Pertussis

[MrNurse(x2), ADN]

I got an email from one of our teachers that all 3 of her daughters, despite vaccination, have pertussis and were in school during the contagious phase. I was pouring over CDC site last night and see that the real threat is to newborns and pregnant women. It appears that the rate of non-immunity post vaccine is highest for pertussis and the anti-vac crowd have increased the risk over the last few years. My Principal wanted to know if a notice should be sent to parents and my initial response was no, as the threat is the same in the community as at school, and unvaccinated kids should have the attitude that their kids are possibly going to come down with one of these things anyway. Looking at risk, there is more possibility of valvular disease from strep throat than complications from pertussis. Has anyone dealt with this and if so, how did you handle it? Thanks once again for your insight.

[scrubsrn24]

We had a pertussis outbreak last year. The department of public health was involved because it is a reportable disease (at least it is in my state). I'd give your local or state health department a call and see how you should proceed. Keep an eye out for any of their contacts developing the cough. After a certain number of cases, our district sent a letter to all parents.

[MrNurse(x2), ADN]

Thanks scrubsRN24. Their pediatrician reported, but our health department is awesome to deal with. Thanks for the reminder.

[Farawyn]

Let us know how it turns out.

I agree with you on your logic, but yea, it's reportable to the DOH.

[OldDude]

Good advice from scrubs. Let the health department take the lead. Although I'm not sure "who" would proclaim an "outbreak" but in Texas those who have not been immunized, by choice, are excluded from school attendance until the outbreak episode is over.

[JustBeachyNurse, LPN]

Board of health took over in my county once any case was confirmed. They sent the notices out to the community and to the potentially affected schools.

[Farawyn]

Board of health took over in my county once any case was confirmed. They sent the notices out to the community and to the potentially affected schools.

What was the fallout with the parents?

Were they directed to call the DOH or contact the school?

I know the few times with flu outbreaks (when I worked in Employee Health) when we had to call DOH, the hospital employees were going ballistic.

[JustBeachyNurse, LPN]

What was the fallout with the parents?

Were they directed to call the DOH or contact the school?

I know the few times with flu outbreaks (when I worked in Employee Health) when we had to call DOH, the hospital employees were going ballistic.

Directed to a DoH hotline. The press releases were pretty comprehensive. The DoH also had FAQ online and an online question submission. Recently a meningitis death after two middle schoolers positive for pertussis. They were proactive before the rumors started, they learned a lot after the West Nile Virus & avian flu outbreaks.

[MrNurse(x2), ADN]

My DoH has been extremely supportive while getting my program up and running, even offering Medical Director services if I didn't have the resources. I trust them to lead me in the right direction and take the lead if necessary, which I am all in favor of.

[AdobeRN]

I had one positive a few years ago - parent did not bother to tell us - I was notified by the Health Department. At that point the kid had already been treated and was back at school. All I did was notify those parents of kids that were not vaccinated - the Health Department sent me an official letter to send out to parents if I wanted to but it was not a requirement.

I have had a few parents say the doctor was treating their child for presumed pertussis but the doctor never sent cultures out to be tested. I did not notify other students or the Health department on those cases.

[MrNurse(x2), ADN]

I have had a few parents say the doctor was treating their child for presumed pertussis but the doctor never sent cultures out to be tested. I did not notify other students or the Health department on those cases.

This is exactly the case here, mom is saying pertussis, not the doctor. Long discussion with the health dept. nurse. Mom feels it meets the criteria, no cultures done, she even called the health dept. on her own. Crisis averted! Thanks for all the info, everybody. Will help next time.

[Farawyn]

This is exactly the case here, mom is saying pertussis, not the doctor. Long discussion with the health dept. nurse. Mom feels it meets the criteria, no cultures done, she even called the health dept. on her own. Crisis averted! Thanks for all the info, everybody. Will help next time.

Is she at least keeping the kid home?