What You Should Know About... Pertussis in the Child Care Setting Pertussis (whooping cough) is a very contagious and dangerous infection of the respiratory tract caused by the bacterium Bordetella pertussis. Whooping cough gets its name from the whooping sound the child makes when trying to draw breath after a coughing spell. Not all children with whooping cough make this sound; very young children may not be strong enough. Symptoms generally include those of a cold, such as runny nose and a cough that gradually worsens. Violent coughing spells frequently end with vomiting. Once the whooping stage begins, antibiotics are of no use. Pertussis is spread from person to person through the air. A person who is not immune to pertussis becomes infected by inhaling air that has been contaminated with the respiratory secretions of an infected person who has coughed. Before vaccines and antibiotics were developed, pertussis was a common cause of death in young children. Today, it is vaccine preventable. Children in the United States are now immunized with the pertussis vaccine beginning at 2 months of age and again at 4 months, 6 months, 15 months, and 4 to 6 years. All children attending a child care facility should be up to date on vaccinations. If a child or adult in your facility is diagnosed with pertussis: •Immediately notify the local health department. Exclude the infected person from the facility until that person has been on antibiotics for at least 5 days or for 4 weeks after onset of intense coughing. Make sure that all children and staff observe careful handwashing technique. In large facilities, follow appropriate group separation as discussed in the chapter, “Following Protective Practices to Reduce Disease and Injury.” Require up-to-date immunization certificates for all children in your care. Carefully monitor all children and staff for coughs. Anyone developing a persistent cough should be immediately referred to his or her physician.