Pertussis Flashcards
what causes pertussis
Bordetella pertussis. The bacteria attach to the cilia in the respiratory tract, releasing toxins that cause inflammation, swelling, and damage.
what are the hallmark symptoms?
Paroxysmal, violent coughing fits (paroxysms) that may cause vomiting
“Whooping” sound during inspiration after coughing fits (often absent in vaccinated individuals and adults)
when are they contagious?
From symptom onset until 3 weeks after coughing begins OR
Until 5 days after starting antibiotics
what does the first stage of pertussis consist of?
Mild upper respiratory symptoms (URI)
Runny nose, watery eyes, malaise
Mild, nonproductive cough
Low-grade or no fever
Symptoms resemble a common cold, making early diagnosis difficult
what does the second stage consist of?
Severe, uncontrollable coughing fits (paroxysms)
Characteristic “whooping” sound on inspiration
Post-cough vomiting & exhaustion
May cause rib fractures, hernias, or subconjunctival hemorrhage due to forceful coughing
what does the third stage consist of?
Coughing gradually decreases
Patient remains fatigued and weak
how is pertussis diagnosed?
Difficult to diagnose early because symptoms resemble a mild upper respiratory infection
Confirmed by
Nasopharyngeal swab culture (gold standard)
PCR testing (rapid detection)
Serology (antibody testing)
what is the first-line treatment of pertusiss?
Macrolide antibiotics (erythromycin, azithromycin, clarithromycin)
what is given as alternative med?
Trimethoprim/sulfamethoxazole (Bactrim) if macrolides are contraindicated
which treatments are ineffective?
Cough suppressants – may worsen coughing
Antihistamines – no benefit
Corticosteroids – not effective
Bronchodilators – no proven role
what is the supportive care for pertussis?
Hydration & nutrition support
Small, frequent meals (to prevent vomiting from coughing fits)
Monitor for respiratory distress (cyanosis, apnea, exhaustion)
how is pertussis prevented?
Vaccination (Tdap/DTaP)
All adolescents (≥11 years) and adults who have not received a Tdap dose should get vaccinated.
Pregnant women should receive Tdap during every pregnancy (27-36 weeks) to pass passive immunity to the newborn.
what should close contacts do?
All close contacts should take prophylactic antibiotics, even if asymptomatic.
what are the precautions of pertussis pt?
Droplet precautions (mask, hand hygiene)
Isolation during contagious period
Avoid close contact with infants and immunocompromised individuals
when should you seek medical attention?
Cyanosis (turning blue) or difficulty breathing
Apnea (pauses in breathing, especially in infants)
Severe exhaustion from coughing fits
Dehydration (decreased urination, dry mouth, lethargy)
