Pertussis

[pistolchick]

Eek! I just found out that some office staff with whom I work closely is at home with her children who have pertussis. I'm pregnant, had my last TDaP in 2012, and not far along enough yet to have my pregnancy TDaP.

I'm substituting as a school nurse right now, and while mostly I see kids with coughs, sniffles and sore throats, I'm terrified about the potential exposure to things like pertussis - or whatever else the handful of kids who aren't vaccinated (or adults whose vaccines are outdated) are carrying around. Am I being paranoid?

[OldDude]

Of course you are. You would be if you weren't a nurse but, since you're a nurse, you're double paranoid. Just like you would advise someone else - I'd advise you not to worry about it but you're going to anyway. You know I'm right, don't you? Congratulations, by the way!!

[MrNurse(x2), ADN]

So we isolate all these nasty superbugs in the hospital, and boom, they are among us after discharge. It is safer in the school than holiday shopping. You have access to hand hygiene after each contact and can approach each child as a contagion. You could always wear a mask, if that would alleviate fear.

[Farawyn]

The TDap from 2012 will probably be fine until your scheduled TDap.

Call your OBGYN and let her/him know you may have been exposed to known pertussis.

What the guys said.^

Congrats!

[pistolchick]

Interesting update to this topic - said staff person is back in the office today, updating me that both of her children who tested positive for pertussis had vaccines within the last 4 years. The family doctor told mom that all symptoms were atypical - the cough especially. The whole family is on erythromycin (some prophylactically). I also spoke with my OB office yesterday, and based on the my latest vac, they were unconcerned. Thanks y'all.

[pistolchick]

UPDATE: We now have had another suspected case in a student, and were told by the parents the test came back "inconclusive" - I didn't talk to the parent so I couldn't find out what test they did. Teachers are upset, wanting to know what that means, and I don't blame them. I also don't know what to tell them, other than it means we don't know if the student has/had it or not, which is, of course, a very unsatisfying answer. My years of nursing experience aren't helpful with this topic, and Google hasn't helped much, either. Ideas?

[JustBeachyNurse, LPN]

Call your county health department. They should have ID/epidemiology nurses plus this is reportable to the county health department as a matter of public safety. The pediatrician should be reporting but it also is the school nurse responsibility.

[Farawyn]

I would also want the actual test results in my hot little hands, if possible, not a call from the parents, since it is reportable to the DOH.

[pistolchick]

I would also want the actual test results in my hot little hands, if possible, not a call from the parents, since it is reportable to the DOH.

Yes, agreed. It's a little tricky with my being a substitute - a lot of the parents don't even realize there is a sub nurse, I'm not here every day, and before I came the office staff was handling all these issues and I've noticed some resistance with wrestling control of some of these situations away from office staff.

[JustBeachyNurse, LPN]

Then call the local or county health department for guidance. You are likely a mandated reporter. They have the power to secure the information & results in the name of public health & safety. Makes me glad my state mandates full time school RNs for all schools with minimal exception.

[RNqueens]

This week one of the teachers notified the princ. that they were infected. Princ. Asked my opinion about it. Reviewed the students in the school vaccine status and shared with princ. To my knowledge what the immunization status of the school is and no known student cases but, will be willing to send out info to staff. Infected teacher proceeds to rant that her doctor is from a prestigious hospital and they are sure they got it from the school even though its not the only public setting I'm sure she has been in especially at this time (insert rolled eyes due to unnecessary banter from teacher as I was doing my job as a school nurse by informing the princ. About the student body).

"Public service announcement" emailed to staff per principal request for 1 known case. Sorry had to get this off my chest. Teacher really annoyed me and was totally out of place. Obviously teacher does NOT respect my job title.

Please note I made sure to add in the email not to send every coughing student to me since sending out PSA's can potentially cause hysteria. Reviewed proper hand hygiene.(not an elementary school)