Subject:	Montgomery County Pertussis Outbreak Continues
Treat Household and High-Risk Contacts with Antibiotics to Decrease Transmission

ID #24-01	Date/Time Sent: 01/19/2024 (3:00 PM)
Urgency Level: * Health Alert  oHealth Advisory  oHealth Update

Sent To: MMRS, and GMVEMSC (already sent to GDAHA (Hospitals), Family Practice, Pediatrics, Urgent Cares & OBGYN) 
From:  Public Health – Dayton & Montgomery County

Montgomery County continues to experience a pertussis outbreak. There have been 171 total cases of pertussis reported since the outbreak began September 2, 2023. Most pertussis infections are occurring in children, with about 1/3 of cases diagnosed in 4–6-year-olds. A majority of children affected have attended school or daycare, although the outbreak is not concentrated in one school district or area of the county.

In addition to Montgomery County, there are smaller numbers of cases in other GMVEMSC counties including Butler, Clark, Greene, and Warren Counties.  CDC’s preliminary Ohio case count of pertussis for 2023 was 810 cases, compared with 149 in 2022.  Ohio has more cases to date in 2024 than any other state.

Many respiratory infections are circulating in our region. With the ongoing pertussis outbreak, it is important to consider pertussis in the differential diagnosis of individuals with respiratory symptoms. Vaccination is the best protection against pertussis. It is important that individuals of all ages are up to date with pertussis vaccinations. Immunity, whether from vaccination or infection, wears off over time. Most of those who have been infected have been vaccinated in the past.

To stop the spread of pertussis in our community, it is important to test individuals with symptoms of pertussis and treat those who test positive. Contacts of people who have tested positive should also be prescribed antibiotics if they live in the same household or have a high-risk condition, even if these individuals do not have symptoms themselves. These post-exposure antibiotics are important to stop ongoing transmission and reduce severe disease.
Actions Required:
1.	Evaluate patients for symptoms of respiratory viral illnesses whether influenza, pertussis, RSV, Covid, or other diseases.  
2.	Take respiratory viral illnesses seriously.
3.	Take appropriate steps to protect yourself and others including having all crewmembers wear respiratory protection (preferably N-95 or higher) and putting a mask on the patient.  
4.	Advise receiving ED personnel that your patient has those symptoms. 
5.	if crews believe an exposure has occurred due to PPE failure or lack of PPE use, follow reporting procedures according to GMVEMSC protocol and your agency’s procedures.

Additional clinical and laboratory guidance is available on the CDC website:
https://www.cdc.gov/pertussis/index.html 
For More Information: Please contact Communicable Disease at (937)225-4508 for additional information or if you have questions. 
*Categories of urgency levels:
Health Alert: conveys the highest level of importance; warrants immediate action or attention. Health Advisory: provides important information for a specific incident or situation; may not require immediate action.
Health Update: provides updated information regarding an incident or situation; unlikely to require immediate action.