Friday February 23, 2018
Toi Te Ora Public Health
PO Box 2120
21 February 2018
National pertussis (whooping cough) epidemic
Toi Te Ora Public Health is seeing a rise in pertussis cases across the Bay of Plenty and Lakes districts as part of the current national pertussis epidemic.
Since 1 November 2017, there have been 217 cases of pertussis notified to the local Medical Officer of Health – 168 in the Bay of Plenty and 49 in the Lakes region.
Diagnosis and notification
If you suspect a patient may have pertussis and they are within four weeks from the onset of any symptoms, or three weeks from onset of cough, please send a nasopharyngeal swab for PCR to confirm the diagnosis.
Pertussis is a notifiable disease, so please notify suspected and confirmed cases to the Medical Officer of Health by completing this notification form and faxing to 0800 66 89 34.
Antibiotics and restriction
Antibiotics can alter the clinical course of pertussis in its early stages and reduce infectivity. A five day course of azithromycin is recommended, however erythromycin, clarithromycin and co-trimoxazole can also be used if needed. See page 392 of the Immunisation Handbook 2017 for details.
Patients diagnosed with pertussis will be required to stay home until:
- they have completed two days of azithromycin, or
- five days of other appropriate antibiotics, or
- three weeks from onset of cough if they don’t take antibiotics.
High priority contacts
The goal of identifying and following up high priority contacts in the same household as a pertussis case is to protect infants, pregnant women and people at high risk of severe or complicated illness. Therefore, please identify, provide antimicrobial prophylaxis (same antibiotic recommendations as for pertussis cases) and advice to household contacts who are:
- children under 12 months old;
- children and adults who live with, or spend much of their time around a child under 12 months old;
- pregnant women (particularly in the last month of pregnancy);
- individuals that are at high risk of severe illness or complications because of a pre-existing health condition that may be exacerbated by a pertussis infection (for example those with chronic respiratory conditions, congenital heart disease or immunodeficiency).
Advice to all household contacts
All household contacts (high priority and otherwise) should receive advice to avoid attending early childhood services, school, work or community gatherings if they become symptomatic. Please explain that early symptoms of pertussis are similar to minor respiratory tract infections, and are highly contagious.
To stop this disease spreading and to ensure the best protection for those most at risk, it is important that:
- all pregnant women are offered a free pertussis vaccine between 28 and 38 weeks of each pregnancy;
- infants and children get all of their immunisations at 6 weeks, 3 months, 5 months, 4 years and 11 years of age.
Please ensure that on time immunisation is actively recommended for all infants, children and pregnant women in your practice and that catch-up immunisation is offered to anyone overdue.
Information for patients on whooping cough is available on HealthEd at: www.healthed.govt.nz/resource/immunise-against-whooping-cough
Information for health professionals is available in the:
- Ministry of Health Immunisation Handbook 2017 - Pertussis chapter
- Ministry of Health Communicable Disease Control Manual - Pertussis chapter
- Toi Te Ora Public Health website: www.toiteora.govt.nz/pertussis_hp
A link to an updated flow chart for management of pertussis in primary care is available on our website here.
Please don’t hesitate to contact us on 0800 221 555 if you have any questions.
Dr Natasha Murray
Medical Officer of Health