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Pertussis FAQ's

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In the first few months of 2010, several states are reporting increased cases of pertussis as compared to the same time last year.
  • In particular, California has reported 2,174 cases and 7 infant deaths due to pertussis as of July 27, 2010.
    • In response to the epidemic in California, efforts are underway to increase awareness of pertussis and get more people vaccinated.
    • Among other efforts, California hopes to prevent pertussis transmission to the most vulnerable population, infants less than 1 year of age.
    • For up to date information on the California epidemic, visit">">
  • There have also been recent news articles regarding increased pertussis activity or outbreaks in Arizona, Georgia, Idaho, Michigan, Minnesota, New York, North Carolina, Ohio, Oregon and South Carolina.
  • However, it’s important to know that while a number of states are reporting an increase in the number of pertussis cases in 2010, other states are reporting less pertussis activity in comparison to this time last year.
The diagnosis of pertussis is usually made based on its characteristic history and physical examination. A laboratory test may be done, which involves taking a specimen from the back of the patient’s throat (through the nose).
Pertussis is spread through the air by infectious droplets and is highly contagious.
  • Many infants who get pertussis are infected by older siblings, parents, or other caregivers who might not even know they have the disease. If you are planning on becoming pregnant or are currently pregnant, talk to your doctor about getting the Tdap vaccine. Don’t risk spreading this disease to your baby. Make sure all people around your baby are vaccinated with Tdap including siblings, grandparents, aunts, uncles, nannies, caregivers, childcare staff, etc.  
  • If pertussis is circulating in the community, there is still a chance that a fully vaccinated person (of any age) can catch this very contagious disease. This is because no vaccine is 100% effective. However, when a vaccinated person gets pertussis, the infection is usually less severe.
  • Keep young infants away from people with cough illness. Likewise, people with cough illness should always stay away from young infants.


The incubation period of pertussis is commonly seven to 10 days, with a range of 5-21 days.

Persons with pertussis are most infectious during the catarrhal period and during the first two weeks after onset of the cough (approximately 21 days).

Pertussis can be a very serious disease, especially for infants. Rates of hospitalization and complications increase with decreasing age. Of the 100 deaths from pertussis during 2000-2004, 76 occurred in infants age one month or younger. Infants younger than age one year accounted for 19% of pertussis cases and 92% of pertussis deaths in the United States during 2000-2004. As noted above in the section on symptoms, the breathing difficulties associated with this disease can be very distressing and scary for the patient and his or her family. Although adults are less likely than infants to become seriously ill with pertussis, most make repeated visits for medical care and miss work, especially when pertussis is not initially considered as a reason for their long-term cough. In addition, adults with pertussis infection have been shown to be an important source of infection to infants with whom they have close contact.
Antibiotics are somewhat helpful in treating pertussis. The drug of choice is usually erythromycin. This antibiotic should also be given for 14 days to all household and other close contacts of the patient to minimize transmission, regardless of age and vaccination status. All close contacts younger than seven years of age should complete their DTaP vaccine series if they have not already done so. If they have completed their primary four dose series, but have not had a dose within the last three years, they should be given a booster dose. Patients also need supportive therapy such as bed rest, fluids, and control of fever.
Again, younger patients have a greater chance of complications from pertussis than older patients. The most common complication is secondary bacterial infection, which is the cause of most pertussis related deaths? Pneumonia occurs in one out of 20 cases. Infants are also more likely to suffer from such neurologic complications as seizures and encephalopathy, probably due to the reduction of oxygen supply to the brain. In 1997-2000, 0.8% of all cases and 1.4% of cases under six months of age, involved seizures. Other less serious complications include ear infection, loss of appetite, and dehydration. Adults with pertussis can have complications such as pneumonia (up to 5% of cases) and rib fracture from coughing (up to 4% of cases). Other reported side effects include (among others), loss of consciousness, female urinary incontinence, hernias, angina, and weight loss.

Pertussis symptoms can be different depending on how old you are or if you’ve been vaccinated.

  • Pertussis usually starts with cold-like symtoms, and maybe mild cough, but not every runny nose is pertussis. Pertussis is often not suspected or diagnosed until a persistent cough with spasms sets in after 1-2 weeks.
  • In infants, the cough may be mild or absent. However, infants may have a symptom known as “apnea.” Apnea is a brief pause in the child’s breathing pattern.  
  • Infants and children with pertussis can cough violently and rapidly, over and over, until the air is gone from their lungs and they're forced to inhale with a loud "whooping" sound. This extreme coughing can result in vomiting and exhaustion. Illness is generally less severe in adolescents and adults.
  • The coughing fits can take place for 10 weeks or more. The coughing fits usually last from 1 to 6 weeks, but can go on for up to 10 weeks or more.
  • Although children are often exhausted after a coughing fit, they usually appear relatively healthy in-between coughing episodes.  
  • The illness can be milder (less severe) and the typical "whoop" absent in children, adolescents, and adults who have been vaccinated.
  • Make sure patients of all ages are up to date on pertussis-containing vaccines (see immunization schedules at  

  • Consider the diagnosis of pertussis in their patients and close contacts. The diagnosis of pertussis is often delayed or missed. In the youngest infants, atypical presentation is common – the cough may be minimal or absent and the primary symptom can be apnea.

  •  Test for pertussis in their patients, using the correct tests (see  

  • Treat appropriately for pertussis. Because pertussis may progress rapidly in young infants, treat suspected and confirmed cases promptly.

  • Quickly report cases of pertussis to their local public health department to assist with preventing additional cases.

Everyone should make sure they are up to date with recommended pertussis vaccines (DTaP for infants/children and Tdap for adolescents/adults). If not sure, call your doctor to see what’s best for you and your family.

  • No serious reactions have been associated with DTaP or Tdap and getting these vaccines is much safer than getting the dangerous kinds of diseases they prevent. 
  • Infants and children are recommended to receive the childhood pertussis vaccine, or DTaP, at 2, 4, and 6 months of age. A fourth shot is given between 15 and 18 months of age, and a fifth shot is given when a child enters school, at 4–6 years of age. To maximize protection, all 5 doses of DTaP are needed on time according to the recommended immunization schedule.
  • Since 2005, there has been an adolescent/adult pertussis booster vaccine (Tdap) that can be used for prevention and control of pertussis.
  • The protection received from DTaP, the childhood vaccine, fades over time. Adolescents and adults need Tdap, even if they were completely vaccinated with DTaP as children.
  • Pre-teens going to the doctor for their regular check-up at age 11 or 12 years should get a dose of Tdap.   
  • If a teenager (13-18 years) missed getting Tdap at his/her check-up, ask the doctor about getting it now.  
  • Adults 19-64 years old who didn't get Tdap as a pre-teen or teen should get one dose of Tdap instead of their next Td booster.
  • The dose of Tdap can be given earlier than the 10-year mark since the last Td booster, so it's a good idea for adults to talk to a healthcare provider about what's best for their specific situation.
  • Getting vaccinated with Tdap is especially important for family members with and caregivers of new infants.

Pertussis (whooping cough) is highly contagious and one of the most commonly occurring vaccine-preventable diseases in the United States.

  • People with pertussis usually spread the disease by coughing or sneezing while in close contact with others, who then breathe in the pertussis bacteria.
  • Many infants who get pertussis are infected by older siblings, parents or other caregivers who might not even know they have the disease.

Seeking treatment when pertussis symptoms first start is important.  If you or your child is having trouble breathing, seek medical attention immediately.

  • Tell the doctor if you or your child has been around others with cough/cold symptoms or if you’ve heard that pertussis is in your community.
  • Antibiotic treatment may make the pertussis infection less severe if it is started early, before coughing fits begin. 
  • Antibiotic treatment can help prevent spreading the disease to close contacts (people who have spent a lot of time around the infected person) and is necessary for stopping the spread of pertussis.

Pertussis is most severe for babies, who often catch the illness from a family member or other caregiver.   

  • More than half of infants less than 1 year of age who get the disease must be hospitalized.
  • About 1 in 5 infants with pertussis get pneumonia (lung infection).
  • About 1 in 100 infants will have convulsions.  
  • In rare cases (1 in 100), pertussis can be deadly, especially in infants less than 1 year of age. This is the age group we’re most concerned about when it comes to pertussis.
  • Many infants who get pertussis are infected by older siblings, parents, or other caregivers who might not even know they have the disease.