Caring for Our Children (CFOC)

Chapter 7: Infectious Diseases

7.3 Respiratory Tract Infections

7.3.7 Pertussis

7.3.7.3: Exclusion for Pertussis


Children and staff members with characteristic symptoms of pertussis (whooping cough) should be excluded from child care pending evaluation by a primary care provider. A symptomatic child or staff member with pertussis or suspected pertussis may not return to the facility until:

  1. Five days after initiation of a course of any of the following antibiotics: azithromycin (full course of treatment is five days), erythromycin (full course of treatment is fourteen days), or clarithromycin (full course of treatment is seven days) antimicrobial therapy;
  2. The medical condition allows;
  3. The child’s need for care does not compromise the
    caregiver’s/teacher’s ability to provide for the health and safety of the other children in the group.

Untreated adults should be excluded until twenty-one days after onset of cough.

RATIONALE
Even if outbreaks of pertussis in child care facilities have not been reported, children and staff who attend out-of-home child care occasionally contract pertussis. The spread of infection to contacts who are incompletely immunized can be reduced by treating the primary case and susceptible contacts with prophylactic antibiotics (1-4).
COMMENTS
For additional information regarding pertussis, consult the current edition of the Red Book from the American Academy of Pediatrics (AAP).
TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS
3.6.1.1 Inclusion/Exclusion/Dismissal of Children
3.6.1.2 Staff Exclusion for Illness
3.6.1.3 Thermometers for Taking Human Temperatures
3.6.1.4 Infectious Disease Outbreak Control
3.6.2.1 Exclusion and Alternative Care for Children Who Are Ill
REFERENCES
  1. Centers for Disease Control and Prevention. 2006. Preventing tetanus, diphtheria, and pertussis among adolescents: Use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccines. MMWR 55 (RR03). http://www.cdc.gov/mmwr/pdf/rr/rr5503.pdf.
  2. Centers for Disease Control and Prevention. 2006. Preventing tetanus, diphtheria, and pertussis among adults: Use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine. MMWR 55 (RR17). http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5517a1.htm.
  3. Centers for Disease Control and Prevention. 2005. Recommended antimicrobial agents for treatment and postexposure prophylaxis of pertussis: 2005 CDC Guidelines. MMWR 54 (RR14). http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5414a1.htm.
  4. Centers for Disease Control and Prevention. 2010. Vaccines and preventable diseases: Pretussis (whooping cough) vaccination. http://www.cdc.gov/vaccines/vpd-vac/pertussis/.