PERTUSSIS - AN UPDATE ON PRIMARY PREVENTION AND OUTBREAK CONTROL

Pertussis is a highly contagious respiratory disease. Infected adolesc ents and adults with mild illness are the source of potentially life-t hreatening illness in infants and young children. The incidence of per tussis has been rising steadily in recent years. Primary vaccination i s 80 percent effective, but protection is transient. Pertussis can be difficult to diagnose because classic whooping cough is uncommon, dise ase manifestations are often atypical, and laboratory and radiologic a ids are frequently nonspecific. Diagnosis is usually based on the clin ical picture, but culture, direct fluorescent antibody tests and serol ogy can be helpful. Antibiotic therapy can decrease the duration and s everity of illness, and prevents secondary spread if started early. Ef fective management of pertussis outbreaks requires early diagnosis and treatment of cases, antibiotic prophylaxis of contacts and accelerate d vaccination of susceptible infants and children. Acellular pertussis vaccine preparations have recently been recommended for the entire pr imary vaccination series.