1. Pertussis is continuing to increase in NSW particularly amongst school-aged children.
2. Ensure infants are vaccinated on time, and all pregnant women are vaccinated between 20 and 32
weeks. Recommend vaccination to parents and carers of babies, grandparents and other people in
close contact with babies and young children.
3. PCR test suspected cases and notify your public health unit about high risk contacts for follow up
Situation
• Pertussis continues to increase and is at the
highest rate in 15 years.
• Over 60% of cases in 2024 have been in
school aged children, 5 to 16 years.
• Increased circulation increases the risk to
infants.
Prevention: vaccinate to protect infants
• Ensure infants are vaccinated on time.
• Ensure all pregnant women are vaccinated
between 20 and 32 weeks in every pregnancy.
• Pregnant women are more likely to get
vaccinated if advised by their doctor.
• Recommend vaccination to parents and
carers of babies, grandparents and other people in close contact with babies and young children.
Testing and treatment
• Consider pertussis in anyone presenting with persistent cough. Early treatment with antibiotics stops
transmission and may reduce the duration of symptoms.
• Testing: a nasopharyngeal swab for PCR testing. Serology testing is not recommended.
• In patients of any age, antibiotic treatment is recommended if the diagnosis of pertussis is made within 3
weeks of cough or other symptom onset. Three weeks after symptoms begin, patients are rarely infectious and
antibiotic therapy is not indicated.
• Check if your patient has had any contact with women in the last month of pregnancy, infants, or attended
childcare while infectious – if so, notify your local public health unit on 1300 066 055.
• Cases should stay at home and not attend school, childcare or any place with infants or pregnant women until
they have completed at least 5 days of antibiotics, or it is 21 days after the onset of their cough.
• In the context of supply disruptions, contact your local community pharmacy to determine antibiotic availability.
International alternatives of azithromycin powder for oral suspension may be available from Medsurge
Healthcare and Pfizer.
Treatment and prevention of pertussis
Medication Available
formulations Adult patients Paediatric patients
1st line Azithromycin Tablet* and oral
suspension
500 mg orally on Day
1, then 250 mg orally
daily
for a further 4 days.
< 6 months: 10 mg/kg orally daily for 5 days.
≥ 6 months: 10 mg/kg up to 500 mg orally on
Day 1 then 5 mg/kg up to 250 mg daily for a
further 4 days.
1st line Clarithromycin Tablet and
oral
suspension
500 mg orally 12-
hourly for 7 days.
1 month – 18 years: 7.5 mg/kg up to 500 mg
orally 12 hourly for 7 days.
2nd line Trimethoprim
plus
sulfamethoxazole
Tablet and
oral liquid
160+800 mg
orally 12-hourly
for 7 days.
> 1 month: 4+20 mg/kg (up to 160+800 mg)
orally 12-hourly for 7 days.
*Azithromycin can be crushed and mixed with liquid to aid administration in patients who cannot swallow tablets (for doses
equivalent to a half or full tablet). Refer to Antibiotic prescribing in primary care: Therapeutic Guidelines summary table for
instructions on crushing and liquids to mix with.
For further information
• See your local HealthPathways or Whooping cough: Information for health professionals
• Previous NSW Health antibiotic oral liquid shortage update- June 2024
Dr Jeremy McAnulty,
Executive Director, Health Protection NSW