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Vaccine Preventable Disease Control
County of Los Angeles
Department of Public Health
Vaccine Preventable Disease Control Program
3530 Wilshire Blvd. Suite 700
Los Angeles, CA 90010
Phone: (213) 351-7800
Email: ip@ph.lacounty.gov
Symptoms
Whooping cough usually starts with cold-like symptoms. These early symptoms can last for one to two weeks and usually include:
Later, the traditional symptoms of whooping cough appear, which include:
The coughing fits can last for up to 10 weeks or more. For teens and adults, especially those who were vaccinated, the "whoop" is often not there, and the disease is generally less severe.
If you think you may have these symptoms, talk with your provider. If you are a provider whose patients have symptoms compatible with this disease, please click here to report to DPH.
Complications
Whooping cough can cause serious illness, leading to hospital stays and even death. Severe illness is often seen in babies less than 6 months old. Many infants may have only congestion and a runny nose, while others may gasp or gag, be tired, vomit, have seizures, or stop breathing. Unfortunately, some infants can die from whooping cough. If your infant has trouble drinking liquids, catching their breath, is breathing fast, has frequent vomiting after coughing, or seems more lethargic than usual, call your doctor right away or go to the nearest emergency room.
Whooping cough can easily spread through the air. When a person who has whooping cough sneezes or coughs, they can release small particles with the bacteria in them. Other people then breathe in the bacteria.
Some people have mild symptoms and don’t know they have whooping cough, but they can still spread it to others. Many babies who get whooping cough are infected by older siblings, parents, or caregivers who do not know they have it.
There are two vaccines to help protect against whooping cough, and both provide protection against other diseases:
Babies and children younger than 7 years old receive DTaP, while older children and adults receive Tdap. Both vaccines are safe and effective and provide protection against severe illness.
CDC recommends whooping cough vaccination for all babies and children, preteens, and pregnant women. Adults who have never received one should also get a Tdap shot. Talk with your, or your child’s, doctor if you have questions about whooping cough vaccines.
In California, students entering school TK/K-12 require 5 doses of DTaP. Four doses are acceptable if one was given on or after 4th birthday. 3 doses accepted if one was given on or after 7th birthday. See Shots for School for more details.
For 7th–12th graders, at least 1 dose of pertussis-containing vaccine is required on or after 7th birthday. See Shots for School for more details.
There are many places to get the whooping cough vaccine. If you have insurance, talk to your doctor or check with your local pharmacy to see what vaccines are offered. Most health insurances cover the cost of all recommended vaccines for children and adults.
If you are uninsured or underinsured, there are programs available to help cover the cost of vaccines. Children who are 18 years of age or younger are eligible to receive vaccines at no cost through the Vaccines for Children (VFC) Program if they are:
Click to see if your child is eligible to receive VFC vaccines: English | Spanish
Uninsured or underinsured adults can access free or low cost vaccines at select clinics enrolled in the Vaccines for Adults (VFA) program. For more information on who is eligible, read VFA Eligibility Based on Insurance Status. You can use the following resources for more information on locating clinics:
You can also dial 2-1-1 for a list of free or low cost vaccine clinics. This includes Vaccines for Children (VFC) provider locations that serve Medi-Cal eligible children and uninsured or underinsured adults. Learn more about specific vaccine information for different age groups:
Are you not sure if you have been vaccinated against whooping cough or you can’t find your vaccine records?
If you need official copies of your vaccine records, or if you need to update your personal records:
This toolkit is a series of documents designed to help schools and daycares/preschools handle cases of pertussis cases at their facilities. Click the toolkit button below to expand the contents.
Parents Guide
Toolkit Contents
Checklists
Factsheets
Tools/Resources
Appendices
To provide feedback on the Pertussis Toolkit, click here to open a fillable PDF. Please email the completed feedback form to the school support team at SchoolSupport@ph.lacounty.gov
General Pertussis Information and Resources:
Resources for Schools:
Resources for Parents:
Pregnancy and Pertussis Information and Resources:
Bordetella pertussis is a gram-negative bacteria that causes a highly contagious respiratory disease (whooping cough) that affects people of all ages, and can be very serious, even deadly, for infants fewer than 12 months old. Clinical presentation may vary by age and immunization status.
Consider and evaluate patients for B. pertussis, if:
Please contact the County of Los Angeles Department of Public Health Vaccine-Preventable Disease Control Program to report a case or obtain technical assistance with specimen collection or completion of forms for the reporting of pertussis cases.
Report suspected or confirmed pertussis cases within 1 business day by electronic transmission (email or digital fax), telephone, or mail (IAW Title 17, California Code of Regulations (CCR), Section 2500
Documents to include:
Digital Fax: 213-351-2782
Email: vpdc@ph.lacounty.gov
Weekday Telephone (7:30 AM to 5:00 PM): 213-351-7800
Non-Business Hours/Weekend Telephone: 213-974-1234
Mail: Vaccine-Preventable Disease Control Program, ATTN: Surveillance Team, 3530 Wilshire Blvd, Suite 700, Los Angeles, CA 90010
A diagnosis of B. pertussis can be challenging based on clinical presentation alone. Multiple diagnostic laboratory tests are available to support as confirmatory evidence.
Culturing B. pertussis from a respiratory specimen is the gold standard, as it is the only 100% specific method available. However, this can be time intensive and is not widely available. Most commonly, providers obtain respiratory specimens for B. pertussis PCR, which is both highly sensitive and will give results quickly, allowing for prompt isolation and treatment of infected patients.
Culture
Optimal timing of pertussis specimen for culture is within the first 2 weeks following cough onset.
Collect a nasopharyngeal (NP) swab and place immediately into transport medium for delivery to laboratory services.
Culture testing can take up to 7 days to provide results.
PCR
Obtain a nasopharyngeal (NP) swab or aspirate within the first 3-4 weeks after cough onset for Bordetella pertussis PCR testing.
A positive PCR result for B. pertussis supports confirmed case classification when paired with clinical criteria.
Patients who are asymptomatic or who have completed 5 days of antibiotics, should not be PCR tested regardless of their exposure status.
Timely vaccination with a pertussis-containing vaccine, such as DTaP and Tdap, is the most effective way to prevent B. pertussis. Studies show fully vaccinated individuals with pertussis like symptoms should receive evaluation and testing, especially if they have been exposed.
Review the CDC’s Catch-up Guidance for infants and children whose vaccine series may be delayed.
| Pertussis – containing Vaccines and Brands | Number of Doses | Age | Dose/Route |
|---|---|---|---|
| Daptacel (DTaP) Sanofi Pasteur |
5 | 2, 4, 6 & 15-20 months; Booster dose at 4-6 years |
0.5mL Intramuscular (IM) |
| Infanrix (DTaP) Sanofi Pasteur |
5 | 2, 4, 6, & 15 -20 months; Booster dose at 4 – 6 years |
0.5mL Intramuscular (IM) |
| Pediarix (DTaP-HepB-IPV) GlaxoSmithKline |
3 | 2, 4, & 6 months | 0.5mL Intramuscular (IM) |
| Pentacel (DTaP-IPV/Hib) Sanofi Pasteur |
4 | 2, 4, 6, and 15 – 18 months | 0.5mL Intramuscular (IM) |
| VAXELIS (DTaP-IPV-Hib-HepB)β MSP Vaccine Company |
3 | 2, 4, and 6 months | 0.5mL Intramuscular (IM) |
| Kinrix (DTaP-IPV)** GlaxoSmithKline |
1 | 4 - 6 years | 0.5mL Intramuscular (IM) |
| Quadracel (DTaP – IPV)*** Sanofi Pasteur |
1 | 4 - 6 years | 0.5mL Intramuscular (IM) |
| Adacel (Tdap)+ Sanofi Pastuer |
>1 | ≥7 years, Recommended at 11-12 years; Booster dose every 10 years |
0.5mL Intramuscular (IM) |
| Boostrix (TdaP)+ GlaxoSmithKline (GSK) |
>1 | ≥7 years, Recommended at 11-12 years; Booster dose every 10 years |
0.5mL Intramuscular (IM) |
| TENIVAC (Td) Sanofi Pasteur |
>1 | ≥7 years; Booster dose every 10 years |
0.5mL Intramuscular (IM) |
*Tetanus–containing vaccines can be co-administered with other vaccines.
*ACIP prefers that, whenever feasible, the doses of vaccine in a series come from the same manufacturer.
**Kinrix is approved only for dose 5 of DTaP and dose 4 of IPV.
***Quadracel is approved only for dose 5 of DTaP and dose 4 or 5 of IPV.
+Either Tdap vaccine administered to a person age 65 years or older is immunogenic and would provide protection. A dose of either vaccine would be considered valid.
βPreferred for American Indian and Alaska Native infants based on the Haemophilus influenzae type b component.
Additional DTaP/Tdap Vaccine Resources
Early treatment of pertussis is most effective for reducing symptom severity and contagiousness. Treating B. pertussis early with antibiotics may make the infection less serious and help to prevent spreading the bacteria to others.
Recommended antimicrobial agents for treatment and chemoprophylaxis of pertussis are:
Patients should stay home from work or school until the full course of treatment is completed.
Chemoprophylaxis treatment is recommended to contacts at high risk for severe disease (e.g. infants, persons in 3rd trimester of pregnancy, persons with chronic lung disease), household members of patient, and to persons who will have close contact with those at high risk of developing severe pertussis (eg healthcare workers, infant daycare workers). Refer to the CDC Pertussis (Whooping Cough) Treatment Guidelines for detailed guidance regarding elevated pertussis risk factors.
Centers For Disease Control and Prevention (CDC) Pertussis Trainings:
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