Whooping cough

Question 1

What is whooping cough

Answer 1

Upper respiratory tract infection caused by gram -negative coccobacillus

= bordetella pertussis

Question 2

When are children vaccinated for whooping cough?

Answer 2

Infants are immunised at 2, 3, 4 months and at 3-5 years

Pregnant women are also immunised

Question 3

What are the 3 phases of whooping cough?

Answer 3

if you catch at cararrhal phase can change course of illness

Question 4

Signs and symptoms of whooping cough?

Answer 4

Catarrhal 1-2 weeks : viral URTI symptoms

Paroxysal 2-8 weeks : increasing cough in severity, post-tussive comiting. Worse at night anf after feeding.

Loud inspiratory woop when coughing ends

Mum or contact will also have long standing cough

Question 5

What are the issues with persistent coughing in a small infant?

Answer 5

Subconjunctival haemorrhage or anoxia = syncope and seizures

Question 6

Investigations?

Answer 6

< 2 weeks :
Nasalpharyngeal swab with PCR testing / bacterial culture

> 2 weeks:
anti-pertussis toxin IgG

Question 7

Management plan for whooping cough?

Answer 7

Notifiable disease to HPU

Admission if <6 months, significant breathing issue, complications

Medical:
<1 month old = clarithromycin
>1 month old = azithromycin
pregnant mum = erythromycin

Avoid school until 48 hrs after abx treatment has ended