infectious diseases
Pertussis
Prevention of Pertussis
Active immunization against pertussis is part of standard childhood vaccination. Five doses of Diphtheria-Tetanus-Pertussis Vaccine are given (usually combined with diphtheria and tetanus [DTaP]) at ages 2, 4, and 6 months, at 15 to 18 months, and at 4 to 6 years. Immunity after natural infection lasts about 20 years. Close contacts<7 years who have had<4 doses of vaccine should complete the recommended childhood vaccination schedule. Postexposure antibiotics should be given to household contacts within 21 days of the onset of cough in the index patient, whether they have been vaccinated or not. Postexposure antibiotics should also be given to the following high-risk people within 21 days of exposure, whether they have been vaccinated or not: Infants < 12 months Women in the 3rd trimester of pregnancy All people with health conditions potentially exacerbated by pertussis infection (eg, immunodeficiency, moderate to severe asthma, chronic lung disease) People who have close contact with infants < 12 months, pregnant women, or patients with conditions that may result in severe illness or complications All people in high-risk settings that include infants < 12 months or women in the 3rd trimester of pregnancy (eg, child care centers, maternity wards, neonatal intensive care units) These people should be given a 7- to 14-day course of oralerythromycin500 mg 4 times a day or 10 to 12.5 mg/kg 4 times a day. Alternative antibiotics includeclarithromycinandazithromycin. For infants < 1 month,azithromycinis preferred for postexposure prophylaxis. 