» Pertussis (whooping cough)

Pertussis (whooping cough)

Published: 16/12/2024 | 1 file | 4 links | Website

Following Te Whatu Ora's announcement of a Pertussis national epidemic Pinnacle has compiled information and resources for practice teams.

Updated guidance for the management of pertussis cases and contacts is now available within the pertussis chapter of the Te Whatu Ora Communicable Disease Control (CDC) Manual.

Since the pertussis epidemic was declared there has been increased demand for pertussis testing at a local level which has led to laboratory capacity constraints in most regions. For guidance on the groups that should continue to be tested in periods of high pertussis activity, please refer to Guidance for prioritisation of testing in periods of high pertussis activity.

Key messages

Pertussis AKA the “100-day cough” is a highly contagious disease that spreads through coughing and sneezing. It has a R0 of 12-17. This means the expected number of secondary cases produced by a confirmed primary case in a completely susceptible population is 12-17.
Pertussis is very serious among very young unimmunised babies and this group are most at risk of severe illness and death. Inequities exist with more Māori and Pasifika babies impacted the worst.
Outbreaks occur every 3-5 years and New Zealand was due a recurrence. Outbreaks tend to last 12-18 months, therefore this is a marathon rather than a sprint.
The illness can look like a cold, and this is when Pertussis is most infectious. Estimating the number and impact of the disease is made difficult by the likelihood of under detection and under reporting. By the time Pertussis is detected, antibiotics may not make a difference to the course of the disease.
Pertussis is a vaccine preventable disease but immunisation wanes over time and requires life-long vaccine boosters for continued protection.

Key actions – protection and prevention

Antenatal immunisations (funded) 16 weeks+ in every pregnancy offers passive protection for the baby with over 90% of babies protected from hospitalisation (in first 3 months of life) and 97% protected against death (in first 3 months of life).
On-time immunisation for young tamariki at 6 weeks, 3 months and 5 months with boosters at 4 years and 11 years of age (funded).
Encourage all clinic staff to have booster vaccinations. IMAC is reviewing their advice (which recommends boosters every 5-10 yrs "depending on employer requirements") and it is likely a booster will be recommended every 5 years during the epidemic for health care workers who come into direct contact with infants including primary care nurses and doctors. Currently these boosters are unfunded.
Pertussis vaccination is recommended, but again not funded, for other groups such as caregivers of infants born less than 32 weeks gestation, early childhood workers, adults with medical conditions who are not eligible for a funded vaccine who are at risk of severe consequences of disease.
Detect and treat cases as soon as possible. Pertussis PCR is the recommended test for people presenting with characteristic symptoms.
If possible, keep suspected cases out of the building. Take universal precautions such as patient wears facemask if tolerated, health care professional wears facemask. Clean equipment and surfaces once vacated. There is currently no advice with regard to the "stand down" period of an isolation room after a pertussis case is seen, the most cautious approach would be to stand the room down for two hours and then clean all surfaces as recommended for measles (which is similarly spread via air and droplets).
Suspect cases should isolate, further information on isolation instructions for confirmed cases can be found on Health Pathways. At this stage, Te Whatu Ora has not issued any update of the provision on systematic support for those requiring isolation.

FILES AND LINKS

Visit: Community Health Pathways management of pertussis

Internal | Te Manawa Taki / Midland Region Community HealthPathways

Visit: ESR dashboard (to track the reported numbers)

External | ESR

Visit: Pertussis guidance

External | Te Whatu Ora

Download: Lab guidance

pdf | 161 KB

Visit: IMAC pertussis resources

External | IMAC