There are increasing cases of pertussis (‘whooping cough’) on the NSW North Coast with 24 cases in November (73 so far for 2023), compared with only 12 during 2021 and 2022 combined.
“We’re seeing a resurgence of pertussis on the North Coast following low case numbers during the COVID pandemic. It is important for GPs to keep pertussis in mind when people present,” said Dr Valerie Delpech, North Coast Population and Public Health Regional Director.
“Prevention of disease in vulnerable infants <6 months is the priority for identifying and treating cases who may transmit pertussis to these infants.”
Pertussis containing vaccines are highly effective in protecting against severe and typical pertussis disease. Vaccine induced immunity and natural immunity does wane significantly over time, particularly in small children, so the importance of timely vaccination and booster doses is crucial.
Newborns benefit significantly from their mothers receiving a pertussis containing vaccine in pregnancy.
Pertussis outbreaks often occur every three to four years as population immunity wanes. “Although we are some way from the case numbers we saw in 2018, its important to put pertussis on the radar again” Dr Delpech said.
Symptoms and diagnosis:
- Consider pertussis if your patient’s symptoms include: rhinorrhoea, paroxysmal and dry cough sometimes ending with vomiting, and low-grade fever. Typically, symptoms may be worse at night-time particularly in immunised individuals.
- PCR is the gold standard for diagnosis. PCR may remain positive for a period of up to 5 weeks after the onset of symptoms and for some time after starting treatment.
- If you suspect pertussis on clinical grounds, ask the patient to avoid contact with babies, pregnant women, and high-risk settings, without waiting for the test results.
Antibiotics:
- Antibiotics given early in the catarrhal stage may ameliorate the disease and reduce the period of communicability. Antibiotics should be initiated as soon as possible.
- Antibiotic prophylaxis is recommended for the subset group who are infants < 6 months of age or people who may transmit pertussis to these infants.
Vaccination:
The pertussis vaccine is funded in combination vaccines under the NSW immunisation schedule:
- Children at the 6-week, 4-month, 6-month, 18-month and 4-year schedule points,
- Adolescents in Year 7 at school
- All pregnant women
The Australian Immunisation Handbook additionally recommends pertussis vaccines for the following groups at a maximum 10 yearly interval:
- As a routine booster in adults
- Healthcare workers
- Early childhood educators and carers
- People in close contact with infants
Pertussis is a notifiable disease. Further information for general practitioners can be found here: General Practitioners and Healthcare Workers (nsw.gov.au) or contact North Coast Population and Public Health on 1300 066 055.
HealthPathways info:
https://manc.communityhealthpathways.org/13614.htm
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