibiotics. Suspected cases who do not receive antibiotics should be isolated for 3 weeks after the onset of cough or until the end of the cough, whichever comes first.

Prevention

A pertussis booster (Tdap) is important to prevent spread to unimmunized infants & young children, as immunity to pertussis wanes in previously immunized adolescents and adults. 

Vaccination

All contacts to a pertussis case should have their immunization status verified and brought up-to-date.

Vaccination is recommended to protect the person against further exposure in case he/she has not been infected, vaccination against pertussis following recent exposure is not effective against infection.

Mel G. Lee, MD, CCFP, RMC, RCN (pilot)
Chief Medical Officer North Carolina
FastMed Urgent Care

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