Parents at Thurston Middle School in Westwood have been informed of a student with a confirmed case of pertussis (whooping cough). Nearly all children in the Westwood-Mansfield Pediatric Associate practices have been adequately immunized against pertussis. The current Massachusetts Department of Public Health recommendations are to not widely provide antibiotic prophylaxis to children unless they have very close contact with the confirmed case. From the MA DPH Website:
Due to multiple known exposures to cases of pertussis over a period of time (e.g., a few months), an individual could receive several courses of antibiotics, which could result in side effects and may promote the emergence of antibiotic resistance.
New recommendations for antibiotic prophylaxis:
◆ Due to the reasons listed above, recommendations have been revised and are now more targeted in nature.
◆ Only close contacts (share food, drink or utensils, contact teammates, shared special needs classroom, boyfriend/girlfriend) should receive antibiotic prophylaxis, AND efforts should be focused on contacts who are at high risk for severe pertussis disease or contacts who could transmit pertussis to those at high risk. High risk for pertussis disease includes children with the following, who live in a household with or have close physical contact with someone with the following conditions:
- Infants < 1 year of age particularly those < 6 months of age
- Pregnant women in their 3rd trimester (due to concern about transmission to their newborn)
- Immunocompromised individuals such as with cancers, HIV/AIDS, autoimmune disorders, transplant patients or living with immunocompromised individuals
- On long term immunocompromising medication
- Individuals with chronic lung diseases such as persistent asthma or cystic fibrosis
- Individuals with neuromuscular disorders that prevent or reduce the ability to clear secretions
- Unimmunized or under-immunized children.
In general, during a school or community outbreak, antibiotics are now indicated for a limited number of individuals who are close contacts with the index patient or who are themselves high risk or live in a household with a person who is high risk. Antibiotic prophylaxis is no longer routinely recommended for entire classrooms of school-aged children when there is only one laboratory-confirmed case of pertussis.
Call the WMPEDS triage line to speak with a nurse if you have questions about close contact or high risk.