Prevention of secondary transmission of pertussis in households with early use of erythromycin
M. A. Sprauer, S. L. Cochi, E. R. Zell, R. W. Sutter, J. R. Mullen, S. J. Englender and P. A. Patriarca
Division of Immunization, National Center for Disease Control, Atlanta, GA 30333.
To examine the effectiveness of erythromycin therapy and prophylaxis for
pertussis, 17 households with one secondary case or more were compared with
20 households without secondary cases following a community-wide pertussis
outbreak in Maricopa County, Arizona, in 1988. There were no significant
differences between the two household groups in age distribution of
members, size, crowding, race, proportion of children aged 7 months to 18
years with three or more diphtheria and tetanus toxoids and pertussis
vaccine doses, or in the age distribution, vaccination status, or medical
care of patients with primary cases. However, median intervals from onset
of illness in primary cases to initiation of erythromycin therapy (for
cases) and prophylaxis (for contacts) were 11 and 16 days, respectively, in
households without secondary spread, vs 21 and 22 days, respectively, in
households with secondary spread. These results provide additional evidence
that erythromycin is effective in the medical management of pertussis and
should be initiated promptly to minimize secondary spread.
