Follow-up Recommendations for Pertussis Exposures in the Health Care Setting

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Health care workers exposed to a patient infected with pertussis
For health care workers (HCW) caring for a patient with pertussis, identify the type of exposure:

Type of HCW exposure (patient's cough was less than 21 days at time of exposure) Recommended follow-up
Face-to-face contact with coughing or sneezing patient while HCW not masked*, or

Performing or assisting with procedures that induce coughing or produce aerosols while HCW not masked*, or

Presence in same room with coughing or sneezing patient while HCW not masked* and performing a close-contact activity (e.g., bathing, feeding)

Antibiotic prophylaxis or 21-day symptom watch from time of exposure

  • Decision whether to prophylax or initiate symptom watch should take in to consideration the patient population seen by the HCW. Example: Antibiotics would likely be preferred over symptom watch for a HCW who staffs a neonatal intensive care unit.
Presence in same room with coughing or sneezing patient while HCW not masked* and without close contact Recommend 21-day symptom watch from time of exposure

 

Patients/staff exposed to a health care worker infected with pertussis
For patients or staff in close contact with an infected HCW, identify the type of exposure:

Type of patient exposure (HCW's cough was less than 21 days at time of exposure) Recommended follow-up
If a HCW has pertussis, please contact the Minnesota Department of Health (MDH) for guidance.
HCW was masked* while infectious and working with patients No notification of patients is needed
HCW was not masked* while infectious and had contact with patients less than 12 months of age or pregnant women Call MDH and notify of exposure. MDH will work with you to recommend post-exposure prophylaxis letters** and/or phone calls
HCW was not masked* while infectious and had contact with patients who had a pre-existing lung condition that would make them susceptible to a more severe case of pertussis Mail notification letter** and recommend post-exposure prophylaxis
HCW was not masked* while infectious and patient was not less than 12 months old, pregnant, or otherwise compromised with a lung condition Mail notification letter** recommending testing if symptoms develop
Staff who worked with an infected HCW and had prolonged, close proximity, and unprotected contact

Recommend antibiotic prophylaxis or 21-day symptom watch from time of exposure

  • Decision whether to prophylax or initiate symptom watch should take in to consideration the patient population seen by the exposed HCW. Example: For exposed HCW that normally sees patients who are pregnant or less than 12 months of age, antibiotics may be preferred over a 21-day symptom watch.

* Surgical or procedure mask is sufficient.
** Letter templates are available through MDH.

  • Repeat exposures
    For questions on whether or not to repeat prophylaxis, please call
    651-201-5414 or 1-877-676-5414.

References

Updated Friday, 07-Jun-2013 11:40:38 CDT