Prevention of pertussis

Ensure vaccinations against Bordetella pertussis are up to date as per the Australian Immunisation Handbook.

Identify contacts of patients diagnosed with pertussis and assess the need for postexposure antibiotic prophylaxis in collaboration with the local public health authority¹². A suggested definition of contacts are individuals who have been within 1 metre of an infectious pertussis patient for longer than 1 hourCommunicable Diseases Network Australia (CDNA), 2024. Patients with pertussis are considered infectious if it has been less than 3 weeks since the onset of cough or other symptoms, and antibiotic therapy has been taken for less than 5 days.

Evidence to support postexposure antibiotic prophylaxis for contacts is limited. Its use is focused on preventing pertussis in children younger than 6 monthsCommunicable Diseases Network Australia (CDNA), 2024.

In community settings, start postexposure antibiotic prophylaxis in the following individuals if they are contacts of patients with pertussis:

• children younger than 6 months
• individuals in the last month of pregnancy
• individuals who may transmit pertussis to children younger than 6 months. This includes children and adults who:
  • have contact with the patient with pertussis in a childcare setting (need for prophylaxis varies depending on whether an outbreak has occurred, the age of children at the childcare setting and vaccination status – seek advice from the local public health authority)
  • reside with a child less than 6 months of age; if the patient with pertussis is a member of the household, all household members should receive prophylaxis
  • reside with an individual in the last month of pregnancy; if the patient with pertussis is a member of the household, all household members should receive prophylaxis.

If the need for postexposure prophylaxis is uncertain (eg healthcare settings, the contact is a grandparent who provides care for a child younger than 6 months but does not reside in the same household), seek advice from the local public health authority, and consider the vaccination status of contacts and the degree of contact with the patient with pertussis.

For comprehensive advice on postexposure antibiotic prophylaxis, see Pertussis (whooping cough) – Communicable Diseases Network Australia (CDNA) National Guidelines for Public Health Units.