14 Pertussis (whooping cough)

Key information

Mode of transmission By aerosolised droplets.
Incubation period 7–10 days (range 5–21 days).
Period of communicability For control purposes, the communicable stage lasts from the catarrhal stage to 3 weeks after the onset of paroxysmal cough in a case not treated with antimicrobials. When treated with an effective antibiotic (eg, erythromycin), infectivity lasts until 5 days of antibiotics have been taken.
At-risk populations Infants aged under 12 months, particularly those too young to be immunised.
Funded vaccines DTaP-IPV-HepB/Hib (Infanrix-hexa).

DTaP-IPV (Infanrix-IPV).

Tdap (Boostrix).
Funded vaccine indications and schedule Usual childhood schedule:
  • at age 6 weeks, 3 months and 5 months: DTaP IPV-HepB/Hib
  • at age 4 years: DTaP-IPV
  • ​at age 11 years: Tdap (no minimum interval is required between Td and Tdap, unless Tdap is being given as part of a primary immunisation course).
During pregnancy (from 28 to 38 weeks’ gestation): Tdap.

For (re-)vaccination of eligible patients.
Dose interval between Td and Tdap No minimum interval is required between Td and Tdap. 
Vaccine efficacy/effectiveness 84 percent efficacy after the 3-dose primary course in infants, lasting up to age 6 years. Immunity (derived from both natural infection and immunisation) wanes over time.
Precautions Children with an evolving neurological disorder.

Very premature babies have shown evidence of apnoea, bradycardia and desaturations with combination DTaP vaccines.
Adverse events from vaccine Thigh or upper arm swelling occurs in 2–3 percent of children after the fourth and fifth doses.