Department of State Health Services
October 5 , 2004
The Department of State Health Service is currently investigating active Pertussis in the Region. Pertussis should be considered when evaluating any patient with an acute cough illness characterized by one or more of the following symptoms: prolonged cough, cough with paroxysms, whoop, or post-tussive gagging/vomiting. Infants may present with apnea and/or cyanosis. An increased white blood cell count with lymphoctytosis is a characteristic but nonspecific finding. Adults, teens, and vaccinated children often have mild symptoms that mimic bronchitis or asthma.
Laboratory tests should be used in conjunction with clinical symptoms for diagnosis and can be used to confirm but not rule out pertussis. The organism is more likely to be found early in the coughing phase. After 3-4 weeks in the disease process the organism may have cleared the nasopharyngeal area.
If you clinically suspect pertussis:
Report immediately to your local health authority.
Submit specimens for laboratory confirmation. The laboratory test for pertussis is isolation of Bordatella pertussis by culture. Polymerase chain reaction (PCR) testing and is considered confirmatory when consistent with a clinical diagnosis.
Begin chemoprophylaxis contacts regardless of age or vaccination status.
- Review immunization records of patient and all household and close for children less than 7 years of age. Children in this age group who have not completed the DtaP four dose primary series should complete the series with minimal intervals. Those who have completed the primary series should be given a booster dose if their last dose of DtaP was given more than 3 years ago.
Treatment of suspects and contacts may include either Zithromax for 5 days or erythromycin, or trimethoprim/sulfamethoxazole administered for 14 days. If these drugs are not tolerated, clarithromycin or azithromycin can be substituted. Symptomatic children and/or adults may return to school or work after completing the first 5 days of medication.
Pertussis immunity is not absolute and may not prevent infection. Older children and adults with mild illness can transmit the infection and are often the source of illness in infants. Therefore, early recognition and treatment of pertussis in contacts of young infants and prophylaxis of their household members is especially important.
Please call the Amarillo Bi-City-County Health District at 806-351-7220, the Lubbock City Health Department at 806-775-2935, or the Department of State Health Services in Lubbock at 806-767-0319 with questions or to report a known or suspected pertussis case.
If you have comments or suggestions please contact us.