Pertussis Flashcards
Can vaccination �give you immunity against Pertussis?
No, Vaccine protects you only lasts 3-5 years.
Which agents cause Pertussis?
Bordetella Pertussis & Bordetella Parapertussis
Who is the most common source of spreading Pertussis?
Family members bc it is DROPLET precaution
The incubation period for Pertusssis?
1 - 3 weeks or longer
Who many Phases does Pertussis presents with?
Pertussis infection in individuals without immunity is characterized by three phases:
- The catarrhal phase
- The paroxysmal phase
- The convalescent phase
3 stages of Pertussis disease progression in detail:
Stage 1: Catarrhal phase indistinguishable from URI (nasal congestion, rhinorrhea, sneezing, low-grade fever, tearing)
Most infectious , communicable 3+ weeks after cough onset
Stage 2: Paroxysmal phase - paroxysms of intense coughing (lasting up to several minutes)
Older infants and toddlers, paroxysms w/ or w/o whoop
Infants < 6 mo do not have the characteristic whoop, more often apnea, at risk for exhaustion
Posttussive vomiting all to common
Stage 3: Convalescent stage - chronic cough lasting weeks to months
What is unique to adolescents or adults with history of prior pertussis infection or vaccine-induced immunity?
- Classic manifestations often do not occur.
- The only symptom may be prolonged cough.
The definition of pertussis?
Cough illness lasting two weeks without clear cause and one of the following symptoms:
- Paroxysms of coughing,
- Inspiratory whoop, or
- Posttussive emesis
How is Pertussis diagnosed in the setting of an outbreak known close contact to a confirmed case of pertussis?
The presence of a cough lasting ≥2 weeks is sufficient for clinical diagnosis
What is the choice of diagnostic test for Pertussis?
Depends upon the duration of cough.
(culture, polymerase chain reaction [PCR], serology)
- Culture and PCR are appropriate for patients with up to four weeks of cough;
- The sensitivity of culture is highest during the first two weeks of illness.
- For patients with more than four weeks of cough, only serology is useful but the lack of a widely available, standardized test limits its use
Confirmed cases of pertussis are defined as?
1) patients with an acute cough illness of any duration and positive culture from nasopharyngeal secretions,
2) patients who meet the clinical case definition with laboratory confirmation by PCR from nasopharyngeal secretions,
3) patients who meet the clinical case definition and are epidemiologically linked to a case confirmed by culture or PCR
Are antibiotics always needed to Tx Pertussis?
Most adolescents and adults clear pertussis infection without antibiotic treatment within 3 - 4 weeks.
Antibiotic treatment later in the course of disease probably does not affect the course of symptoms, but may be useful to reduce the spread of the infection.
When are antibiotics recommended for Tx of Pertussis?
For patients with duration of symptoms ≤2 weeks
For patients with persistent symptoms for up to eight weeks, we suggest antibiotic treatment for individuals in the following categories:
- Healthcare workers
- Pregnant women &
- Individuals working with infants
Antibiotic treatment later in the course of disease (when the diagnosis is usually established) probably does not affect the course of symptoms, but may be useful to reduce the spread of the infection
Which antibiotics are used to Tx Pertussis?
- Azithromycin or
- Clarithromycin
These are better tolerated and have more convenient dosing than erythromycin.
For patients who cannot tolerate macrolide antibiotics, trimethoprim-sulfamethoxazole is an acceptable alternative
What vaccines are recommended for people against Pertussis?
We recommend booster vaccination with Tdap for adolescents and adults
