Whooping cough

Question 1

What is the cause of whooping cough?

Answer 1

Bordetella pertussis

Gram negative bacterium

Question 2

What is the incubation period of Bordetella?

Answer 2

10-14 days

Question 3

At what ages are infants routinely immunized?

Answer 3

2,3,4 months

And 3-5 years

Question 4

Who else receives the whooping cough vaccine?

Answer 4

Pregnant women.

Question 5

When should pregnant women receive the vaccination?

Answer 5

Between 28-38 weeks.

Question 6

What are the features of whooping cough?

Answer 6

• 2-3 days of coryza followed by:
  
  • Coughing bouts - worse at night and after feeding.
  • Inspiratory whoop may not be present.
  • Persistant coughing
• There is an associated lymphocytosis.

Question 7

What causes the whooping sound?

Answer 7

Forced inspiration against a closed glottis)

Question 8

How long do symptoms last for?

Answer 8

10-14 weeks

Question 9

How is whooping cough diagnosed?

Answer 9

Nasal swab cultures (May take days or weeks to come back)

(NOTE: Bronchiolitis is NPA)

PCR and serology are now becoming more popular.

Question 10

How is whooping cough treated?

Answer 10

Erythromycin

Question 11

What are the 2 important things to tell parents?

Answer 11

1/ Erythromycin will not shorten the length of illness just help to stop it spreading

2/ School exclusion criteria - 5 days after commencing antibiotics

Question 12

At what ages is the acellular vaccination given?

Answer 12

2months

3months

3-4 years old

Question 13

How long does immunity last for once the booster is given at 3-4 years of life?

Answer 13

It is thought to last for 9 years.

(If the booster isn’t received - pre-1996, as booster was given then, and immunity only lasts 5-6 years)

Question 14

A 27 year old woman presents with a 2 week history of pertussis. She lives with her husband and 2 children aged 18 months and 7 years. The chidlren have received all immunisations for their age.

While awaiting confirmation, who should be offered antibiotics?

Answer 14

The whole family

Whe a suspected or confirmed case of pertussis presents less than 21 days from onset and a vulnerable contact is present in the household, ALL household contacts regardless of age or immunisation status should be offered prophylactic antbiotics to reduce transmission.

Question 15

Who are defined as vulnerable contacts?

Answer 15

• Newborn infants born to symptomatic mothers
• Infants under 1-year-old who have received less than three doses of DTaP/IPV/Hib
• Unimmunised or partially immunised infants or children up to 10 years
• Women in the last month of pregnancy
• Adults who work in a healthcare, social care or childcare facility
• Immunocompromised individuals
• Those with the presence of other chronic illnesses