Pertussis Advisory Update: Chittenden County
To: Health Care Providers, Hospitals, Ambulatory Care Centers
From: Patsy Kelso, State Epidemiologist for Infectious Disease
Date: November 23, 2011
– Please Distribute Widely –
- Seven cases of pertussis have been confirmed in Chittenden County in
the past three weeks.
- Four of these cases were associated with two schools. All parents and
staff have been notified about the cases, with close contacts referred for
prophylaxis, or evaluation if symptomatic.
- Clinically suspect cases and a single confirmed case have been reported
from five other Chittenden County schools.
- While most cases are in children, confirmed or probable pertussis has
been reported in seven adults ages 33 through 76 statewide since
Actions Requested –
Maintain a high index of suspicion for pertussis for clinical
diagnosis, testing, treating, providing prophylaxis, and reporting cases to the Health Department. Information from the Health Department Laboratory regarding weekend specimen collection and testing is provided below.
- Report suspected cases to the Vermont Department of Health (802-863-7240 or 1-800-640-4374). An epidemiologist is on call over the holiday weekend. Even if a patient has been coughing for more than three weeks, reporting allows for public health interventions to identify others at risk. Epidemiologists can also provide information regarding pertussis in schools or other institutional settings.
- Test for pertussis. While patients with clinical pertussis should be treated and reported as suspect cases, testing helps to define risk to the community and helps inform decisions for others. Testing for B. pertussis is available at the Health Department Laboratory. Please request VDH Kit #5 for proper collection and transport materials. Culture testing (no charge) or culture/PCR testing ($36) can be requested. Culture results are available within seven days of receipt at the Health Department Laboratory, and PCR is performed on Mondays and Thursdays.
PCR testing will be performed on November 23 for specimens already in the lab. Specimens collected over the Thanksgiving holiday and weekend (November 24-27) should be sent via normal procedures for culture, with PCR testing performed on Monday, November 28 (if ordered). PCR testing for high priority specimens in high-risk situations (such as children in school or childcare) may be possible over the Thanksgiving holiday. Contact the Health Department’s Epidemiology Section 24/7 (802-863-7240 or toll-free at 800-640-4373) to discuss the need for testing over the holiday.
- Provide treatment and prophylaxis of close contacts. Clinicians should
strongly consider treating without delay when the clinical history indicates
pertussis, especially if the patient is at risk for severe or complicated disease (e.g. infants) or the family reports exposure to pertussis. The prompt initiation of prophylaxis to household and other close contacts of clinical cases is also important in order to avert secondary transmission.
- Exclude anyone who has clinical or lab-confirmed pertussis from school,
work, group and family activities until five days of antibiotic therapy have
been completed. Particular care should be taken to avoid infants. Asymptomatic contacts who are receiving antibiotic prophylaxis do not need to restrict their activities.
- Provide vaccination. One dose of the Tdap vaccine is recommended for people 11 years and older. There is no minimal time interval between doses of Td and Tdap. Vaccinating adolescents and adults, especially family members or caregivers of infants and health care workers, can help prevent pertussis transmission to infants too young to be vaccinated. For questions regarding immunizations, please contact the Immunization Program (802-863-7240).
Read the Pertussis Advisory dated November 15, 2011, posted on the Vermont
Department of Health website, for more information: