Whooping Cough (Pertussis) Flashcards
what is the causative agent in whooping cough?
bordetella pertussis
gram -ve
when are people immunised against bordetella pertussis?
- 2, 3 and 4 months
- 3-5 years
neither infection nor immunisation results in lifelong protection
what are the phases of pertussis?
- catarrhal phase
- paroxysmal phase
- convalescent phase
describe the catarrhal phase
- symptoms similar to viral URTI
- lasts 1-2 weeks
describe the paroxysmal phase
- cough increases in severity
- coughing worse at night and after feeding
- inspiratory whoop
- spells of apnoea
- subconjunctival haemorrhages
- lasts 2-8 weeks
what causes inspiration whoop?
caused by forced inspiration against a closed glottis
what causes subconjunctival haemorrhages in whooping cough?
persistent coughing
describe the convalescent phase
cough subsides over weeks to months
what is the diagnostic criteria for whooping cough?
suspect –> acute cough lasting >14 days
* paroxysmal cough
* inspiratory whoop
* post-tussive vomiting
* undiagnosed apnoeic attacks in young infants
what is the investigations are done in suspected whooping cough?
- per nasal swab culture
- PCR
- serology
is pertussis a notifiable disease?
yes
who should be admitted with pertussis?
infants <6 months
management of whooping cough
onset of cough = 21 days
oral macrolide
e.g. clarithromycin, azithromycin or erythromycin
who should be given antibiotics in whooping cough?
- patient
- household contacts
what is the rules for school exclusion for whooping cough?
- 48 hours after commencing antibiotics
- 21 days from onset of symptoms if no antibiotics
