Pertussis Flashcards
Define pertussis
Infectious disease caused by the Gram-negative bacterium Bordetella pertussis
Pertussis causative organism
Bordella pertussis
Clinical features of pertussis
2-3 days of coryza preceding onset of:
Coughing bouts (usually worse at night and after feeding)
Inspiratory whoop (not always present)
Infants may have spells ofapnoea
Subconjunctival haemorrhages or even anoxia caused by persistent coughing
Symptoms may last 10-14 weeks
Marked lymphocytosis
Diagnostic criteria for pertussis
Acute cough that has lasted for 14 days or more without another apparent cause, and one or more of the following features:
Paroxysmal cough
Inspiratory whoop
Post-tussive vomiting
Undiagnosed apnoeic attacks in young infants
Investigations in pertussis
Nasal swab culture forBordetella pertussis- may take several days or weeks to come back
PCR and serology now increasingly used
Management of pertussis
Infants under 6 months with suspect pertussis should be admitted
Notifiabledisease
Mainly supportive care
An oralmacrolide(e.g. clarithromycin, azithromycin or erythromycin) is indicated if the onset of the cough is within the previous21 daysto eradicate the organism and reduce the spread
Household contacts should be offered antibiotic prophylaxis
School exclusion
Complications of pertussis
Subconjunctival haemorrhage
Pneumonia
Bronchiectasis
Seizures
Immunisation against pertussis
Infants routinely immunised at 2, 3, 4 months and 3-5 years
Pregnant women between 16-32 weeks offered vaccine
Does pertussis immunisation provide lifelong protection?
No
