Whooping cough

Clinical picture

Whooping cough is a contagious respiratory infection caused by the Bordetella pertussis bacterium.

In the Netherlands most children are vaccinated against whooping cough under the National Vaccination Programme. Nevertheless, whooping cough occurs regularly in the Netherlands in both children and adults. Partly thanks to vaccination, it tends to be a mild form.

Vaccination provides only a limited period of protection (4-12 years). Experiencing an infection also does not provide lifelong immunity.

Additional information from the RIVM.

Infection route

Transmission takes place by patients coughing droplets out their pharynx.

Contagious period

Until 4 weeks after the onset of symptoms. The duration of infectiousness is reduced to 5-7 days after starting therapy with antibiotics.

Incubation time

7 to 10 days, never longer than 21 days.

 

Potential infectees

Anyone who is not or no longer protected by vaccination or an experienced infection can get whooping cough or get it again. The potential infectees at the UMCs are all workers who may occupationally come into contact with whooping cough. The risk of contracting whooping cough due to contamination at work is no greater than outside work.

Prevention

Pre-employment examination: none.

Training: information must be available to staff, for example via the company doctor or a leaflet.

General measures: Follow the isolation regulations drawn up by the hospital hygiene department.

Vaccination: not indicated.

PME: none.

Post-exposure policy

Staff who have had intensive and unprotected contact with a proven positive patient, colleague or housemate receive instruction: if symptoms of the cold occur 7-21 days after contact with the source, antibiotic prophylaxis is indicated (from a pragmatic point of view, this is possible without microbiological confirmation; if desired, first PCR or serology). Please note: it takes a few weeks for serology to be positive; at the beginning of the infection, make a diagnosis with a PC. As a precautionary measure, offering temporarily adapted duties (non-patient-related) may be considered.

Potential infectors

Staff who have direct contact with infants under 6 months of age. These infants have not yet been – or not fully – vaccinated, and contracting whooping cough can be life-threatening for them.

Vaccination: there is no national position yet on vaccinating health care workers against whooping cough to protect newborns (under 6 months). It is worth considering offering vaccination potential infectors.

Post-exposure policy: after intensive unprotected exposure, consider giving immediate prophylaxis in order to reduce the risk of further spread among vulnerable infants as much as possible.