About Pertussis Outbreaks
Pertussis (whooping cough) is a common (endemic) disease in the United States, with peaks in reported disease every 3 to 5 years and frequent outbreaks. In 2012, the most recent peak year, 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 babies; a secondary goal is to decrease morbidity among people of all ages.
Identifying Pertussis Outbreaks
Pertussis outbreaks can be difficult to identify and manage. Other respiratory pathogens (germs) often cause symptoms similar to pertussis, and pertussis does co-circulate with other pathogens (bacterial and viral) at times. Polymerase chain reaction (PCR) tests are commonly used to diagnose pertussis. PCR tests vary in their ability to correctly show who does not have pertussis (specificity). This is important because if a test has a high specificity and someone tests positive, then it is very likely they actually have the disease. Since PCR tests vary in specificity, 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. False (pseudo) 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.
Protecting Babies during Pertussis Outbreaks
To reduce the risk of pertussis in new mothers and their young babies, CDC recommends that pregnant women receive Tdap vaccine during each pregnancy, ideally between 27 and 36 weeks gestation. During outbreaks, prevention efforts should focus on improving rates of Tdap vaccination among pregnant women to reduce serious illness and possible deaths in vulnerable babies.
Trends and Activity
Learn more about the latest pertussis outbreak trends and states with high rates of disease...
Using Antibiotics during Pertussis Outbreaks
With more cases occurring and pertussis spreading through communities, it may not be effective for health departments to spend a lot of time and resources looking for those exposed to pertussis (extensive contact tracing) and providing them with antibiotics to help prevent pertussis infection (post exposure antimicrobial prophylaxis, or PEP). While antibiotics may prevent pertussis disease if given before symptoms begin, there are no data showing that widespread use of PEP among contacts of people with pertussis 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 professionals and patients. Given these considerations, CDC supports targeting PEP to people at high risk of developing a serious case of pertussis and to people who will have close contact with those at high risk of developing a serious case of pertussis, such as young babies. See PEP guidance.
Active Screening during Pertussis Outbreaks
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.
- Page last reviewed: August 31, 2015
- Page last updated: September 8, 2015
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