Health Advisory

Pertussis Advisory: Managing Pertussis

To:     Health Care Providers, Hospitals, Ambulatory Care Centers
From: Susan Schoenfeld, Deputy State Epidemiologist for Infectious Disease
Date:  December 13, 2011

– Please Distribute Widely –        

Growing number of pertussis cases
There have been 59 cases of pertussis confirmed in Vermont this year as of Dec.13; 38 have been confirmed since mid-October. This is compared to 164 cases per year for the 10-year period of 1997 to 2007, and 14 cases per year from 2008 to 2010.

Most cases this year have occurred in Chittenden County, but recent confirmed or probable cases have been reported in Lamoille, Franklin, Washington and Windsor counties. Families are notified when cases are identified in schools or child care settings.

Information for clinicians
Expanded information for clinicians about pertussis has been added to the Health Department’s website: http://healthvermont.gov/prevent/pertussis/providers.aspx.

The information below includes highlights from the Dec. 16, 2011 pertussis conference call and from materials at that web location.

Think of pertussis.
Consider pertussis as a diagnosis for anyone who has the following symptoms, regardless of vaccination history:

Report suspected cases to the Health Department’s Epidemiology Unit at 802-863-7240.

Test for pertussis.

Do not test if there are no symptoms.

For questions about testing or to order specimen collection kits, call the Health Department Laboratory at 802-863-7335.

Interpreting Test Results

Test

Timing of specimen collection

Test result interpretation

PCR   PCR

(results within 24-96 hours of receipt at laboratory)

Collect specimens as early as possible after cough onset. PCR will detect non-viable organisms present, even in persons who have been treated with antimicrobials; however, false negatives can occur and are more common later in the illness or after start of antibiotics.

(+)   Positive: Confirms B. pertussis if patient has cough greater than 2 weeks and either paroxysmal coughing, post-tussive vomiting, or whooping.

(-)    Negative: Does not rule out B. pertussis infection; consider other factors.

Cult    Culture

(results can take up to 7 days)

Collect specimens as early as possible after cough onset. Recovering the organism is unlikely beyond 3 weeks of cough or in patients who have received antimicrobials. False negatives are common even early in illness.

(+)   Positive: Confirms B. pertussis infection.

(-)    Negative: Does not rule out B. pertussis infection; consider other factors.

Treat and report suspected and confirmed cases.
Treatment guidelines are available on the Health Department website: http://healthvermont.gov/prevent/pertussis/documents/pertussistreatment.pdf

For questions about treatment, call the Health Department’s Epidemiology Unit at (802) 863-7240.

Stop Transmission.

For information about ordering vaccine, call the Health Department’s Immunization Program at 802-863-7240.

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