Article Figures & Data
Figures
- Figure 2.
Relationship between time since pertussis vaccination and attack rate.12
Tables
A clinical case is defined as an acute cough illness lasting ≥14 days in a person with at least one pertussis-associated symptom (ie, paroxysmal cough, post-tussive vomiting without other apparent cause, or inspiratory whoop) or, in an outbreak setting, ≥14 days of cough with no other symptoms. A confirmed case is defined as a cough illness of any duration in a person from whom B. pertussis is isolated, or a case that meets the clinical case definition and is confirmed by polymerase chain reaction (PCR) or by epidemiologic linkage to a culture- or PCR-confirmed case. A probable case meets the clinical case definition but is neither laboratory confirmed nor epidemiologically linked to a laboratory-confirmed case. Confirmed and probable cases of pertussis should be reported to the National Notifiable Disease Surveillance System (NNDSS) of the US Centers for Disease Control and Prevention. Duration Characteristic Signs and Symptoms Incubation period 7 to 10 days (range, 4 to 21 days) — Catarrhal stage 7 to 14 days Insidious onset of coryza, sneezing, and a mild, nonspecific cough that gradually becomes more severe In infants: excessive sneezing or ‘throat clearing’ Paroxysmal stage 1 to 6 weeks (up to 10 weeks) Bursts, or paroxysms, of numerous, rapid coughs followed by a long inspiratory effort often associated with a high-pitched whoop; post-tussive vomiting. In infants: paroxysms of coughing, but may not have sufficient musculature to develop a whoop. In addition, they may experience gagging, gasping, or eye bulging, and occasionally bradycardia or cyanosis. Convalescent stage Weeks to months Recovery gradual, with cough becoming less paroxysmal and then disappearing. Fever is generally minimal - Table 3.
DTaP/Tdap Vaccination: Recommendations of the Advisory Committee on Immunization Practices37–39
Dose Age Minimum Interval Routine Primary Immunization of Infants 1 2 months – 2 4 months 4 weeks 3 6 months 4 weeks 4 15 to 18 months* 6 months 5 4 to 6 years† Booster dosing of adolescents: 11 to 12 years – 13 to 19 years‡ Dosing of Adults§ All adults who expect to be in close contact with a vulnerable infant 19 to 64 years Health care personnel 19 to 64 years * May be given at 12 months.
† If 4th dose given before age 4 years.
‡ Catch-up vaccination recommended if Td not received at 11 to 12 years; vaccination with Tdap encouraged for those who received Td at 11 to 12 years with a 5-year interval between Td and Tdap.
§ A single dose of Tdap booster to replace the next scheduled dose of tetanus diphtheria vaccine.
¶Infant who has not received 2 to 3 doses of DTaP.
