Pertussis (whooping cough) is on the rise – test and treat early to protect our infants.

Pertussis (whooping cough) notifications are rapidly rising in the NEPHU catchment with multiple clusters and outbreaks occurring in school-aged children. Infants younger than 6 months experience disproportionately high morbidity and mortality from pertussis, and often acquire their infection from older children, adolescents and adults.

Clinicians and public health units can work together to slow the spread and protect infants from pertussis.

Older children and adults may not have the classical symptoms of pertussis and may present with only a persistent cough. A low threshold for testing is advised, and NAAT (e.g. PCR) of nasopharyngeal swab is the preferred diagnostic test for pertussis for both children and adults. For recommended treatment, see the Therapeutic Guidelines or the Royal Children’s Hospital Melbourne Clinical Practice Guideline. If one person in a household has been diagnosed with pertussis by NAAT, the clinician may decide to commence antibiotic treatment for symptomatic household contacts while awaiting confirmatory testing.

All people diagnosed with pertussis should avoid contact with infants younger than 6 months and pregnant women in the last month of pregnancy. Children diagnosed with pertussis must be excluded from primary school, education and care service premises and children’s services for 21 days after the onset of cough or until they have completed five days of a course of antibiotic treatment. The parent or guardian of the child must inform the person in charge of the facility that the child has pertussis as soon as practicable. Other people with pertussis should be excluded from school or work, preschool and childcare and restrict their attendance at other settings – especially where there are infants – until they are no longer infectious.

Contacts who have been exposed to a confirmed case of pertussis should monitor for symptoms and seek testing and treatment as required. Prophylactic antibiotics are recommended for a subset of contacts who are at higher risk of transmitting infection to infants, and school and children’s service exclusion requirements may apply to under vaccinated contacts.

Pertussis immunity is known to wane over time so please ensure your patients are up to date as per the Australian Immunisation Handbook, including adult boosters at between 20 to 32 weeks gestation in each pregnancy, at age 50 and 65 years, and every 10 years for healthcare workers, early childhood educators and professions or people in close contact with infants.

For detailed information of pertussis notification and management requirements, visit: https://www.health.vic.gov.au/...