Pertussis

**FOR QUICK REFRENCE EXPOSURE PROCESS PLEASE REFER TO ATTACHMENT E

Overview:

Pertussis is a bacterial infection of the respiratory tract. It is also called “whooping cough”. The disease is more common in young children, however, adolescents and adults can also develop pertussis. Whooping cough gets its name from the high pitched gasp or whooping sound the child makes when trying to breath after a coughing spell. Pertussis often starts with a runny nose and cough that gradually worsens over 1 to 2 weeks. Violent coughing spells frequently end in a whooping sound, vomiting or loss of breath. The cough can last for 1 to 2 months. The disease is most severe in infants under 1 year of age

Mode of Transmission:

Airborne

Examples of Transmission:

Pertussis is spread very easily from infected persons to others through coughing or sneezing. Persons can spread the germ from the time they get the infection until 3 weeks after the coughing attacks start or until they have taken the medication erythromycin for 5 days. It takes between 6 to 20 days to come down with pertussis after coming in contact with someone else who has it.

Prevention:

The recommended vaccine is DTaP which is a combination vaccine for diphtheria, tetanus and pertussis. Children need five DTaP shots. A sixth dose is now recommended at age 11 or 12 years. Healthcare personnel should receive a single dose of Tdap if they have not previously received Tdap and regardless of the time since last Td (tetanus and diphtheria) dose.

Precautions:

droplet

Signs and Symptoms:

Pertussis symptoms usually begin 7-10 days after exposure to the bacteria. Early symptoms can last for 1 to 2 weeks and usually include:

Runny nose
Low-grade fever
Mild, occasional cough
Apnea – a pause in breathing (in infants)

During the next stage, severe coughing fits with “whooping" occurs. Coughing can be so severe that vomiting occurs. Coughing episodes can continue for 10 weeks or more.

Complications:

most severe in infants and include pneumonia, seizures, apnea, encephalopathy (infection around the brain) and death. More than half of infants less than one year old who get pertussis must be hospitalized. In teenagers and adults, complications are much less severe and include pneumonia and rib fractures from severe coughing; hospitalization is uncommon.

Exposure Determination: An obvious exposure involves direct contact with respiratory, oral, or nasal secretions from a case-patient during the contagious period (e.g., a cough or sneeze in the face, sharing eating utensils, sharing water bottles, mouth-to-mouth resuscitation, or performing intubation or nasotracheal suctioning without a mask).

Post Exposure Treatment:

Some health care workers still get pertussis even though they have been vaccinated. Therefore, in 2011, the CDC’s Advisory Committee for Immunization Practices recommended antibiotic prophylaxis for all health care workers who have unprotected exposure to pertussis and are likely to expose a patient at risk for severe pertussis. They recommended that all other health care workers either receive post exposure antibiotic prophylaxis or be monitored daily for 21 days after pertussis exposure and treated if they develop signs and symptoms of pertussis.

Paperwork Required

OC Public Health Communicable Disease Exposure Form (policy 330.96) with Fire incident number on top. Should be faxed while still in the hospital Fax: (714) 564-4050 per county policy must be received within 7 calendar days

OC Public Health Communicable Disease Exposure Form

The City “Report of Employee Injury” form
Medical Service Order- RM -67 (when medical care is required)
Sharps Injury Log