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Pertussis (whooping cough) is a respiratory tract infection caused by the bacterium, Bordetella pertussis. Before the advent of the pertussis vaccine, pertussis was a leading cause of morbidity and mortality in children. Pertussis routinely occurs in Nebraska, although undoubtedly it is under reported as many infections in older children and adults are not recognized.

For information about pertussis in schools, click here.

For health care provider information, click here.


Symptoms of Pertussis

Classic pertussis infections have three distinct phases of illness. Symptoms may begin 6-20 days following exposure to the pertussis bacteria.

Stage 1; the catarrhal stage


  • sinus congestion
  • runny nose
  • slight sore throat
  • low grade or absent fever

This stage lasts one to two weeks.

Stage 2; the paroxysmal stage


The coughing progressively becomes more severe. Coughs may become severe in a series so close together that the person cannot take a breath between coughs. Following the coughing spells, there are gasps for air which may sound like a whoop. Vomiting may follow the coughing spells

This stage may last two to four weeks.

Stage 3; the convalescent stage

This is the stage when the vomiting and whooping gradually lessen.

This stage may last two to four weeks.

The illness in adults is often milder and without the whooping and vomiting.


Treatment of Pertussis

Antibiotics appear to be useful in shortening the illness if given during the catarrhal stage. Azithromycin and Clarithromycin are now considered the drug of choice for treating Pertussis. After the catarrhal stage, antibiotics cannot shorten the duration of the illness, but do reduce the amount of time an infected person can transmit the pertussis bacteria to others.


Prevention of Pertussis

A person is considered communicable until five days of appropriate antibiotic therapy have been completed.

An infected person should be excluded from day care, school and/or work for five days after beginning antibiotic treatment. If treatment is refused or the diagnosis is delayed, exclusion for three weeks after onset of the violent coughing.

Pertussis vaccine is given in the same shot with diphtheria and tetanus vaccines. Immunization is required for child care and school attendance. Children routinely receive pertussis vaccine at 2, 4, 6 and 15 months of age and a booster dose at 4 to 6 years of age (DTaP vaccine). Children should receive another booster shot at age 11 or 12 (Tdap vaccine). All adults should substitute one 'tetanus booster' (recommended every 10 years) with a pertussis-containing booster shot (Tdap vaccine).

For a copy of this fact sheet, click here.


Health Care Provider Information:

School Information:


If you need assistance reading these documents, please contact the Health Department.

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