Pertussis

Question 1

What is pertussis (whooping cough)?

Answer 1

It is a highly contagious respiratory infection caused by bordetella pertussis.

It is endemic and there is an epidemic every 3/4 years

Question 2

How does the whooping cough present?

Answer 2

Catarrhal phase
It initially presents with coryzal symptoms: malaise, rhino sinusitis, mild fever and a cough. This lasts 1-2 weeks.

Paroxysmal phase
Paroxysmal cough with a characteristic whoop in infant children. Older children and adults do not whoop and young infants may have apnoeas.

This cough may last for several months.

Question 3

Describe the characteristic cough?

Answer 3

The child will cough, cough, cough without drawing breath until the lungs are virtually emptied.

A small child learns to follow this by breathing in through partially closed vocal cords and this causes the characteristic whoop.

Question 4

What are the 2 most common complications?

Answer 4

Pneumonia and apnoeas.

Question 5

How should you manage whooping cough?

Answer 5

Younger than 6 months in age = admit higher mortality and complication rates.

Treat with clarithromycin only reduces symptoms if started in catarrhal phase but reduces infectivity.

Prophylactic abx for close contacts and immunisation if not already.

Note: immunisation is not completely effective. However if they develop the disease it will be less severe