I can recall when I was pregnant with our third child, my husband had whooping cough. Oh my…. what a doozy that was for him. He took antibiotics appropriately and STILL whooped for 6 months (while the cilia in his lungs was regrowing).

Consider getting a Tdap booster. (The T is tetanus, and the P is pertussis/whooping cough.) This is suggested once as an adult, for pregnant women in the third trimester of every pregnancy, or for those who have exposure to infants (like new grandparents) . You can also opt to get a Tdap every 10 years instead of a tetanus booster every 10 years.

Consistent with CDC guidance, most asymptomatic patients without prolonged close contact to a known pertussis case should NOT be tested or treated with antibiotics (e.g., azithromycin).

Asymptomatic Patients (in the setting of increased incidence and widespread community transmission)

• Pertussis lab testing is not recommended
• Antibiotic treatment or prophylaxis is indicated only in select situations, including:
  • Household or prolonged close contact with a confirmed case
  • High-risk individuals or those caring for them

Post-exposure prophylaxis is recommended for:

• All household contacts of a person with confirmed pertussis, regardless of vaccination history
  • High-risk persons:
    • Infants (particularly those ≤12 months)
    • Hospitalized neonates and newborn infants
    • Women in the third trimester of pregnancy
    • Immunocompromised individuals
    • Patients with chronic respiratory conditions or other chronic health conditions that may increase pertussis-related morbidity
  • Persons who have or anticipate having close contact with high-risk individuals, particularly:
    • Those in contact with infants aged ≤12 months
    • Healthcare personnel in contact with hospitalized neonates, newborn infants, or patients with chronic respiratory conditions
  • Other healthcare personnel and close contacts can either receive postexposure prophylaxis or be carefully monitored for 21 days after exposure

Symptomatic Patients

• Suspect pertussis in patients with a persistent, paroxysmal cough, often with a characteristic “whoop”
• Patients with symptoms consistent with pertussis, and their close contacts, may be treated empirically with azithromycin without testing
• Symptomatic patients should:
  • Isolate for 5 days after starting antibiotics
  • May return to school or work after 5 days (cough may persist for weeks)
• Cough suppressants have limited effectiveness
• Healthcare precautions for suspected and confirmed cases is droplet + standard precautions for the same duration.
• Provide a regular ear-loop mask for the patient to wear

Additional Notes

• Prior Tdap vaccination reduces disease severity but does not eliminate transmission or prophylaxis considerations
• Antibiotics are not recommended after 21 days of cough, except for infants and pregnant patients in the 3rd trimester (up to 6 weeks)

I hope this helps.