Learn About Pertussis Prevention and Treatment

You’ll hear more about pertussis now that there’s an uptick in cases across several Canadian provinces and abroad.

Pertussis, or whooping cough, is a respiratory infection spread through air droplets caused by Bordetella pertussis bacteria.

Initial symptoms usually include fever and mild cough...but severe coughing then develops over several weeks. Young kids may also develop a characteristic “whooping” sound when coughing.

Infants under 2 to 3 months old are at highest risk of complications...respiratory distress, shock, etc...and hospitalization.

It’s not clear why cases are up...but it may be due to waning immunity with current vaccines and increasing vaccine hesitancy.

Be ready with knowledge on prevention and treatment.

Prevention. Regular handwashing, covering coughs, and staying home when sick are the best ways to stop pertussis transmission.

Help promote vaccination...immunizing kids with DTaP, an acellular pertussis-containing vaccine, will help limit pertussis.

Adults should receive a Tdap booster dose, especially those who got a pertussis shot more than 10 years ago.

And pregnant patients should get Tdap typically in the third trimester, regardless of vaccination status. This prevents up to 90% of newborn pertussis cases, since they aren’t vaccinated until 2 months old.

Watch for mix-ups of the diphtheria, tetanus, and acellular pertussis vaccines. DTaP is for children through age 6...and Tdap is a booster for adolescents and adults.

Think “caps for kids” to remember that DTaP is the pediatric formulation...and Tdap is for adolescents and adults. The three capital letters in DTaP signify the higher antigen dose kids need.

Treatment. Antibiotics work best when started immediately after diagnosis.

Most patients will receive a macrolide first-line, such as azithromycin for 5 days...or co-trimoxazole for 14 days when a macrolide can’t be used, such as due to a heart condition.

Expect azithromycin or co-trimoxazole to be given as prophylaxis to immediate household contacts, especially infants and pregnant women.

Tap into our updated technician tutorial, The Basics of Immunization and Vaccines, for links to vaccine schedules and other tools.

Key References

  • Public Health Ontario. Public Health Management Considerations for Pertussis. 2nd revision, December 2022. https://www.publichealthontario.ca/-/media/Documents/P/2020/pertussis-case-contact-management.pdf?rev=5cc57421eab74dd580c2411e916eb8e1b&sc_lang=en (Accessed June 27, 2024).
  • Kilgore PE, Salim AM, Zervos MJ, Schmitt HJ. Pertussis:  Microbiology, Disease, Treatment, and Prevention. Clin Microbiol Rev. 2016 Jul;29(3):449-86.
  • Cherry JD, Doustmohammadi S. Pertussis vaccines. Curr Opin Pediatr. 2022 Apr 1;34(2):126-131.
Pharmacy Technician's Letter Canada. July 2024, No. 400728

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