Pertussis Parent Notification

Home Health Columnist / Guide · Jan 19, 2020

Dec. 26. 2018 pertussis (whooping cough) notification - https://kessler.longviewschools.com/2019/01/03/dec-26-2018-pertussis-whooping-cough-notification/

CDC: Letter of Guidance for Use during Outbreaks

This draft letter can be adapted for use during pertussis outbreaks in schools or other closed or contained settings. View the letter of guidance.: https://www.cdc.gov/pertussis/guidance-letter.html

jnemartin, BSN, RN · Jan 20, 2020

is one case an outbreak?

i'm not asking for my own practice, i'm asking because another school *apparently* has a case, sent a letter to parents, and it ended up on my neighborhood facebook page (with over 7k members). The entire community is freaking out, and I know for other communicable diseases and conditions letters are NOT sent home, partially for this reason. The school where this allegedly happened does not have a school nurse, so the admin may not have the most up-to-date school health practices in place.

I'd like to know what is the policy in other schools regarding when letters are sent out in the wake of a CONFIRMED pertussis case (I don't even know if this case is confirmed because, let's be honest, did the principals review the appropriate documents?)

UrbanHealthRN, BSN, RN · Jan 20, 2020

If the disease is serious enough, 1 case can be all it takes to be considered an outbreak (ex. 1 case of anthrax is an "outbreak" in my state because it's so rare and dangerous). Check with your state or local DPH to see what's considered a pertussis outbreak. Off the top of my head, I'm pretty sure I'd be notifying parents if there was one case.

When it comes to letters, I'd be putting out a letter that was worded from the DPH, which isn't exactly the most reassuring sounding piece of paper. And I'd be there to take parent calls and hopefully squash some of the questions and concerns early. I wonder if part of the hysteria was related to no health professionals being on staff at the school to help parents figure out what was going on?

guest464345 · Jan 20, 2020

In my state, an outbreak of pertussis is 3 epi-linked (same classroom/area, or some known connection) confirmed cases within 21 days. @UrbanHealthRN is right, you have to check with Public Health or your state health services, because it varies... It's probably findable on their web site too.

Public health might require notifications and/or surveillance (typically for 21 days since the last known case).

I previously worked as a county PH disease surveillance nurse, and we provided letters and helped school nurses talk principals/parents off the ledge all the time! So hopefully your jurisdiction will help you.

Meanwhile you can tell people generally that it's not a case until someone reliable sees lab results (pertussis testing is tricky and often done wrong. in my county we regarded IgM/IgG serology as basically useless, we only counted positive PCRs or cultures -done in an appropriate timeframe - as confirmed cases). Providers and labs are required to report positive results to PH, and PH will follow up.... no need for parents/Facebook to handle disease investigation! ?

AdobeRN · Jan 21, 2020

I am in Texas - If it is a confirmed case we get a call from the Health department. I have had only had one confirmed case in my 10 years as a school nurse, parents never even bothered to let me know their kid was being treated for it. I was notified about 10 days after the kid had completed his treatment by the Health department. The Health department then sent me a letter to send out to parents.

ihavealltheice · Jan 21, 2020

We would sent notification only after a confirmed case by the county health department. The health department should be the ones initiating the call to the nurse or admin,but sometimes you get notification from the parent earlier. I'd NEVER send out any information until I get confirmation from the health department though. It's a huge hullabaloo.

NutmeggeRN, BSN · Jan 21, 2020

We looked a several scenarious last year when there was a reported (later unfoiunded case) in our state. We spoke with DHHS and they said they are the lead, as there are many factors involved in a case/outbreak. They will guide us with notifications and responses and information. I'm very glad of that!!!

ruby_jane, BSN, RN · Jan 21, 2020

2 hours ago, AdobeRN said:
I am in Texas - If it is a confirmed case we get a call from the Health department. I have had only had one confirmed case in my 10 years as a school nurse, parents never even bothered to let me know their kid was being treated for it. I was notified about 10 days after the kid had completed his treatment by the Health department. The Health department then sent me a letter to send out to parents.

Yup. We're not diagnosing, just mitigating the damage.