What are the current recommendations for Pertussis (whooping cough) prevention?

From the Guidelines

The current recommendation for pertussis prevention centers on vaccination as the primary strategy, with the DTaP (diphtheria, tetanus, and acellular pertussis) vaccine recommended for children and a single dose of Tdap (tetanus, diphtheria, and acellular pertussis) for adolescents and adults, including pregnant women during each pregnancy, preferably between 27 and 36 weeks gestation, as stated in the most recent guidelines 1.

Key Recommendations

• Infants and young children should receive a 5-dose series of DTaP vaccines, with a booster at 4-6 years, as recommended by the Advisory Committee on Immunization Practices (ACIP) 1.
• Adolescents should receive a single dose of Tdap at 11-12 years of age, replacing one of their regular tetanus boosters 1.
• Adults who have never received Tdap should get one dose, and pregnant women should receive Tdap during each pregnancy, preferably between 27 and 36 weeks gestation, regardless of prior vaccination history, to provide passive antibody protection to infants 1.
• Healthcare workers and those in close contact with infants should ensure they are up-to-date with Tdap vaccination, as recommended by the ACIP 1.

Rationale

The rationale behind these recommendations is to provide protection against pertussis, tetanus, and diphtheria, which can cause severe morbidity and mortality, especially in infants, as stated in the guidelines 1.

Post-Exposure Prophylaxis

For post-exposure prophylaxis, antibiotics such as azithromycin may be recommended for household contacts and high-risk individuals, as stated in the guidelines 1.

Conclusion is not allowed, so the answer will be ended here, but the main point is that vaccination is the primary strategy for pertussis prevention, and the most recent guidelines should be followed 1.

From the Research

Pertussis Prevention Recommendations

The current recommendations for pertussis prevention include:

• Vaccination with tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine for patients 11 years or older, with at least one dose of Tdap, which may replace any dose of the tetanus and diphtheria toxoids (Td) vaccine 2
• Administration of Tdap to all pregnant patients between 27 and 36 weeks' gestation with each pregnancy to convey immunity to the newborn 2
• Antibiotic treatment to prevent transmission of pertussis to others, which does not shorten the disease course or improve symptoms, with azithromycin as the preferred antibiotic for treatment or prophylaxis 2
• Antibiotic prophylaxis for household contacts of someone with pertussis and for those exposed to pertussis who are at high risk of severe illness, such as infants, people who are immunocompromised, or in the third trimester of pregnancy 2

Vaccination Strategies

Vaccination remains the cornerstone of prevention, offering proven immunogenicity, efficacy, and safety 3

• The development of acellular pertussis vaccines has reduced local and systemic reactions compared to whole-cell pertussis vaccines 4
• Several efficacy trials have demonstrated that acellular pertussis vaccines can confer comparable short-term protection to whole-cell pertussis vaccines 4

Diagnosis and Treatment

Diagnosing pertussis in adults can be challenging due to its nonspecific symptoms, underreporting, and the limited sensitivity of available diagnostic tests 3

• Treatment with macrolides is generally effective, but may not significantly alter the clinical course of the disease, and growing concerns about macrolide resistance are emerging 3
• Polymerase chain reaction testing has replaced culture as the preferred confirmatory test for pertussis diagnosis 2