On February 14, 2017, the Taiwan Centers for Disease Control (Taiwan CDC) announced this year’s first pertussis cluster consisting 2 confirmed patients. As of now, both patients have recovered and none of the contacts have developed suspected symptoms. The contacts will be monitored and followed up until March 12, 2017. As the first symptoms of pertussis are similar to those of a common cold, patients often delay seeking medical attention and pass the infection to their contacts, leading to clusters of cases. Therefore, the public is urged to heighten vigilance for pertussis and seek medical attention in a timely manner to protect their own health and the health of their family.

The index case is a 2-month-old baby boy who resides in central Taiwan. The patient was one month old when he developed symptoms. During January 14 and 21, he subsequently developed symptoms, including cough and vomiting, and sought medical attention at a clinic twice. On January 22, when his symptoms persisted and he developed cyanosis, he was transferred to a hospital and hospitalized in an isolation ward. After the hospital collected specimens from the case for laboratory testing and reported the case to the health authority as a suspected case on January 23, the result came back positive for pertussis on January 26 and the diagnosis was confirmed in the case on February 6. The local health authority collected specimens from 4 contacts who reside in the same household with the case and provided them with postexposure prophylaxis on January 24. 3 of the contacts tested negative for pertussis, except the mother of the index case who was diagnosed with pertussis on February 7. Further investigation found that the mother had not left the house after giving birth to the index case and developed cough on January 2, but had not sought medical attention. Prior to her disease onset, four friends had visited her and none of them had developed suspected symptoms. Hence, it is determined that the mother could have contracted the disease from the index case. Nonetheless, the actual source of her infection is still underway.

According to Taiwan CDC’s statistics, the total number of pertussis cases confirmed during 2012 and 2016 is 270 and the majority of the cases are unvaccinated infants aged below 2 months (105 cases, 38.9%), followed by adults aged over 21 (48 cases, 17.8%). During the recent 5 years, a total of 51 clusters (124 cases) have been confirmed and 44 of the clusters are family clusters (101 cases).

Pertussis is an acute respiratory infectious disease that is highly contagious and primarily transmitted through airborne droplets. The symptoms include cough that lasts at least two weeks, followed by cold-like symptoms such as rhinitis, sneezing, and slight fever. Patients often overlook the severity of the disease and do not seek medical attention. As a result, they often pass the infection to infants and children with a compromised immune system. The disease is more serious for infants and children, and babies under the age of one is a high risk group. Taiwan CDC once again reminds the public that vaccination is the most effective way to prevent pertussis. In Taiwan, the existing routine childhood vaccination schedule recommends one dose of pertussis vaccine to children 2, 4, 6, 27 months and 5 years of age and first graders in elementary schools. Parents are urged to ensure their children are vaccinated in a timely manner in order to protect their children from the threat of the disease.

Taiwan CDC urges both adults and older children to pay attention to cough etiquette and respiratory hygiene, especially when returning home from the outside. Prior to contacting infants and children, one should wash his/her hands and change clothes to prevent passing on germs to the infants and children. Avoid visiting crowded and poorly ventilated public places and hospitals with infants and children to lower the risk of infection. If symptoms develop, please seek immediate medical attention, put on a mask, follow the doctor’s instructions in completing the treatment, and cooperate with the health authorities in implementing relevant infection control measures to prevent further transmission of the disease. For more information, please visit the Taiwan CDC website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline, 1922 (or 0800-001922).