Pertussis (Whooping Cough)
Reportable to the Medical Officer of Health. Public Health will do contact investigation, follow-up, and prophylaxis.
Jump to Prophylaxis
- Adults are important reservoirs of B. pertussis (by 12 years post-immunization there is no demonstrable protection against pertussis).
- All adolescents in Canada are given a booster of dTap (diphtheria-tetanus-acellular pertussis vaccine).
- Prophylaxis should be given to the following significant contacts (immunized or un-immunized):
- Individuals who are vulnerable persons AND are residing in the same household as the case
- Individuals who are vulnerable persons AND have had face to face exposure and/or have shared confined air with the confirmed case for > 1 hour and/or other significant exposure decided upon on a case by case basis (e.g. being coughed on by a confirmed case)
- Individuals who are residing in households (or working in or attending day care centres and family day homes) in which a vulnerable person also lives (or attends on a regular basis)
- Antibiotic post exposure prophylaxis should be offered to all eligible contacts (regardless of immunization status) as soon as possible after first contact with index case and within 21 days of onset of cough in the index case.
Prophylaxis
| Antibiotic | Children | Adults |
|---|---|---|
| Azithromycin |
<6 months 10mg/kg (max 500mg) PO daily x 5 days or ≥6 months 10mg/kg PO first day (max 500mg) then 5mg/kg PO daily (max 250mg) x 4 days |
500mg PO first day then 250mg PO daily x 4 days |
| Clarithromycin |
15mg/kg/d PO div bid (max 1g/day) x 7 days |
250-500mg PO bid x 7 days |
| Erythromycin |
250-500mg PO qid x 7 days (base) |
|
Alternative |
||
| TMP/SMX (> 2 months of age) | ≤ 40kg: 4-6mg TMP/kg/d PO div bid x 10 days > 40kg: 8mg TMP (max 320mg)/kg/d PO div bid x 10 days |
1 DS tab PO bid x 10 days |