From the Guidelines
For a pertussis outbreak in 2025, vaccination remains the primary preventive strategy, with DTaP recommended for infants and young children, and Tdap for adolescents and adults, including a dose during each pregnancy, as outlined by the Advisory Committee on Immunization Practices (ACIP) 1. The recommended vaccination schedule includes a 5-dose series of DTaP vaccines for infants and young children, with a booster dose of Tdap for adolescents, and a Tdap dose for adults who have never received it, as well as for women during each pregnancy, from 27 through 36 weeks’ gestation 1. Key points to consider for prevention and treatment include:
- Vaccination with DTaP and Tdap as the primary preventive measure
- Antibiotic treatment for infected individuals, ideally within the first 1-2 weeks of symptom onset
- Post-exposure prophylaxis for high-risk contacts
- Respiratory hygiene and isolation of infected individuals for 5 days after starting antibiotics
- Enhanced surveillance in affected communities It is essential to prioritize vaccination and early antibiotic treatment to reduce transmission and potentially lessen symptom severity, as pertussis is highly contagious and can cause severe symptoms, especially in infants and young children 1. Additional measures, such as respiratory hygiene and isolation, can help prevent the spread of the disease, and enhanced surveillance can aid in early detection and response to outbreaks.
From the FDA Drug Label
Erythromycin tablets are indicated in the treatment of infections caused by susceptible strains of the designated microorganisms in the diseases listed below: ... Pertussis (whooping cough) caused by Bordetella pertussis. Erythromycin is effective in eliminating the organism from the nasopharynx of infected individuals, rendering them noninfectious Some clinical studies suggest that erythromycin may be helpful in the prophylaxis of pertussis in exposed susceptible individuals.
The recommended treatment for pertussis (whooping cough) is erythromycin, which is effective in eliminating the organism from the nasopharynx of infected individuals.
- Erythromycin can be used for treatment of pertussis.
- Erythromycin may also be helpful in the prophylaxis of pertussis in exposed susceptible individuals 2.
From the Research
Recommended Treatments for Pertussis Outbreak
- Antibiotic therapy is recommended to decrease disease severity and limit communicability 3, 4, 5
- Effective regimens include:
- Three days of azithromycin
- Seven days of clarithromycin
- Seven or 14 days of erythromycin estolate
- 14 days of erythromycin ethylsuccinate
- Short-term antibiotics (azithromycin for three days, clarithromycin for seven days, or erythromycin estolate for seven days) were equally effective with long-term antibiotic treatment (erythromycin estolate or erythromycin for 14 days) in the microbiological eradication of Bordetella pertussis from the nasopharynx 5
Preventive Measures for Pertussis Outbreak
- Vaccination is a crucial preventive measure, with a focus on boosting immunity in adults to protect vulnerable populations 6
- Antibiotic postexposure prophylaxis (PEP) following pertussis exposure is recommended, particularly for healthcare personnel 7
- Daily symptom monitoring without PEP may be considered noninferior to PEP after pertussis exposure, but further study is needed to confirm this approach 7
- Contact prophylaxis with antibiotics did not significantly improve clinical symptoms or the number of cases that developed culture-positive B. pertussis 5