Strategy for effective collaboration in the control of pertussis outbreaks that involve schools

Outbreaks of pertussis are increasing in size and frequency in the US. Experts believe that this is due in part to differing protective characteristics of pertussis vaccines currently in use as compared to pertussis vaccines used previously. Pertussis outbreak control requires use of antibiotics to prevent or treat infection among persons exposed or ill regardless of immunization history. It also may be necessary to provide vaccines to the exposed groups--often outside of the typical immunization schedule. Primary care providers (PCPs) are crucial in the diagnosis of cases and early identification of an outbreak. Prompt notification of public health authorities allows rapid initiation of outbreak investigation and response activities. Partners in outbreak investigation and response will include school nurses, PCPs, local public health authorities, and parents. Larger outbreaks may also involve state public health authorities, school administrators, county health officers, local elected officials, emergency management officials, other community leaders, and/or various mass media outlets. Strong relationships of local public health nurses with school nurses and PCPs can greatly aid the timeliness and effectiveness of a response. Clear consistent messages are critical to prevent confusion or panic as well as misuse of limited resources. State and local public health communications experts are willing and available to assist school administrators or local leaders with effective messaging. In summation, controlling a pertussis outbreak involving a school is complicated. It requires strong collaborative efforts and excellent communication between school nurses and administrators, PCPs, and public health authorities. When all involved partners understand each others' roles and responsibilities, opportunity for rapid and successful control of the outbreak is maximized.