Download Actions needed following pertussis notification

Actions needed following pertussis notification
Advice to OOH/BECS
To be followed for a case of clinically suspected whooping cough or laboratory diagnosed pertussis. To be
read in conjunction with the document ‘Pertussis Management Guidelines’
Please note:
 This disease is notifiable to Public Health
 Due to delay in patient presentation or in laboratory results, there can be a delay of around 4 weeks
before the public health department becomes aware of a suspected or confirmed case
 We request all physicians clinically suspecting pertussis to notify us within 48 hours
 On notification we will make contact with the relevant GP, or the on call GP, to determine the date of
onset of symptoms. We recognise that some cases will have been seen/diagnosed in secondary care.
Symptom onset is more than 3 weeks ago
The case is no longer infectious
Action plan:
1. Antibiotic treatment for pertussis is no longer indicated. Offer treatment for other co-morbidities where
appropriate. (OOH)
2. Ensure that there are no other suspect cases in the household and if so treat as appropriate (OOH)
3. Provide Public Health with a contact telephone number of patient at 8am the next day including
weekends and Public Holidays (OOH)
4. Contact case, check and feedback to OOH and patients own GP any outstanding actions required
(Public Health)
5. Provide information about Pertussis to patient next working day (Public Health)
6. Refer back to patients own GP. This will be sent via the Adastra handover sheet (OOH)
Symptom onset is less than 3 weeks ago
The case may still be infectious. There are a number of issues to address that we require your assistance with.
Action plan:
1. Check case has been treated appropriately (OOH) ie as per Appendix 2 ‘Pertussis Management
Guidelines’ and for other co-morbidities.
2. Advise exclusion of case for five days from onset of treatment if attends school/preschool or works at
educational/healthcare setting (OOH)
3. Check if prophylaxis is needed. If any household member falls into one of the below at-risk categories
provide prophylaxis to ALL household members (regardless of age or previous immunisation
history):***
a)
b)
c)
d)
e)
f)
g)
Newborn infants born to symptomatic mothers
Infants under one year who have received less than three doses of DTaP/IPV/Hib
Unimmunised and partially immunised infants or children up to ten years
Women in the last month of pregnancy
Adults who work in a healthcare, social care or childcare facility
Immunocompromised individuals (as defined in the Green Book)
Presence of other chronic illnesses e.g. asthma, congenital heart disease.
If no-one falls into an above at-risk category prophylaxis is not needed (OOH)
4. Provide Public Health with treatment details & patient contact telephone number(s) - home and
mobile (OOH). This can be left until 8am the next day, including weekends and Public Holidays.
5. Contact case, check and feedback to OOH and patients own GP any outstanding actions required
(Public Health)
6. Provide information about Pertussis to patient next working day (Public Health)
7. Refer back to patients own GP. This will be sent via the Adastra handover sheet (OOH)
*** Access to medications out of hours when pharmacy is closed.
 Given that this is likely to be an ongoing public health concern, the BECS OOH pharmacy master
list will be altered to ensure that recommended medications to treat pertussis will be in all OOH
Cupboards.
 If it is overnight period/there is an issue with supply, it is safe to wait until the next day for
contacts to access medication and start prophylactic treatment. Contacts can be given a GP10
for the appropriate treatment by a BECS GP to take to pharmacy the next day.
 Actual cases need to be provided with medications at the time of review

In areas where there is no pharmacy provision locally OOH medicines can be dispensed from
BECS stocks at community hospitals by arrangement .This will be coordinated by BECS.