The document outlines the transmission, clinical features, treatment, vaccination, and prevention strategies for pertussis (whooping cough) in Minnesota, emphasizing its endemic nature and peak incidence patterns. It provides vaccination schedules for infants, children, adolescents, and adults, and highlights the importance of immunization for healthcare workers, particularly those caring for infants. Recommendations for exposure scenarios and infection control measures are also discussed, including the use of masks and antibiotic prophylaxis.

1. Pertussis
Pediatric Home Service
Infection Control Committee
December 9, 2010

2. Mode of Transmission
• Bacteria is found in fluids from the mouth and
nose.
• Bacteria can be spread by coughing, sneezing, or
having it on your hands and rubbing your eyes,
nose, or mouth.
• Greatest risk comes from being within three feet
of someone with pertussis for at least 10 hours
per week (close contact).

3. Pertussis in Minnesota
• Pertussis is endemic in Minnesota
• Occurs year round, peaking in the later part of
the year
• Annual incidence peaks every 3-5 years
• Adults and adolescents are half of all cases
nationally
• Waning immunity leads to a substantial
number of older children and adults

4. MN Pertussis Statistics
1,600
1,400
1,200
1,000
800
600
400
200
0
2005 2006 2007 2008 2009 2010
(thru 10-21-10)

5. Clinical Features
• Common incubation period of 7-10 days with a
range of 4-21 days
• Severe rapid, violent cough
• Bursts of coughing resulting in shortness of
breath
• After a coughing spell, the person breathes in
deeply and the breathing pattern often makes a
whooping sound followed by the next coughing
spell

6. Treatment
• Can be treated with antibiotics
• Antibiotic treatment may not cure the
symptoms
• Will reduce the spread of disease to others
• Antibiotics lessen the symptoms if given in
the early stage of the illness

7. Fatal Cases
• Pertussis in infants is often severe
• Infants are more likely than older children and
adults to develop complications
– Most common complication is bacterial pneumonia
– Rare complications include seizures, inflammation of
the brain, and death

8. Pertussis Vaccination
• Two types of pertussis vaccination
– DTaP for infants and children
– Tdap for adolescents and adults

9. Vaccination
• Infants and children
– 5 doses of the DTaP at:
• 2, 4, 6 months
• 15-18 months
• 4-6 years
– All doses are needed for maximum protection
• Immunity is not permanent

10. Vaccination (cont’d)
• Adolescents
– Tdap vaccine at age 11 or 12
• Adults 19-64 years of age
– One-time Tdap in place of the Td booster every 10 years
• Pregnant women
– Tdap before pregnancy; otherwise, it is recommended that
Tdap be given in the postpartum period before leaving the
hospital or birth center
• Hospitals and acute ambulatory facilities should provide
Tdap for healthcare workers
– An interval as short as 2 years from the last Td may be used

11. Implications for
Healthcare Workers
• Priority for vaccination should be given to
those caring for infants younger than 12
months of age

12. MN Department of Health
• Recommendations for preventing pertussis
spread to healthcare workers
– Immunization
– Surgical masks when in contact with any
coughing patient
– Wash hands after contact

13. Additional Precautions
• At PHS, employees may be performing close contact
procedures (suctioning with possible coughing
resulting)
• The MN Department of Health recommends the use of
eye and face protection, in addition to masks when
performing procedures, such as close suctioning for all
patients, not just those with pertussis
• What to Do After an Exposure to a Patient with
Pertussis?
– If you were wearing a mask during the exposure, antibiotic
prophylaxis is not recommended
– If you were not wearing a mask and had close face-face
contact, preventive antibiotics would be recommended

14. What to Do After an Exposure to
a Patient with Pertussis?
• If you were wearing a mask during the exposure,
antibiotic prophylaxis is not recommended
• If you were not wearing a mask and had close
face-face contact, preventive antibiotics would
be recommended

15. References
• Center for Disease Control and Prevention. (2010, August).
Pertussis: Clinical features. Retrieved from
www.cdc.gov/pertussis/clinical/features.html
• Center for Disease Control and Prevention. (2010, August).
Pertussis: Outbreaks-questions and answers. Retrieved from
www.cdc.gov/pertussis/outbreaks-faqs.html
• Minnesota Department of Health. (2010, August). Pertussis: school
and activities exclusion recommendations. Retrieved from
www.health.state.mn.us/immunize
• Minnesota Department of Health. (2010, August). Pertussis: Fact
sheet for EMS, public safety and first responders. Retrieved from
www.health.state.mn.us/divs/idepc/dtopics/infectioncontrol/ps
/pertussis.pdf