This month, I received an update from the Michigan Health Alert Network. In it, they describe how pertussis activity has increased in Michigan since late fall 2016. The increase has been mostly in kids age 4 or younger who haven't had their full set of DTaP vaccinations who are in daycare settings.
Pertussis is also known as the "whooping cough" because of the classic inspiratory pattern that kids show when they take a deep breath between fits of coughing. Pertussis is also called the "100 day cough" because it goes through several phases with active coughing lasting for several weeks. In those children who have been partially vaccinated, that classic whoop may be absent.
Appropriate testing includes culture or PCR of nasopharyngeal (NP) aspirate or swab (polyester tip). The Michigan Health Alert Network recommends reporting positive case to local public health departments. Appropriate treatment is with a 5-day course of azithromycin; other choices include 7 days clarithromycin or 14 days erythromycin; an alternative is 14 days of TMP-SMZ.
Importantly, close contacts who are un-immunized or under-immunized should get the pertussis vaccination! This includes off-label use of Tdap in children 7 through 10 years of age who did not complete the DTaP series. A pertussis vaccine booster dose (Tdap) is recommended for adolescents and adults, and is especially important for those in contact with infants. Current recommendations call for a single lifetime Tdap booster dose with the following exception: a dose of Tdap is recommended for pregnant females in each pregnancy between weeks 27 and 36. Comprehensive pertussis information is available at www.cdc.gov/pertussis
If you need to get updated with your TDaP vaccine, we have that in stock at our Plum Health DPC office. It costs $47.47 at wholesale, and that's what we give it to you for, no mark up.
Thanks for reading, and have a great day!
- Paul Thomas, MD