We have been in daily contact with the Kansas Department of Health and Environment (KDHE) throughout this outbreak and together have developed some guidance for our community. I am confident that the prevention and control recommendations we have implemented will work to slow and eventually stop the spread of pertussis in this community.
Even though Barton County is experiencing a pertussis outbreak, it is important to keep in mind that it is the time of year that other respiratory illnesses may be circulating in our community.
KDHE has notified Barton County Health Department that in addition to pertussis, several persons have tested positive for influenza and parainfluenza. For these reasons, please consider the information below, which has been provided by KDHE in regards to pertussis testing and treatment. As you already have done, please continue to consider other illnesses if the symptoms are not consistent with pertussis.
1. Patients should only be tested when symptoms are clinically compatible with pertussis, which include an acute cough illness with one or more of the following symptoms;
a. Paroxysms (severe coughing fits)
b. Post-tussive vomiting
c. Inspiratory whoop
2. The preferred laboratory test for confirmation of pertussis is isolation of Bordatella pertussis by culture; however, polymerase chain reaction (PCR) testing is more widely available, and is considered confirmatory when consistent with a clinical diagnosis. If you have a patient that is uninsured and is symptomatic, testing is available at the Kansas Department of Health and Environmental Laboratories. To request pertussis testing please call KDHE at 877-427-7317. Serology is not useful in diagnosing pertussis.
3. Pertussis patients should be treated and all household contacts and high risk contacts should be chemoprophylaxed regardless of age or vaccination status. Initiating treatment >3 weeks after cough onset has limited benefit to the patient or their contacts. However, treatment is recommended up to six weeks after cough onset in late pregnancy.
a. Recommended antibiotic treatment/chemoprophylaxis:
i. 5-day course of azithromycin
ii.7-day course of clarithromycin
iii. 14-day course of erythromycin
b. Alternative treatment:
i. 14-day course of trimethoprim-sulfamethoxazole
4. Symptomatic children and/or adults must be isolated for five days following initiation of antibiotic therapy; if untreated, the period of isolation is 21 days from cough onset.
5. It is not recommended that students with a cough be excluded from school until they can provide negative pertussis results. Testing persons with only a cough increases the likelihood of false positive results. Many respiratory illnesses circulate during the winter months so it is best to refer ill students to their healthcare providers for proper diagnoses.
If you have any questions at all, please do not hesitate to call the Barton County Health Department at (620) 793-1902.