Bordetella Pertussis Epidemiology Program
Pertussis, or whooping cough, is on the rise in New Mexico. Anyone can get pertussis and, in fact, increases in disease are occurring in all age groups. But babies who get pertussis are the group at greatest risk of complications, including pneumonia, seizures, brain damage and death.
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New Mexico Families
Whooping cough disease (also called pertussis) causes fits of coughing that in some persons make it hard to breathe. Cases of whooping cough (pertussis) are on the rise and young infants are the most vulnerable to severe disease and possible complications. Many are hospitalized every year and some have died.
Circle Your Baby with Protection
Pertussis vaccination is safe and can protect against the disease. But babies cannot get their first pertussis vaccine until they are at least 2 months old. The first few months of life are also when babies are at the highest risk of severe pertussis and life-threatening complications. There are two important groups of people who should be vaccinated to help protect your baby:
- Mothers should receive a Tdap1 pertussis vaccine during each pregnancy. The best time to get it is between 27 and 36 weeks gestation, in order to maximize the protective antibodies that the mother is able to pass on to the baby before birth.
- It is safe to receive the Tdap vaccine earlier in pregnancy if your healthcare provider recommends it (such as for wound care or if there is a community pertussis outbreak). It is also safe to receive Tdap vaccine while breastfeeding.
- Make sure that anyone else who will be living with, caring for, or visiting your baby is also up-to-date on their pertussis vaccines:
- Young children are recommended to get three doses of DTaP2 at ages 2, 4, and 6 months; a booster dose of DTaP at age 15-18 months; and another DTaP booster at age 4-6 years.
- Older children and adolescents aged 11-18 years are recommended to get a Tdap booster, preferably at age 11-12 years.
- Adults aged 19 years and older who have not previously received a Tdap booster should get a dose.
Not sure which vaccines you’ve had? You can look up your vaccine record in New Mexico VaxView. If your vaccine record is not complete in VaxView (for example, if you received vaccines in another state or many years ago), you can also try checking with your healthcare provider, another state’s vaccine registry, your school or college/university, or check your paper records for a vaccine card.
If you do not have a prenatal or primary care provider, and would like to get yourself or a family member vaccinated, contact your local Public Health Offices for assistance.
- Tdap: Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine
- DTaP: Diphtheria toxoid, tetanus toxoid, and acellular pertussis vaccine.
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Frequently Asked Questions
What is Pertussis?
Pertussis, also known as whooping cough, is a highly contagious respiratory disease. It is caused by the bacterium Bordetella pertussis.
What are the symptoms of pertussis infection?
Symptoms usually appear 4 to 21 days after exposure to someone with the illness. The symptoms of pertussis occur in three stages.
- The first stage begins like a cold, with a runny nose, sneezing, mild fever and cough. The cough may be mild at first but soon gets worse.
- The second stage includes uncontrolled coughing or coughing spasms followed by a whooping noise when the person breathes in air. During these severe coughing spells, a person may vomit, or their lips or face may look blue from a lack of oxygen. The infected person may appear well between coughing spells. This stage may last several weeks.
- The third stage is the last stage where the cough slowly begins to disappear. This stage may also last for several weeks.
How is pertussis spread?
The bacterium that causes pertussis is found in the nose and throat of infected people. These bacteria spread through the air in droplets produced when an infected person sneezes or coughs. People in the early stage of illness are the most contagious.
How long are people contagious?
After five days of the proper antibiotics, people are no longer contagious. If a person does not take antibiotics, s/he is contagious for 21 days after the onset of the coughing spasms.
Who gets pertussis?
Anyone can get pertussis, but vaccination lowers the risk. It most commonly occurs in very young children who have not been vaccinated. Older children and adults can also get pertussis, but it is usually not as severe as it is in young babies. A person who has had pertussis before can get it again.
What treatment is available for people with pertussis?
Antibiotics will shorten the length of time the person is contagious and the length of time the illness can be spread. If started in the early stage of the disease, antibiotics may make the illness less severe. However, even with the antibiotics, people may cough for many weeks.
Do infected people need to be kept home from school, work or daycare?
People sick with a cough should be kept home until they have been treated with antibiotics for at least five days and are well enough to return to school, work or daycare.
How can I protect myself and my family from getting pertussis?
- If you are a household member or high-risk close contact of a person with pertussis, take the proper preventive antibiotics.
- Keep up to date on vaccinations. Pertussis-containing vaccine is given at 2, 4, and 6 months, with boosters at 15-18 months of age and at 4-6 years of age. Persons 11-18 years of age should receive a single booster dose of pertussis vaccine, preferably at 11-12 years of age. All adults should get a Tdap booster if they haven’t had one before.
- People who are pregnant need a Tdap at each pregnancy, ideally between the 27th and 36th weeks of pregnancy. This helps protect the baby in his or her first months of life.
- Keep infants away from people who are sick. Cover your cough and wash your hands frequently if you are coughing or sneezing. See your healthcare provider right away if you develop symptoms.
Healthcare Professionals
Pertussis, or whooping cough, is an acute infectious disease caused by the bacterium Bordetella pertussis. Outbreaks of pertussis were first described in the 16th century, and the organism was first isolated in 1906.
In the 20th century, pertussis was one of the most common childhood diseases and a major cause of childhood mortality in the United States. Before the availability of pertussis vaccine in the 1940s, more than 200,000 cases of pertussis were reported annually. Since widespread use of the vaccine began, incidence has decreased by more than 75% compared with the pre-vaccine era.
Pertussis remains a major health problem among children worldwide, with an estimated 160,700 deaths resulting from the disease in 2014 (World Health Organization estimate).
To learn more about the bacteria, pathogenesis, clinical features, and epidemiology of pertussis, visit the Centers for Disease Control and Prevention (CDC) Pink Book website.
Testing
There are three options for diagnostic pertussis testing.
- Culture
- Culture is the gold standard, as it is 100% specific for pertussis. It is rarely performed because it requires special media, should be done within the first two weeks of illness and before antibiotic treatment, and can take several days for a result. However, isolates are valuable for genomic surveillance of pertussis, so the state public health lab, SLD, offers free PCR testing for pertussis if a plate for pertussis culture is also submitted.
- PCR
- PCR is the most commonly used confirmatory test for pertussis, because it is widely available and has a quick turnaround. It also has high sensitivity, and certain assays can distinguish between pertussis and other Bordetella species like B. parapertussis. PCR testing is most successful when done in the first 3 to 4 weeks of illness, ideally before antibiotic treatment.
- Serology
- Commercially-available serology is not recommended for pertussis diagnosis or confirmation. Although it can be performed later in the course of disease, commercially-available tests have unproven or unknown clinical accuracy, and false positives are common.
For more information, including videos demonstrating how to collect a nasopharyngeal swab for PCR or culture, please visit the CDC Laboratory Testing for Pertussis site.
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Pertussis Surveillance
Pertussis is nationally notifiable and cases should be reported to the appropriate health department. Pertussis cases are reported by states to the Centers for Disease Control and Prevention (CDC). Although many pertussis cases are not diagnosed and therefore not reported, the surveillance system is useful for monitoring epidemiologic trends. The limitations of laboratory diagnostics make the clinical case definition essential to pertussis surveillance.
Pertussis Case Definition (2020)
Clinical Criteria
In the absence of a more likely diagnosis, a cough illness lasting at least 2 weeks with at least one of the following: paroxysms of coughing, inspiratory “whoop”, post-tussive vomiting, or apnea (with or without cyanosis).
Laboratory Criteria for Diagnosis
- Isolation of B. pertussis from clinical specimen
- Positive polymerase chain reaction (PCR) for B. pertussis
Case Classification
Probable:
- In the absence of a more likely diagnosis, an illness meeting the clinical criteria, or
- Contact with a laboratory-confirmed case (epidemiologic linkage) and illness with cough of any duration, with at least one of the following symptoms: paroxysms of coughing, inspiratory “whoop,” post-tussive vomiting, or apnea (with or without cyanosis)
Confirmed:
Acute cough illness of any duration, with:
- Isolation of B. pertussis from a clinical specimen or
- PCR positive for B. pertussis
National Notifiable Diseases Surveillance System (NNDSS)
2020 Case Definition: Pertussis (Bordetella pertussis) (Whooping Cough)
Enhanced Pertussis Surveillance
CDC has partnered with seven states (CO, CT, GA, MN, NM, NY, and OR) participating in the Emerging Infections Program (EIP) network to conduct enhanced surveillance of pertussis and other Bordetella species. Enhanced Pertussis Surveillance is characterized by enhanced case ascertainment and augmented data collection that goes beyond what is requested nationally through NNDSS. Participating sites collect clinical isolates and specimens, when available, for further characterization at the CDC Pertussis and Diphtheria Laboratory. Enhanced Pertussis Surveillance sites also provide the infrastructure for conducting pertussis special studies including those aimed at evaluating pertussis prevention and control strategies.
Reporting
Report all confirmed, probable, and suspected cases of pertussis immediately (24/7/365) to the New Mexico Department of Health at 1-833-SWNURSE (1-833-796-8773). Fax lab results or clinical reports to 505-827-0013.
Surveillance Data
Take a look at the New Mexico Infectious Disease Surveillance page for detailed surveillance reports.