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Flashcards in Pertussis Deck (12):

Causative organism of pertussis

Bordetella pertussis


Spread of pertussis

Resp. droplet


Risk factors for pertussis

• Age < 6 month 
• Baby born to mother who became infected at ≥34 weeks gestation 
• No or incomplete immunisation 
• High-risk groups for Tx 
• School teachers or HCW 
• Close contacts 
• Household contacts


Natural Hx of pertussis

• Incubation period 6-20 days

• Prodromal catarrhal stage (1-7d):
• URTI Sx (coryza, mild cough, sneezing) with no or low-grade fever 

• Paroxysmal stage (lasts 4-6 weeks):
• characterised by paroxysms of cough, sometimes followed by inspiratory whoop 
• Attacks may be precipitated by yawning, sneezing, eating, physical exertion  
• May have post-tussive emesis 
• Infants may have post-tussive apnoea 

• Convalescent stage (lasts 1-2 weeks):
• occasional paroxysms of cough, but decreased frequency and severity 
• Non-infectious but cough may last up to 6/12 


When is pertussis most contagious? When is an index case contagious?

- Most contagious during prodromal, catarrhal stage
- An index case is considered infectious if <21 days cough or <5days effective abx treatment


What are some possible complications of pertussis? Who is at greatest risk?

Infants < 6mo greatest risk of complications:
• Pneumonia -> respiratory failure -> ?death
• Bronchiectasis
• Seizure: likely due to cerebral hypoxia secondary to severe paroxysms of cough 
• Apnoea/bradycardia 
• Encephalopathy
• Rib fracture 

*Bacteraemia doesn't occur


Ix for pertussis

Not needed (NPA swab for PCR if needed)


Clinical Dx criteria for pertussis

Cough lasting at least 2 weeks with at least one of the following symptoms: 
• Paroxysms of coughing 
• Inspiratory whooping 
• Post-tussive vomiting without other apparent cause 

• NB: Pertussis can also present as a non-specific persistent cough

• NB: Whoop often absent in infants 


Prevention of pertussis

Vax - 85% effective. Wanes after 6-10y.


Mx of pertussis

- Abx maybe
- Exclusion until 5 days Abx/coughing for > 21 days
- Vax 3 dose
- Notifiable
- Treat close contacts - abx, vax, exclusion


When to admit pertussis?

- <6mo
- Complications e.g. apnoea, cyanosis, pneumonia, encephalopathy


When would you consider using abx in pertussis?

○ Diagnosed in catarrhal or early paroxysmal phase (may reduce severity)
○ Cough for less than 14 days (may reduce spread; reduces school exclusion period)
○ Admitted to hospital/complications