Whatcom County Health and Community Services (WCHCS) staff continue to respond to a rise in pertussis infections at the local levels. Pertussis reports have also been rising in Washington state and nationally. WCHCS asks that healthcare providers remain alert for patients with symptoms of pertussis and to report suspected cases. Reporting options:
- Communicable Disease Report Line: 360-778-6150
- Confidential Fax: Send pertussis case report form to 360-778-6103
Current Situation
As of October 23, 2024, Whatcom County has reported 27 persons with confirmed and probable pertussis. 11 persons reported October 1st through October 23rd. Multiple school settings have been affected.
Summary
- Pertussis symptoms:
- Early symptoms can be similar to an upper respiratory infection
- Cough that lasts longer than 2 weeks, up to 10 weeks or longer
- Uncontrolled coughing
- “Whooping” sound on inhalation after coughing
- Shortness of breath
- Vomiting during or after coughing fits
- Apnea
- Considered high risk if exposed to pertussis:
- Infants under 1 year old are at highest risk for severe disease and death
- Pregnant people at 27–36 weeks gestation (third trimester)
- Healthcare workers who come into direct contact with patients
- People who come into direct contact with infants under 1 year old or pregnant people, like childbirth educators, childcare workers, and members of a household with an infant
- All children and adults should be up to date on recommended pertussis vaccine.
- Pregnant people at 27–36 weeks gestation (third trimester) should receive 1 dose of Tdap (tetanus, diphtheria, pertussis) vaccine (during each pregnancy)
Recommendations for Healthcare Providers
- Consider pertussis in:
- Respiratory illness in infants under 1 year old, especially when paired with difficulty feeding or apnea
- Cough illness, in patients of any age, paired with any of these:
- Paroxysms of coughing
- Gagging, post-tussive emesis, or inspiratory whoop
- Lasts 2 weeks or longer
- Respiratory illness of any duration in patients who came into direct contact with someone with pertussis or pertussis symptoms
- Consider testing. Collect a nasopharyngeal swab for pertussis PCR (polymerase chain reaction) or culture. PCR is the most sensitive and fastest diagnostic test. While culture is the most specific option, it is not the most sensitive and is rarely done. Do not use serology to diagnose pertussis in Washington
- Negative pertussis PCR or culture cannot rule out pertussis. Treatment and case reporting may still be warranted, per clinician’s assessment
- See CDC’s best practices for using PCR to diagnose pertussis
- Treat following CDC’s treatment guidance
- Instruct people with suspected pertussis to stay home from work, school, or childcare. Advise them that they are considered contagious until they complete 5 full days of prescribed antibiotics
- Notify Whatcom County Health and Community Services of suspected or confirmed cases within 24 hours by calling the reporting line: 360-778-6150. We will help you determine prophylaxis and exclusion recommendations
- Consider preventive antibiotics for the entire household if a member meets any high-risk criteria
- Keep in mind, diagnosing pertussis can be difficult. During the early (catarrhal) stage of illness, symptoms may be non-specific and may not include cough. When a patient has respiratory symptoms and known or suspected exposure to pertussis, include pertussis in the differential diagnosis. The incubation period for pertussis is 5–21 days. The duration of the cough (usually longer than 2 weeks, up to 10 weeks or longer) can distinguish pertussis from other respiratory illnesses
Vaccine recommendations
- All children and adults should be up to date on recommended pertussis vaccines. See CDC’s recommended vaccine schedule
- Prioritize vaccinating people who come into direct contact with infants under 1 year old
- Pregnant people at 27–36 weeks gestation (third trimester) should receive 1 dose of Tdap vaccine (during each pregnancy)
More Resources
- Pertussis clinical features, CDC.
- Collecting a nasopharyngeal swab clinical specimen video, CDC.
- Pertussis treatment, CDC.
- Best practices for using PCR to diagnose pertussis, CDC.
- Weekly pertussis update, DOH.
- Immunization schedules, CDC Advisory Committee on Immunization Practices (ACIP).
- Ask the experts about pertussis, immunize.org.
- Report notifiable conditions, Whatcom County Health and Community Services.
- Vaccines are available from most pharmacies and healthcare providers.
Get in Touch.
Contact Whatcom County Health and Community Services at 360-778-6100- 360-778-6100 Main Call Line – available M-F 8:30am to 4:30pm.
- Afterhours Answering Service – available after 4:30pm and weekends, call 360-778-6100 and press 2 to be connected to the on-call manager or health officer.
- 360-778-6150 Communicable Disease Report Line – 24 hours a day 7 days a week
- 360-778-6103 Confidential Communicable Disease Fax – 24 hours a day 7 days a week
- 509 Girard Street, Bellingham WA 98225