Section 8.9
Written 9/96
Infection Control Manual Revised 10/97, 2/01
Reviewed 4/04
MANAGEMENT OF PERTUSSIS/PARAPERTUSSIS EXPOSURES
A. General
Pertussis is an acute bacterial respiratory infection. Cold/flu symptoms are followed by an irritating
cough that gradually becomes paroxysmal. Paroxysms are characterized by repeated violent
coughing spells during which it is difficult to inhale. The coughing spells may be followed by a crowing
or whooping noise when the individual is able to inhale. Infants may exhibit periods of apnea and may
not have typical paroxysm. Vomiting may follow coughing spells. Parapertussis is a similar but
usually milder disease.
B. Infectious agents: Bordetella pertussis and Bordetella parapertussis. A similar clinical syndrome may
be produced by viruses.
C. Incubation period: 7-10 days, rarely up to 14 and not exceeding 21 days.
D. Mode of transmission: direct contact with discharge from the respiratory secretions of infected
persons usually through the droplet route. Adults and older children, in whom immunity has waned,
are often the source of infection for infants and younger children. Health care workers may self-
inoculate their mucous membranes following contact with infectious secretions.
E. Period of infectiousness: from onset of cold or flu-like symptom through three weeks of cough if not
treated with an appropriate antibiotic. Individuals are considered non-infectious after they have
completed five days of a 14-day course of appropriate antibiotic therapy.
F. A pertussis exposure is defined as face-to-face (within three feet) contact with an individual known to
have pertussis during which the caregiver did not use a mask and protective eyewear.
G. Infection Precautions:
1. Private room (negative pressure is NOT needed.)
2. Respiratory Secretion precautions are required. Use gloves and handwashing for anticipated
contact with body substances, especially for contact with respiratory secretions, linen and other
objects that may be contaminated by respiratory secretions.
3. Surgical mask and PROTECTIVE EYEWEAR for Healthcare Workers and visitors with face-to-
face contact within 3 feet of patient.
4. Gowns are recommended to prevent direct contact with respiratory secretions. For example,
caregivers should don a gown when holding an infant with pertussis.
5. Visitor restriction: no children or immunosuppressed visitors.
6. Duration: Isolation precautions are required until patient has had five days of recommended
antibiotic therapy with clinical improvement.
H. Nursing, Departmental and Physician responses:
1. Prompt identification of cases.
2. Initiate and maintain Respiratory Secretions precautions. Place appropriate signage on the
patient’s door. Do not write the organism name on the sign.
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Section 8.9
Written 9/96
Infection Control Manual Revised 10/97, 2/01
Reviewed 4/04
3. Notify Infection Control of cases and exposures when appropriate.
4. Managers assist Infection Control in developing patient, visitor, and worker exposure lists.
I. Infection Control Responsibilities
Infection Control will initiate and manage the initial exposure followup which will include:
1. Notification of department/unit managers and staff of potential exposure. Infection Control will
obtain a contact exposure list from the department managers.
2. Consultation to exposed staff. Provide “Pertussis Fact Sheet (Attachment A).
3. Notification of Employee Health. Infection Control will send by fax a “Communicable Disease
Exposure Report” (Attachment B) and an “Employee Contact List” (Section 8.10). For serious
exposures, Infection Control will contact the Employee Health department as soon as possible.
4. Notification of Safety Officer (if appropriate)
5. Notification of Risk Management (if appropriate)
6. Notification of Public Health
J. Employee Health responsibilities:
1. Employee Health Service shall provide exposure followup in accordance with the Employee
Health Pertussis Exposure Protocol.
2. Exposed asymptomatic employees will be informed of the signs and symptoms of pertussis and
may receive prophylaxis. Prophylaxis with antibiotics will not be required. However, exposed
employees will be required to inform Employee Health of any symptoms consistent with Pertussis.
If symptoms occur between 7-21 days, employees shall receive antibiotic therapy.
3. Symptomatic employees need to complete five days of antibiotic therapy and be assessed by
Employee Health prior to returning to work.
a. Employees who do not take appropriate antibiotic therapy will not be allowed to work in
accordance with employee health policy.
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