About Pertussis Outbreaks
Pertussis is an endemic (common) disease in the United States, with peaks in disease every 3 to 5 years and frequent outbreaks. In 2012, 48,277 cases of pertussis were reported — and many more cases go unreported. The primary goal of pertussis outbreak control efforts is to decrease morbidity (amount of disease) and mortality (death) among infants; a secondary goal is to decrease morbidity among people of all ages.
Pertussis outbreaks can be difficult to identify and manage. Other respiratory pathogens (germs) often cause symptoms similar to pertussis, and co-circulation with other pathogens (bacterial and viral) does occur. Polymerase chain reaction (PCR) tests, which are commonly used to diagnose pertussis, vary in specificity — the ability to correctly confirm individuals who do not have pertussis. Therefore, getting confirmation with culture (a lab test where the bacteria are grown) for at least one suspicious case is recommended any time there is suspicion of a pertussis outbreak. Pseudo (false) outbreaks of pertussis have resulted because of false positive test results with PCR. This highlights the importance of recognizing clinical signs and symptoms and practicing careful laboratory testing.
To reduce the risk of pertussis in new mothers and their very young infants, CDC now recommends that pregnant women receive Tdap vaccine during each pregnancy. During outbreaks, prevention efforts should focus on improving rates of Tdap vaccination among pregnant women to reduce severe illness and possible deaths in vulnerable infants.
Trends and Activity
Learn more about the latest pertussis outbreak trends and states with high rates of disease...
With increasing rates and widespread community transmission of pertussis, extensive contact tracing (looking for those exposed to pertussis) and broad scale use of postexposure antimicrobial prophylaxis (PEP, giving antibiotics to someone exposed to pertussis to help prevent the infection) among contacts may not be an effective use of limited public health resources. While antibiotics may prevent pertussis disease if given before symptoms begin, there are no data showing that widespread use of PEP among contacts works well to control or limit the size of pertussis outbreaks. Another important consideration is the overuse of antibiotics; CDC is engaged in actively promoting the appropriate use of antibiotics among healthcare providers and patients. Given these considerations, CDC supports targeting PEP to people at high risk of developing severe pertussis and to people who will have close contact with those at high risk of developing severe pertussis. See PEP guidance.
Active screening for symptomatic patients with suspected pertussis can be considered during outbreaks in settings such as schools, day care centers, and hospitals. Active screening for suspected cases potentially reduces exposure to people with pertussis, encourages timely medical evaluation and treatment of cases, and promotes prompt administration of antibiotics to high risk close contacts.
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