Paeds

Question 1

pertussis

Answer 1

Persistent cough >2 weeks with one or more of:

• paroxysms of coughing
• inspiratory whoop
• post-tussive vomiting.

Dx: NAAT (eg PCR) on a nasopharyngeal swab for Bordatella Pertussis
Reportable disease!
Source: eTG

Question 2

Pertussis Mx

Answer 2

• Abx eliminate B. pertussis but unclear if they alter the course of the disease
• Mx of established disease minimises transmission (however pts are rarely infectious if cough >3w)

Pts should avoid contact with others until 5 days of abx. Use:

• azithromycin 500 mg stat followed by 4days of 250mg (children >6/12: 10mg/kg then 5mg/kg, <6/12: azithro 10mg/kg for 5/7) OR
• trimethoprim+sulfamethoxazole 160+800 mg BD 7days
• clarithromycin 500 mg BD for 7 days

Question 3

Pertussis Prophylaxis: contacts

Answer 3

Incl house hold & face to face >1hr
Recommended in :
-infants <6/12
-<2yr unvaccinated
-women in last month preg
-people who may transmit to any of these high risk groups (ie health care workers)

Mx: same as treatment for Acute infection
-ASAP after contact, no benefit >3weeks