IMMEDIATE REPORTABLE DISEASE: Any suspected case should be reported immediately by telephone to the Local Health Officer and by the Health Officer to the State Department of Health and Senior Services; include clinical and laboratory information supporting the diagnosis for appropriate investigation and control recommendations.

CLINICAL DESCRIPTION

Pertussis is a disease of the respiratory tract which begins with mild symptoms such as cough (catarrhal stage) and usually progresses to severe paroxysms of coughing (paroxysmal stage), often with a characteristic inspiratory whoop, followed by vomiting. Fever is absent or minimal. Symptoms wane gradually. Older children and adults may have atypical manifestations, with persistent cough and no inspiratory whoop. In infants younger than 6 months of age, whoop is often absent.Communicability is most likely in the catarrhal stage before the onset of paroxysms; subsequently the risk diminishes rapidly, but may last as long as 3 weeks. Erythromycin or trimethoprim-sulfamethoxazole therapy shortens the period of carriage and presumed contagiousness to 5 days or less.The incubation period is usually 7 to 10 days, rarely more than 2 weeks.

1. CONFIRMED
   

   A confirmed case has all of the following:

   • A cough lasting at least 2 weeks (as reported by a health professional),
     AND

   • Paroxysms of coughing or inspiratory "whoop" or post-tussive vomiting,
     AND

   • Either of below:

     • Laboratory confirmation consisting of:Bacterial isolation (preferably), OR
       Positive direct immunofluorescence antibody test of nasopharyngeal secretions, OR
       Positive polymerase chain reaction (PCR) to Bordetella pertussis.
     • Epidemiologic link to a laboratory-confirmed case.

2. PROBABLE
   

   A probable case meets the above clinical case definition but is not laboratory-confirmed as specified above or epidemiologically linked to a confirmed case.

What should you know about Pertussis (Whooping Cough)?