Pertussis (whooping cough)

Question 1

Features

Answer 1

Mainly occurs in infants <2 yrs.

Diagnosis is basically clinical—cough lasting 2–12 wks with three distinct stages of the disease.

Confirmed by PCR tests of nasopharyngeal aspirate or throat swab: IgA serology.

Note: Chlamydia respiratory infection can cause a ‘pseudopertussis’ type of illness.

Question 2

Treatment

Answer 2

Admit to hospital if severe attack and all infants <6 mths

Symptomatic (cough mixtures are ineffective)

• Clarithromycin or
• azithromycin or
• erythromycin for 7 d

esp. in catarrhal stage to reduce period of communicability
* (won’t alter illness)

Question 3

Prevention

Answer 3

Triple antigen (DTP) 2 mths, 4 mths, 6 mths, 4 yrs

Question 4

Exclusions

Answer 4

Patient 5 d after starting antibiotics

14 in non-immunised contacts inc. family

• who should have 7 d of prophylactic antibiotics