Increasing pertussis infections: assessment and immunization

Advisory Alert

July 18, 2024

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To: Local Health System Partners

FOR IMMEDIATE ATTENTION

Public Health Sudbury & Districts has identified several pertussis infections and community exposures within our service area. We are reminding health care providers of the importance of immunization and active screening to prevent disease transmission and outbreaks.

Clinical assessment of pertussis

Pertussis can mirror a mild respiratory infection prior to presenting classic symptoms.

- Pertussis progresses through 3 stages, the catarrhal stage characterized by mild upper respiratory tract symptoms and occasional cough that lasts 1 to 2 weeks. The paroxysmal stage, which presents with increased severity and frequency of cough, can last 1 to 2 months and sometimes longer. During this phase, repeated violent coughing and high-pitch inspiratory “whoop” may occur, commonly followed by vomiting. Fever is absent or minimal. The convalescent stage is when the cough becomes less paroxysmal and disappears, and may take weeks to months[1].
- The clinical course varies with age. Young infants are at highest risk, and their clinical symptoms are frequently typical. This group has the most serious complications. Pertussis presentation may be atypical in adults or among persons previously immunized.
When assessing symptomatic patients for pertussis, patient risk factors should be considered such as immunization status, travel history, and exposure history.

If pertussis is suspected, please follow testing requirements as described in the Public Health Ontario Laboratory – Test Information Index, and request that patients isolate until results are received.

Immunization

Immunization is an effective form of prevention. Refer to the Ontario Publicly Funded Immunization Schedule to verify that your clients, especially young children, have received all necessary immunizations based on their age and other eligibility criteria and requirements. As well, pregnant persons are recommended to receive pertussis-containing vaccine between 27 and 32 weeks gestation to provide increased passive immunity to their newborn.

Reporting diseases of public health significance

Vaccine preventable diseases and other diseases of public health significance are reportable. If you suspect or are testing for pertussis, patients should be reported to Public Health by faxing or emailing the reporting form to 705.677.9618 or HPT_FAX_confidential@phsd.ca in addition to calling the number below, as applicable.

If you have any questions, please contact the Communicable Infectious Disease Program at 705.522.9200, ext. 772 (toll-free 1.866.522.9200), Monday to Friday, 8:30 a.m. to 4:30 p.m., or after hours and on weekends at 705.688.4366.

Sincerely,

Original Signed By

M. Mustafa Hirji, MD, MPH, FRCPC
Acting Medical Officer of Health and Chief Executive Officer

NOTE: All Advisory Alerts are found on our website.

[1] Infectious Disease Protocol, 2019, Appendix 1: Pertussis (whooping cough). https://files.ontario.ca/moh-ophs-pertussis-whooping-cough-en-2022.pdf

This item was last modified on July 18, 2024