Pertussis (whooping cough) is a very contagious disease caused by a type of bacteria called Bordetella pertussis.  Among vaccine-preventable diseases, pertussis is one of the most commonly occurring ones in the United States.  It can cause serious illness―especially in infants who are too young to be fully vaccinated. 

Pertussis Symptoms

Pertussis can cause serious illness in children and adults.  The disease starts like the common cold, with runny nose or congestion, sneezing, and maybe mild cough or fever.  After 1 to 2 weeks, severe coughing begins.  Children with the disease cough violently and rapidly, over and over, until the air is gone from their lungs and they’re forced to inhale with a loud “whooping” sound.

Pertussis is worse for very young children; more than half of infants less than 1 year of age who get the disease must be hospitalized.  About 1 in 10 children with pertussis get pneumonia (lung infection), and about 1 in 50 will have convulsions.  In addition, about 1 in 250 people who become infected with pertussis develop a brain disorder called encephalopathy.  In even rarer cases, pertussis can be deadly.

Pertussis Transmission (How it Spreads)

People with pertussis usually spread the disease by coughing or sneezing while in close contact with others, who then breathe in the pertussis bacteria.  Many infants who get pertussis are infected by older siblings or parents who might not even know they have the disease.  Infected people can pass the disease on to others from the onset of cold-like symptoms until after 5 days of treatment or until 21 days after cough onset if no (or partial) treatment is given.

It is important that individuals who have been diagnosed with pertussis take antibiotics.  Antibiotics reduce transmission of the disease to others if they are taken for 5 days.  Infected individuals should stay home from work or school until they have taken 5 days of antibiotic treatment for pertussis. It is especially important to avoid being around babies and pregnant women until your antibiotic treatment is finished to keep from spreading the disease to them.

Antibiotics are effective against the bacteria but not against the toxins the pertussis bacteria produce, so sometimes people continue to cough for a while even after taking antibiotics.

Pertussis Prevention

The best way to prevent pertussis is to get vaccinated.  In the US, the recommended pertussis vaccine for children is called DTaP.  This is a safe and effective combination vaccine that protects children against three diseases: diphtheria, tetanus, and pertussis.  For maximum protection against pertussis, children need five DTaP shots.  The first three shots are given at 2, 4, and 6 months of age.  The fourth shot is given between 15 and 18 months of age, and a fifth shot is given when a child enters school, at 4–6 years of age. 

Vaccine protection for pertussis, tetanus, and diphtheria can fade with time.  Before 2005, the only booster available contained tetanus and diphtheria (called Td), and was recommended for adolescents and adults every 10 years.  Today there are boosters for adolescents and adults that contain tetanus, diphtheria, and pertussis (called Tdap).  Pre-teens going to the doctor for their regular check-up at age 11 or 12 years should get a dose of Tdap.  Adults who didn’t get Tdap as a pre-teen or teen should get one dose of Tdap instead of the Td booster. 

Pregnant mothers who get vaccinated in the third trimester of pregnancy can produce protective antibodies against pertussis that will be passed on to their baby.  The baby then has some protection against pertussis until he/she is old enough to get vaccinated.

For Schools and Early Childhood Education Settings

Pertussis can cause illnesses in daycare and school-age children ranging from mild cough to severe disease.  It is highly infectious from the beginning of symptom onset until 2 weeks after the cough begins without antibiotic treatment.  

Case and Outbreak Reporting Form

Case and Outbreak Reporting Guidelines

Guidance for Classroom Pertussis Exposures

Sample Classroom Pertussis Exposure Letter – English

Sample Classroom Pertussis Exposure Letter – Spanish

Pertussis Information for Parents (CDC) – English

Pertussis Information for Parents (CDC) – Spanish

For more information about pertussis, please call the Monterey County Health Department’s Communicable Disease Unit at 831-755-4521.

To report a suspected outbreak, please call the Monterey County Health Department’s Epidemiology & Surveillance Unit at 831-755-4698.

Pertussis Surveillance Data

Please click to view the Communicable Disease dashboard with local pertussis data available in English and Spanish.

California data is available at the California Department of Public Health’s pertussis website.

United States data is available at the Centers for Disease Control and Prevention’s pertussis website.

For Healthcare Providers

Pertussis is a reportable disease in the state of California.  Please complete a Confidential Morbidity Report (CMR) for each suspected and confirmed case of pertussis and fax it to the County of Monterey Health Department’s Communicable Disease Unit at 831-754-6682 within one working day.  Alternatively, providers may report through the California Department of Public Health's California Reportable Disease Information Exchange (CalREDIE).  Medical providers may contact the Communicable Disease Unit at 831-755-4521 to learn more about electronic reporting. 

The County of Monterey Health Department recommends polymerase chain reaction (PCR) for confirming pertussis diagnosis, if specimens can be collected within 3 weeks of symptom onset.  PCR is available at the Monterey County Public Health Laboratory and any many commercial laboratories.  For more information about pertussis testing at the Monterey County Public Health Laboratory, call 831-755-4516.

Follow us on Twitter for up-to-date public health information! @WashCoverStay