COW Flashcards
Why has the # of cases of pertussis increased since the 1980s?
PCR detection
anti-vacc movement
increased surveillance
waning immunity
What is the pathogenesis of pertussis?
attaches to resp cilia & paralyzes them w/ toxin
can’t clear resp secretions & get inflammation
Who is at the greatest risk for whooping cough?
infants
What can pertussis be confused with?
asthma exacerbations
more common at night
cough so hard you can vomit
Diagnosis of pertussis?
Nasopharyngeal swab or aspirate for PCR w/i first 3 wks
Culture w/i 2 wks
Later stages–>2-8 wks after onset use serology
WHen should you treat pertussis?
w/i 1-3 wks
if less than 1 yo or pregnant can still treat w/i 6 wks
Treat w/ Azithromycin or macrolide
alternative: bactrim (if long QT, allergy, bradycardia)
Which treatment should you use for
azithromycin b/c erythromycin can increase risk of pyloric stenosis
HOw long are you contagious after taking antibiotics?
5 days
When should kiddos be vaccinated for pertussis?
DTAP for kid (more diphtheria)
2 mo, 4mo, 6 mo, 15-18 mo, 11-12 yr
TDAP for adult (more tetanus)
Post-exposure prophylaxis for pertussis?
do this w/ household contacts w/i 21 days
OR if you are near an immunocompromised person & there has been some sort of exposure
mod-severe asthma
Symptoms of pertussis in infants?
sometimes only apneic episodes
**NOTE: adult may not show whooping too.
