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Pertussis Information for Health Professionals

Contact Info

Infectious Disease Epidemiology, Prevention and Control Division

651-201-5414

IDEPC Comment Form

Contact Info

Infectious Disease Epidemiology, Prevention and Control Division

651-201-5414

IDEPC Comment Form

Managing Pertussis: Think, Test, Treat & Stop Transmission

Fact sheet for health professionals on when to think of pertussis, how to test for pertussis, how to treat and report suspected and confirmed cases, and stop transmission.

Download PDF version formatted for print: Managing Pertussis: Think, Test, Treat & Stop Transmission (PDF)

On this page:
Think of pertussis
Test for pertussis
Interpreting Test Results
Treat and report suspected and confirmed cases
Stop Transmission

THINK of pertussis in anyone with the following symptoms, regardless of vaccination history

A cough of any duration in a person who has been notified of a close exposure to pertussis,
A paroxysmal cough of any duration, with whooping, post-tussive vomiting/gagging or apnea, or
A persistent cough of unknown etiology, lasting more than seven days.

TEST for pertussis

Based on the guidance in the table, collect a specimen using a nasopharyngeal (NP) swab, wash or aspirate for PCR or culture. Collect serum for IgG.

Do not test if symptoms are not present. It is unlikely that B. pertussis can be recovered through testing if the patient is not experiencing symptoms.
Most reference laboratories provide PCR testing for individuals with suspect pertussis. The MDH Public Health Laboratory (MDH-PHL) also provides PCR testing.
- For information and supplies on testing for pertussis through MDH-PHL, please complete the VPD Test Kit Requests.

Interpreting test results

Test	Timing of specimen collection	Test result interpretation
PCR (results within 24-96 hours)	Best if collected within first 2-3 weeks of cough. PCR will detect non-viable organisms present, even in persons who have been treated with antimicrobials; however, false negatives can occur and are more common later in the illness.	(+) Positive: Confirms B. pertussis if clinical and/or exposure history support the diagnosis of pertussis. (-) Negative: Does not rule out B. pertussis infection. Consider clinical presentation.
IgG Serology (results can take up to a week)	In general, specimens are best collected at 2-3 weeks or later after onset of cough. Collected earlier in cough illness can lead to false negatives.	(+) Positive: Likely pertussis, although should be interpreted in combination with recent pertussis vaccine history (can give a false positive) and in combination with each lab's specific panel. (-) Negative: Likely negative for pertussis.
Culture (results can take up to 10 days)	Best if collected within first 2-3 weeks of cough. Recovering the organism is unlikely beyond 3 weeks of cough or in patients who have received antimicrobials. False negatives are common even early in the illness.	(+) Positive: Confirms B. pertussis infection. (-) Negative: Does not rule out B. pertussis infection. Consider clinical presentation.

Test

Timing of specimen collection

Test result interpretation

PCR
(results within 24-96 hours)

Best if collected within first 2-3 weeks of cough. PCR will detect non-viable organisms present, even in persons who have been treated with antimicrobials; however, false negatives can occur and are more common later in the illness.

(+) Positive: Confirms B. pertussis if clinical and/or exposure history support the diagnosis of pertussis.

(-) Negative: Does not rule out B. pertussis infection. Consider clinical presentation.

IgG Serology (results can take up to a week)

In general, specimens are best collected at 2-3 weeks or later after onset of cough. Collected earlier in cough illness can lead to false negatives.

(+) Positive: Likely pertussis, although should be interpreted in combination with recent pertussis vaccine history (can give a false positive) and in combination with each lab's specific panel.

(-) Negative: Likely negative for pertussis.

Culture
(results can take up to 10 days)

Best if collected within first 2-3 weeks of cough. Recovering the organism is unlikely beyond 3 weeks of cough or in patients who have received antimicrobials. False negatives are common even early in the illness.

(+) Positive: Confirms B. pertussis infection.

(-) Negative: Does not rule out B. pertussis infection. Consider clinical presentation.

TREAT and report suspected and confirmed cases

Use Erythromycin, Azithromycin, Clarithromycin, or Trimethoprim-Sulfamethoxazole for treatment. If 21 days have already elapsed since cough onset, treatment is not recommended, as it will not improve outcome.
Prescribe antimicrobial prophylaxis (same regimen as treatment) to persons who are household contacts or high-risk contacts of the pertussis case.
- High-risk contacts include infants less than 1 year of age, pregnant persons, other immunocompromised people, and those who have contact with high-risk people.
- Asymptomatic contacts receiving prophylaxis should not be excluded from their usual activities.
- Symptomatic contacts should be evaluated for pertussis.
For recommendations on pertussis treatment and prophylaxis of case contacts, see Pertussis Treatment and Prophylaxis.
Laboratory confirmed and clinically diagnosed cases are reportable.
Call your local health department if you have questions.

STOP TRANSMISSION

Inform patients with suspected pertussis to stay at home and avoid close contact with others until they have:

Completed the fifth day of an appropriate antibiotic.

Had cough symptoms for at least 3 weeks (cases are potentially infectious for the first 3 weeks of cough).