Persistent cough? Pertussis may be lurking behind you

Introduction
The main problem with Pertussis is that an adult can transmit the illness to infants and babies under the age of one year. The mortality rate in babies from pertussis is approximately 2%. The Israeli health authorities suggested to inoculate all HCW in Israel with DTaP, with the cost to be paid by the employer. Insofar as the price of the vaccinations is quite high most health care institutes did not follow this instruction.

Methods
During April 2010 until April 2011, 50 hospital employees were diagnosed with pertussis in our medical center. All were diagnosed according to antibodies for pertussis. Only three employees agreed to undergo nasopharynx smear exam

Results
Due to the known limitations of the serologic exam, 750 employees received prophylaxis against Pertussis. 180 women admitted for childbirth received prophylactic treatment against pertussis, in addition to 292 infants and 110 premature newborns and their parents, as well as 439 imunosupressed hemato-oncological patients.

Discussion
There are most likely many adults in the community infected with pertussis who are not diagnosed as such, insofar as family physicians do not always put pertussis in the differential diagnosis for persistent cough. That is the reason that pertussis is not only an occupational disease, but it does in any case have an even greater significance when health care personnel who treat children and immunosuppressed patients become ill. Conclusion: DTaP vaccinations should be given to HCW, but this is insufficient, as we do not actually know how to evaluate the immunization level for pertussis. It is therefore of great importance to increase the use of pertussis immunization in the general population by giving DTaP to all adults who require tetanus vaccination, and thereby, to decrease the need for widespread prophylaxis treatment, and to reduce the threat of severe illness to infants and immunosuppressed patients.