2.9 Whooping Cough

Question 1

What pathogen causes whooping cough?

Answer 1

Bordetella pertussis (gram negative) 
(notifiable disease)

Question 2

What causes the “whoop”?

Answer 2

Severe coughing fits means unable to take air in during coughs, when they do it is a forceful sucking in of air.

Question 3

Who is vaccinated against pertussis?

Answer 3

children and pregnant women (less effects after several years)

Question 4

Presentation / history of pertussis?

Answer 4

Starts with mild coryzal sx, low grade fever, mild cough.

After a weeks more severe coughing fits / ie paroxysmal cough.

Large inspiratory whoop when cough ends, some may have apnoeas rather than cough.

Question 5

Diagnosis of pertussis?

Answer 5

nasal swab with PCR or culture
or
anti-pertussis toxin IgG if cough has been present >2 weeks (from saliva or blood if >17 yrs)

Question 6

Who do you speak to about whooping cough?

Answer 6

Pertussis is a notifiable disease - notify public helath

Question 7

Management of whooping cough?

Answer 7

• notify public health
• supportive care
• prevent spread
• macrolide abx (azithromycin, erythromycin, clarithromycin) or co-trimoxazole
• prophylactic abx for vulnerable contacts

Question 8

When does whooping cough resolve?

Answer 8

typically in 8 weeks but can last months aka “100-day cough”

Can complicate as bronchiectasis